Supply Requisition Form – Central Orleans Volunteer Ambulance

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0.9 Sodium Chloride Injection USP 1000mL

10% Dextrose Injection USP 500mL

5% Dextrose Injection USP (PAB®) (50 Fill in 100mL)

5% Dextrose Injection USP 250mL

8.4% Sodium Bicarbonate Injection USP Adult LifeShield™ Abboject™ Glass Syringe 50mL

Adenosine Injection USP 2mL 3mg/mL

AIRCARE® Endotracheal Tubes (Oral / Nasal) with Preloaded Stylet Cuffed 5.0mm

AIRCARE® Endotracheal Tubes (Oral / Nasal) with Preloaded Stylet Cuffed 7mm

AIRCARE® Endotracheal Tubes (Oral / Nasal) with Preloaded Stylet Cuffed 8.0mm

AIRCARE® Endotracheal Tubes (Oral / Nasal) with Preloaded Stylet Uncuffed 4.5mm

Albuterol Sulfate Inhalation Solution 0.083% 3mL 2.5mg/3mL

Amiodarone Hydrochloride Injection Single Dose Vial 3mL 50mg/mL

AMSafe® Piggyback I.V. Sets (Vented/Non-Vented, Back Check Valve, Roller Clamp, Pre-Pierced Y site, AMSafe Needle-Free Y-Site, 10 Drops, 83", 17mL Priming Vol.)

AMSure® Suction Catheter (Coiled Pack) 12Fr, 23"

AMSure® Suction Catheter (Coiled Pack) 14Fr, 23"

AMSure® Suction Catheter (Coiled Pack) 16Fr, 23"

AMSure® Suction Yankauer (Flexiible), Vented

AMSure® Suction Yankauer Kit (Rigid), Non-Vented

Argyle™ Suction Tubing 1/4" x 10' (6 mm x 3.1 m)

Argyle™ Suction Tubing 3/16" x 6' (5mm x 1.8m)

ARS® for Needle Decompression 14G x 3.25"

Atropine Sulfate Injection USP LifeShield® Abboject® Pre-filled Syringe 10mL 0.1mg/mL

Burn Sheet 60" x 90"

Calcium Chloride Injection USP 10% LifeShield Abboject Pre-filled Syringe 10mL 10%

CaviWipes Flat Pack

Citrus II Solid Air Freshener 8 oz

Co-Flex® Med Latex Flexible Cohesive Bandage Colorpack 3" x 5yds

COBALT® Nitrile Powder-Free Examination Gloves Large

COBALT® Nitrile Powder-Free Examination Gloves Medium

COBALT® Nitrile Powder-Free Examination Gloves Small

COBALT® Nitrile Powder-Free Examination Gloves X-Large

CONTOUR® Blood Glucose Test Strips

Diltiazem Hydrochloride Injection Single Dose Vial 5mL 5mg/mL

Diphenhydramine Hydrochloride Injection USP Carpuject Sterile Cartridge Unit 50mg/mL

Dopamine Hydrochloride and 5% Dextrose Injection USP 500mL 800mcg/mL

Draw Tight Seal Numbered Red

Eclipse™ Safety Syringe and Needles 22G x 1-1/2" 5cc

EMS Primary I.V. Sets (Pre-Pierced Y-Site, AMSafe® Needle-Free Y-Site, 10 Drops/mL, 83", 16mL Priming Vol.)

End-Tidal C02 (EtCO2) FilterLine Sets Includes airway adapter. FilterLine (79") for short-term intubated patients, 24 hours typical. Adult/Pediatric

End-Tidal C02 (EtCO2) Smart CapnoLine Sets Smart CapnoLine® Plus with O2 Delivery for patients above 44 lbs, O2 delivery and CO2 sampling via mouth or nose, 12 hours equals typical length of use). Adult/Intermediate

Epinephrine 1:10000 10mL 0.1mg/mL

EtCO2 Mainstream Monitoring Airway Adapters Single Patient use Pediatric/Adult

Flow-Safe II EZ® Disposable CPAP System with Integrated Nebulizer (Large Adult Deluxe Mask with Ports and EZflow Max Nebulizer)

Flow-Safe® Disposable CPAP System with large adult cushion mask, blue headstrap

Flow-Safe® Disposable CPAP System with small adult cushion mask, blue headstrap

Flow-Safe® II Disposable CPAP System with Deluxe Mask (Large adult deluxe mask with straight swivel port, head harness)

Flow-Safe® II Disposable CPAP System with Deluxe Mask (Small adult deluxe mask with straight swivel port, head harness)

Gallant™ Disposable Prep Razors

GreenLine® D™ Disposable Fiber Optic Laryngoscope Blades Mac Child, #2

GreenLine® D™ Disposable Fiber Optic Laryngoscope Blades Miller Child, #2

GreenLine® D™ Disposable Fiber Optic Laryngoscope Blades Miller Large Adult, #4

GreenLine® D™ Disposable Fiber Optic Laryngoscope Blades Miller Medium Adult, #3

Hand Held Nebulizer with 7 ft. oxygen tubing, T-Piece and Mouthpiece

Hi-D Big Stick Suction Tip

InstaKool Instant Cold Compress 6" x 8.75"

Intraosseous Needle Disposable 15G

Intraosseous Needle Disposable 18G

Ipratropium Bromide Albuterol Sulfate Inhalation Solution Unit Dose Vials 0.5/3mg

IV Solutions 0.9% Sodium Chloride Injection 1000mL

IV Solutions Ringers Lactate 1000mL

Kendall™ 530 Series Foam Electrodes 30-Pack 530 series

KING LT-D™ Disposable Supraglottic Airway Green #2 (Patient Criteria 35-45 inches)

KING LT-D™ Disposable Supraglottic Airway Orange #2.5 (Patient Criteria 41-51 inches)

KING LT-D™ Disposable Supraglottic Airway Purple #5 (Patient Criteria Greater than 6 feet)

KING LT-D™ Disposable Supraglottic Airway Red #4 (Patient Criteria 5-6 feet)

KING LT-D™ Disposable Supraglottic Airway Yellow #3 (Patient Criteria 4-5 feet)

Little Junior™ Manikin (Four Pack, Light Skin)

MAD Nasal™ Drug Delivery Device without Syringe

Magellan™ Safety Needle and Syringe Combination 3cc 23G x 1

Max® Foam Ear Plugs Corded

Meconium Aspirator

MegaMover® Portable Transport Unit

Methylprednisolone Tablets 4mg

Metoprolol Tartrate Injection USP Single Dose Vial 5mL 1mg/mL

MooreBrand® ABD Pads 5" x 9"

MooreBrand® Alcohol Prep Pads Sterile Sterile

MooreBrand® Conforming Bandage Sterile 2" x 4.1 yds

MooreBrand® Conforming Bandage Sterile 3" x 4.1yds

MooreBrand® Conforming Bandage Sterile 4" x 4.1 yds.

MooreBrand® Disposable Cardboard Splint 18"

MooreBrand® Disposable Cardboard Splint 24"

MooreBrand® Disposable Cardboard Splint 36"

MooreBrand® IV Start Kit with Tegaderm Dressing

MooreBrand® Padded Board Splint (15")

MooreBrand® Sterile Gauze Pads Sterile 2" x 2" 12-ply

MooreBrand® Sterile Gauze Pads Sterile 4" x 4" 12-ply

MooreBrand® Triangular Bandage Unisize

MooreBrand® TRUE METRIX® PRO Professional Monitoring Blood Glucose System (Meter)

MooreBrand® TRUE METRIX® PRO Professional Monitoring Blood Glucose System (Test Strips)

Multi-Grip Head Immobilizer Adult

Multi-Purpose Sharps Containers with Sliding Lid Counter Unit with Slide Lid Red with Clear Lid 2 Gallon

Multi-Use One-Piece Sharps Collector Red 6.9qt

Naloxone Hydrochloride Injection, USP Carpuject™ Luer Lock Glass Syringe without Needle 1mL 0.4mg/mL

Naloxone Hydrochloride Injection, USP Fliptop Single-Dose Vial 1mL 0.4mg/mL

Nasal Cannula With Star Lumen Tubing Adult

Nitrostat® Bottle 0.4mg

Nonrebreathing Oxygen Mask with Safety Vent Adult

Ondansetron Injection USP Single Dose Vial 2mL 2mg/mL

PosiFlush™ Prefilled Syringes (10mL Normal Saline Syringe in 10mL Syringe)

Prednisone Tablets 20mg

ProtectIV® Plus Safety IV Catheters (Straight Hub) Blue 22G x 1"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Gray 16G x 1 1/4"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Green 18G x 1 1/4"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Orange 14G x 1 1/4"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Pink 20G x 1 1/4"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Pink 20G x 1"

ProtectIV® Plus Safety IV Catheters (Straight Hub) Yellow 24G x 3/4"

Purell® Bag-In-Box Instant Hand Sanitizer Refill 800mL

PURELL® Traditional Bag-in-Box Dispenser White 800mL

QuikClot Combat Gauze® LE

QuikClot Combat Gauze® 3" x 4 yds

QuikClot® EMS Rolled Gauze™ 3" x 48"

Rusch® QuickTrach® Cricothyrotomy Kit Adult 4.0mm (77 lbs. and Higher)

Rusch® QuickTrach® Cricothyrotomy Kit Pediatric 2.0mm (22 lbs. to 77 lbs.)

Safety Clear® Endotracheal Tube Uncuffed 2.5mm

Saline Flush Syringe 10mL

SaniZide Plus® Surface Disinfectant Spray 32oz

SharpSafety™ Safety In Room Sharps Disposal System 5 Quart In Room Sharps Containers with Counter Balanced Lid Transparent Red 12.5"H x 5.5"D x 10.75"W

Slick Stylet® Device (For tube sizes: 2.0-3.5mm, 31cm Length) 6Fr

Sodium Chloride 0.9% USP 500mL

Sodium Chloride Injection USP 0.9% 100mL

Sodium Chloride Injection USP Excel Bag 1000mL .9%

Solu-Medrol® Act-O-Vial Single-Use Vial 2mL 125mg

Standard Extension Sets ***SEE AMSINO CROSS REFERENCE SHEET ABOVE*** -- (Removable AMSafe® Needle-Free Connector, Pinch Clamp, 8" Length, 1.76mL Priming Vol.)

Sterile Water for Irrigation USP 500mL

Stifneck® Select™ Collar Blue

Stifneck® Select™ Collar Pediatric

Suction Canister 1200cc

Suction Canister System II 1200cc

Tactical Surgical Cricothyroidotomy Kit (Tactical CricKit)

Thomas Tube Holder Adult

Thomas Tube Holder Pediatric

Transcend™ Glucose Gel Strawberry 15gm

Triangular Bandage

TUBERSOL® Tuberculin Purified Protein Derivative (PPD) (Mantoux) 50 Test Vial 5mL

Urgent Assist Convenience Bags

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