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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> &gt; <a href="index.html" class="crumb_link">Disaster Alternate Care Facility Selection Tool</a> &gt; <a href="dacfrep.htm" class="crumb_link">Disaster Alternate Care Facilities: Selection and Operation</a> &gt; Tables 6-9</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Disaster Alternate Care Facility Selection Tool </span></td>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h3><a name="tab6" id="tab6"></a>Table 6. Equipment Considerations for Level III Comprehensive ACF Medical Cache (50 Bed Unit)</h3>
<table border="1" cellpadding="2" cellspacing="0" width="70%">
<tr align="center">
<th scope="col" width="40%">Equipment</th>
<th scope="col" width="10%">Infectious</th>
<th scope="col" width="10%">Non-Infectious</th>
<th scope="col" width="10%">Quarantine</th>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Beds/Cots (with extra) </td>
<td>52</td>
<td>52</td>
<td>52</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Chairs correlation with staffing level</td>
<td>12</td>
<td>12</td>
<td>4</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Desks correlation with staffing level</td>
<td>6</td>
<td>6</td>
<td>2</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Fax Machine</td>
<td>1</td>
<td>1</td>
<td>?</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Housekeeping Cart with supplies</td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Internet email Access</td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV Poles</td>
<td>50</td>
<td>50</td>
<td>0</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Linens (sheets/pillows/pillow cases/hand towels/ bath towels)</td>
<td>100</td>
<td>100</td>
<td>100</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Patient Commodes</td>
<td>4</td>
<td>4</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Pharmacy Carts</td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Privacy Dividers</td>
<td>25</td>
<td>25</td>
<td>25</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Refrigerators (food/meds)</td>
<td>3</td>
<td>3</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Stretchers</td>
<td>2</td>
<td>2</td>
<td>0</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Supply Carts</td>
<td>3</td>
<td>3</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Telephones</td>
<td>5</td>
<td>5</td>
<td>5</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Treatment Carts</td>
<td>2</td>
<td>2</td>
<td>0</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Washing Machine </td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Wheelchairs</td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
</table>
<p class="size2"><a href="dacfrepch4.htm#tab6">Return to Document</a></p>
<br />
<h3><a name="tab7" id="tab7"></a>Table 7. Patient Care-Related Consumables for Level III Comprehensive ACF Medical Cache (50 Bed Unit)</h3>
<table border="1" cellpadding="2" cellspacing="0" width="70%">
<tr align="center">
<th scope="col" width="20%">Item Description</th>
<th scope="col" width="20%"> Calculations of Quantities</th>
<th scope="col" width="10%">Total Item Count</th>
<th scope="col" width="10%">Unit of Issue</th>
<th scope="col" width="10%">Total UoIs Required</th>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Alcohol pads (multiple widespread use)</td>
<td>2-4 Boxes per 24 hours</td>
<td>14-28</td>
<td>Box</td>
<td>1 Box</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Catheters, intraosseous module blue (pediatric use)</td>
<td>May use 1/day max.</td>
<td>6-7/wk of 1 standard size</td>
<td>Each</td>
<td>7 Each</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Intermittent IV access device (lock)</td>
<td>50 pts initially (first day) then 10% </td>
<td>250/wk</td>
<td>50/Box</td>
<td>5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV catheters, 18g with protectocath guard</td>
<td>40% of pts req IVs</td>
<td>150/wk</td>
<td>50/Box</td>
<td>3 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV catheters, 20g with protectocath guard</td>
<td>40% of pts req IVs</td>
<td>150/wk</td>
<td>50/Box</td>
<td>3 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV catheters, 22g with protectocath guard</td>
<td>10% of pts req IVs</td>
<td>25/wk</td>
<td>50/Box</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV catheters, 24g with protectocath guard</td>
<td>10% of pts req</td>
<td>25/wk</td>
<td>50/Box</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV fluid bags, NS, 1000cc (required by 60% of patients)</td>
<td>(50% of pts(25)/day x 3L/pt)x</td>
<td>315 L/wk</td>
<td>12/Case</td>
<td>18 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV fluid bags, D5 1/2NS, 1000cc (required by 40% of patients)l </td>
<td>(50% of pts(25)/day x 3L/9t)x</td>
<td>210 L/wk</td>
<td>12/Case</td>
<td>18 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV start kits</td>
<td>Same # as intermittent access device</td>
<td>60</td>
<td>25/Box</td>
<td>2.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV tubing w/ Buretrol drip set for peds</td>
<td>10% peds/wk</td>
<td>25/wk</td>
<td>20/Case</td>
<td>1.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV tubing w/ standard macrodrip for adults</td>
<td>Same # as intermittent</td>
<td>250/wk</td>
<td>48/Case</td>
<td>5 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Needles, Butterfly, 23g</td>
<td>10% peds/wk</td>
<td>25/wk</td>
<td>50/Box</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Needles, Butterfly, 25g</td>
<td>10% ped/wk</td>
<td>25/wk</td>
<td>50/Box</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Needles, sterile 18g</td>
<td>1 box/day</td>
<td>7 boxes/wk</td>
<td>100/Box</td>
<td>7 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Needles, sterile 21g</td>
<td>1 box/day</td>
<td>7 boxes/wk</td>
<td>100/Box</td>
<td>7 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Needles, sterile 25g</td>
<td>1 box/day</td>
<td>7 boxes/wk</td>
<td>100/Box</td>
<td>7 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Saline for injection 10cc bottle</td>
<td>50 bottles/day</td>
<td>350 bottles/wk</td>
<td>24 /Box</td>
<td>14.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">ABD bandage pads, sterile</td>
<td>10% pts/day = 5 pads/day+35 pads/wk</td>
<td>7 boxes/wk</td>
<td>50/Box</td>
<td>7 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">BandAids</td>
<td>1 box/day</td>
<td>7 boxes/wk</td>
<td>50/Box</td>
<td>7 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Basins, bath</td>
<td>20 pts/day</td>
<td>140/wk</td>
<td>100/Case</td>
<td>1.5 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Bathing supply, prepackaged (e.g.Bath in a Bag (TM))</td>
<td>50 pts every day</td>
<td>350/wk</td>
<td>&nbsp;</td>
<td>350</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Bedpans - regular</td>
<td>40 pts/day initially then 10%</td>
<td>65/wk</td>
<td>50/Case</td>
<td>1.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Toilet Paper</td>
<td>25 rolls/day</td>
<td>175 rolls/wk</td>
<td>&nbsp;</td>
<td>175 Rolls</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Blankets</td>
<td>50 pts/day; changed daily</td>
<td>50/day or 350/wk</td>
<td>&nbsp;</td>
<td>350/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Carafes - 1 liter (for variety of uses)</td>
<td>30/day</td>
<td>210/wk</td>
<td>&nbsp;</td>
<td>210/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Cart, supply</td>
<td>3/unit (1 for IV's;1 for Pt</td>
<td>3/unit</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Chux protective pads (many uses)</td>
<td>3/pt q3hrs = 24 chux/pt/day x 50 pts + 1200/day</td>
<td>8400/wk</td>
<td>50/Box</td>
<td>168 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Cots (have extras available to replace broken equipment)</td>
<td>50/unit plus 2 extra</td>
<td>52/unit</td>
<td>&nbsp;</td>
<td>52/Unit</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Curtains, privacy (wheeled)</td>
<td>25 (every other bed)</td>
<td>25/unit</td>
<td>&nbsp;</td>
<td>25/Unit</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Diapers - adult</td>
<td>10/day</td>
<td>70/wk</td>
<td>72/Case</td>
<td>1 Case</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Diapers - infant</td>
<td>8/day/infant x 5 infants/day</td>
<td>280/wk</td>
<td>144/Case</td>
<td>3 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Diapers - pediatric</td>
<td>5/day/ped x 5 peds/day = 25/day</td>
<td>175/wk</td>
<td>144/Case</td>
<td>1.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Emesis basins</td>
<td>100/wk</td>
<td>100/wk</td>
<td>250/Case</td>
<td>0.5 Case</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Facial tissue, individual patient box</td>
<td>1 box/pt/day</td>
<td>350 boxes/wk</td>
<td>200 Boxes</td>
<td>1.75 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Feeding tubes, pediatric</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left"> - 5 French</td>
<td>10/wk</td>
<td>10/wk</td>
<td>10/Box</td>
<td>1 Box</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left"> -8 French</td>
<td>10/wk</td>
<td>10/wk</td>
<td>10/Box</td>
<td>1 Box</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Foley Catheters - 16F Kits (includes drainage bag)</td>
<td>&gt;50% of pts wk</td>
<td>100/wk</td>
<td>10/Case</td>
<td>10 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves non-sterile, small/medium/large (latex and non latex)</td>
<td>6 boxes/day</td>
<td>42 boxes/wk</td>
<td>100/Box</td>
<td>42 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Goggles / face shields, splash resistant, disposable</td>
<td>6 boxes/day</td>
<td>42 boxes/wk</td>
<td>100/Box</td>
<td>42 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gown, splash resistant, disposable</td>
<td>3/staff/shift = 36/day</td>
<td>252/wk</td>
<td>Box</td>
<td>42 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Mask, N95, for staff (particulate respirator)</td>
<td>36/day</td>
<td>252/wk</td>
<td>210/Case</td>
<td>1.2 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gown, patient</td>
<td>75/day</td>
<td>525/wk</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Mask, 3M 1800 for patient</td>
<td>150/day</td>
<td>1050/wk</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gauze pads, non-sterile, 4x4 size, </td>
<td>400/day</td>
<td>2800/wk</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Hand cleaner, waterless alcohol-based </td>
<td>1 per handwash station/day x </td>
<td>28/wk</td>
<td>25 Bottles/Case</td>
<td>1 Case</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Paper Towels</td>
<td>25 rolls/day</td>
<td>175 rolls/wk</td>
<td>&nbsp;</td>
<td>175 Rolls</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Lubricant, Water soluble</td>
<td>&nbsp;</td>
<td>1-2 boxes wk</td>
<td>25 Boxes</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Medicine cups, 30ml, plastic</td>
<td>2/pt/day = 100/day</td>
<td>700/wk</td>
<td>&nbsp;</td>
<td>700/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Morgue Kits</td>
<td>Tularemia: 15pt/day mortality</td>
<td>300/wk</td>
<td>&nbsp;</td>
<td>300/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Nasogastric tubes - 18F</td>
<td>&nbsp;</td>
<td>25/wk</td>
<td>50/Case</td>
<td>0.5 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">OB Kits</td>
<td>&nbsp;</td>
<td>1/wk</td>
<td>&nbsp;</td>
<td>1/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Pen lights</td>
<td>&nbsp;</td>
<td>12/unit</td>
<td>6/Box</td>
<td>2 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Povidone-iodine bottles, 12 oz</td>
<td>2/day</td>
<td>14/wk</td>
<td>48 Bottles</td>
<td>0.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Restraints, Extremity, soft - adult</td>
<td>&nbsp;</td>
<td>25/wk</td>
<td>48/Case</td>
<td>0.5 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Sanitary pads (OB pads)</td>
<td>2 women/wk; 10 pads/day</td>
<td>20 pads/wk</td>
<td>12 Pads</td>
<td>2 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Sharps disposal containers - 2 gallon</td>
<td>2-4/wk/unit</td>
<td>2-4/wk</td>
<td>20/Case</td>
<td>0.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Sheets, disposable, paper, for stretchers &amp; cots</td>
<td>100/day</td>
<td>700/wk</td>
<td>&nbsp;</td>
<td>700/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Syringes, 10cc, luer lock</td>
<td>4 boxes/wk (100 ct box)</td>
<td>400 wk</td>
<td>100/Box</td>
<td>4 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Syringes, 3cc, luer lock, w/ 21g 1.5" needle</td>
<td>200/day</td>
<td>1400/wk</td>
<td>100/Box</td>
<td>14 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Syringes, catheter tip 60cc</td>
<td>&nbsp;</td>
<td>25/wk</td>
<td>50/Box</td>
<td>0.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Syringes, Insulin</td>
<td>4/day</td>
<td>28/wk</td>
<td>100/Box</td>
<td>0.25 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Syringes, TB</td>
<td>2/day</td>
<td>14/day</td>
<td>100/Box</td>
<td>0.4 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Tape, silk - 1 inch</td>
<td>12/day</td>
<td>96/wk</td>
<td>12 Rolls/Box</td>
<td>8 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Tape, silk - 2 inch</td>
<td>6/day</td>
<td>42/wk</td>
<td>12 Bolls/Box</td>
<td>3.5 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Toilet tissue</td>
<td>25 rolls/day</td>
<td>175 rolls/wk</td>
<td>&nbsp;</td>
<td>175 Rolls</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Tongue depressors</td>
<td>&nbsp;</td>
<td>2 boxes/wk</td>
<td>500/Box</td>
<td>2 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Tubex [TM] pre-filled syringe holders</td>
<td>1 per staff member plus</td>
<td>12/sub-unit</td>
<td>50/Case</td>
<td>0.25 Cases</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Urinals</td>
<td>&nbsp;</td>
<td>50/wk</td>
<td>50/Case</td>
<td>1 Case</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Washcloths, disposable</td>
<td>&nbsp;</td>
<td>10/pt/day</td>
<td>3500/Wk</td>
<td>3500/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Water, bottled 1 liter (for mixing ORT)</td>
<td>1/patient</td>
<td>200/wk</td>
<td>&nbsp;</td>
<td>200/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Water container, 1 gallon potable</td>
<td>&nbsp;</td>
<td>125/wk</td>
<td>&nbsp;</td>
<td>125/Week</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Drinking cups</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left" colspan="5"><strong>Diagnostic Supplies</strong></td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Glucometer</td>
<td>&nbsp;</td>
<td>1 per unit</td>
<td>Each</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Glucometer test strips </td>
<td>&nbsp;</td>
<td>2 bottles/wk</td>
<td>50 Strips/Viles</td>
<td>2 Viles</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Probe covers for thermometers</td>
<td>4 boxes/day</td>
<td>28 boxes/wk</td>
<td>20/Box</td>
<td>28 Boxes</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Protocol unit (or other brand), 02 sat monitor, thermometer, BP, HR</td>
<td>&nbsp;</td>
<td>4 per unit</td>
<td>Each</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Protocol unit, disposable plastic BP covers</td>
<td>200/day</td>
<td>1400/wk</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Single Use Shielded Lancets</td>
<td>25/day</td>
<td>175/wk</td>
<td>&nbsp;</td>
<td>1 Box</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Stethoscopes</td>
<td>&nbsp;</td>
<td>12/unit</td>
<td>Each</td>
<td>12</td>
</tr>
</table>
<p class="size2"><a href="dacfrepch4.htm#tab6">Return to Document</a></p>
<br />
<h3><a name="tab8" id="tab8"></a>Table 8. Administrative Consumables for Level III Comprehensive ACF Medical Cache (50 Bed Unit)</h3>
<table border="1" cellpadding="5" cellspacing="0" width="50%">
<tr align="center">
<th scope="col">Item Description</th>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Pens - Black ballpoint</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Pens - Red ballpoint</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Stapler</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Staples</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Tape</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Tape dispenser</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Paper clips</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Paper punch (3- or 5-hole based on chart holders)</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Chartholders/Clip boards</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">File Folders - letter size, variety of colors</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Namebands for Identification and Allergies</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Batteries - 9V</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Batteries - AA</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Batteries - C</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Batteries - D</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Clipboards</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Chalk or white boards</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Dry-erase markers</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Chalk</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Trashcans and liners</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Flashlights</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Plastic bags for patient valuables</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Floor lamps</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Table lamps</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Lightbulbs </td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Plain paper</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Filing cabinets - rolling</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Black permanent markers</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Yellow highlighter markers</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Time cards</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Generic sign-in, sign-out forms</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Pre-printed admission Order forms</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Blank physician order forms</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Multidisciplinary progress notes</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Nursing flowsheets</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Admission history &amp; physical forms (include area for Nrsg Hx)</td>
</tr>
<tr valign="middle" align="left">
<td scope="row" align="left">Death certificates/Death packets</td>
</tr>
</table>
<br />
<h3><a name="tab9" id="tab9"></a>Table 9. Oxygen and Respiratory-Related Equipment Considerations for Level III Comprehensive Medical Cache (50 Bed Unit)</h3>
<table border="1" cellpadding="2" cellspacing="0" width="60%">
<tr align="center">
<th scope="col" width="50%" align="left">Item Description</th>
<th scope="col" width="20%">Quantity</th>
</tr>
<tr>
<td scope="row">Bag-Valve-Mask w/adult and peds masks - adult 1600 ml reservoir</td>
<td align="center">1</td>
</tr>
<tr>
<td scope="row">Cascade gauge for oxygen cylinders</td>
<td align="center">14</td>
</tr>
<tr>
<td scope="row">Catheters, suction</td>
<td align="center">20</td>
</tr>
<tr>
<td scope="row">Connector, 5 in 1</td>
<td align="center">8</td>
</tr>
<tr>
<td scope="row">Cylinder holders for E Cylinder oxygen tanks</td>
<td align="center">4</td>
</tr>
<tr>
<td scope="row">Mask, oxygen - nonrebreather, pediatric</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Mask, oxygen - nonrebreather, adult</td>
<td align="center">20</td>
</tr>
<tr>
<td scope="row">Nasal cannula, adult</td>
<td align="center">40</td>
</tr>
<tr>
<td scope="row">Nasal cannula, pediatric</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Regulator, Oxygen (Flow meter)</td>
<td align="center">14</td>
</tr>
<tr>
<td scope="row">Suction unit - Collection System</td>
<td align="center">2</td>
</tr>
<tr>
<td scope="row">Suction unit - Portable</td>
<td align="center">1</td>
</tr>
<tr>
<td scope="row">Suction unit Battery</td>
<td align="center">1</td>
</tr>
<tr>
<td scope="row">Tank, Oxygen "E" cylinder (700 L O2)</td>
<td align="center">4</td>
</tr>
<tr>
<td scope="row">Tank, Oxygen "H" cylinder (7000 L O2)</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Tubing, oxygen - with connector</td>
<td align="center">40</td>
</tr>
<tr>
<td scope="row">Tubing - suction, connector</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Tubing, suction, 10F</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Wrench, Oxygen tank</td>
<td align="center">2</td>
</tr>
<tr>
<td scope="row">Yankaur Suction Catheter</td>
<td align="center">10</td>
</tr>
<tr>
<td scope="row">Intubation equipment with oral airways/ET tubes; adult &amp; peds</td>
<td align="center">1 set</td>
</tr>
<tr>
<td scope="row">Ventilators</td>
<td align="center">1</td>
</tr>
</table>
<p class="size2"><a href="dacfrepch4.htm#tab6">Return to Document</a></p>
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<p> The information on this page is archived and provided for reference purposes only.</p></div>
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