2024 AEMS Pediatric Requests

Page 1

Arizona City Fire District

Person's Name Completing this Form

Shirley Sutherland

Organization Name

Arizona City Fire District

Complete Mailing Address

Arizona City Fire District Attn: Shirley Sutherland P.O. Box 6 Arizona City, AZ 85123

Email: shirley.sutherland@azcityfire.com

Phone 5204665542

Detail PEDIATRIC Equipment/Medical Supplies to be Purchased and Its Estimated Cost 2024 Updated PALS Dose By Growth Pediatric Advanced Life Support Em ergency Length-Based Tape with Broselow Compatible Color Zones Desig ned for Paramedics, Nurses & EMS Providers $29 per unit x 32 units = $92 8.00 plus tax 6.7% = $990.18

*

Indicate Amount of Funding Requested. Limit is $1,000 $ 990.18

Name of Authorized Organization Contact Signing this Form

Shirley Sutherland

Date 2024-04-17

Regional Fire & Rescue Dept.

Person's Name Completing this Form

John Bayles

Organization Name

Regional Fire & Rescue Dept.

Complete Mailing Address

7951 W. McCartney Rd Casa Grande, AZ 85194

Emailj

ohn.bayles@regionalfire.org

Phone

520-723-4680 x 107

Detail PEDIATRIC Equipment/Medical Supplies to be Purchased and Its Estimated Cost

We would like to purchase the following items for our ped-ready kits within our response boxes. G3+ quick roll intubation Kits: $70.00 each total of $14 0.00 G3+ Circulatory Kit: $55.00 Each total of $110.00 G3+ Medicine Cell: $159.00 each total of $636.00 For a grand total of $886.00. These items wil l be carried to place pediatric supplies in their own containers to separate fr om adult supplies.

Indicate Amount of Funding Requested. Limit is $1,000 $ 886.00

Name of Authorized Organization Contact Signing this Form

John Bayles

Date 2024-04-30

Superior Fire Dept

Person's Name Completing this Form

Bonnie Lusk

Organization Name

Superior Fire Dept

Complete Mailing Address

PO Box 218 Superior, Arizona 85173

Email

bmariscal@superioraz.gov

Phone 6023619610

Detail PEDIATRIC Equipment/Medical Supplies to be Purc hased and Its Estimated Cost

Emergency Child Restraint, Biothane ea. 959. 00

Indicate Amount of Funding Requested. Limit is $1,000 $ 959.00

Name of Authorized Organization Contact Signing this For m

Bonnie Lusk

Date

2024-04-30

Hellsgate Fire Dept

Person's Name Completing this Form

Morey Morris

Organization Name

Hellsgate Fire Dept

Complete Mailing Address

80 S. Walters Lane Star Valley, AZ 85541

Emailmmorris@hellsgatefire.org

*Phone

602-680-8514

Detail PEDIATRIC Equipment/Medical Supplies to be Purchased and Its Estimated Cost

LA840CC- pediatric ALS Attack Kit; 2 @ $344.99=$689.98 2521-87060-i-G el O2 Resus EMS Storage Bag,$186.99 2114-08201- i-Gel Neonate size 1 =23.99 2114.08215- i-Gel Infant size 1.5=23.99 2114-08202-i-Gel Small pe ds 2 =23.99 2114-08225-i-Gel Large Peds 2.5=23.99 803-2248-50BG- Red Dot Peds EKG pads=33.49 TOTAL=$1006.42 This quote comes from Boun dtree; amounts may vary; does not include shipping and sales tax, of which Hellsgate will pay the difference due to amount over $1000.00

Indicate Amount of Funding Requested. Limit is $1,000 $ 1,000.00

Name of Authorized Organization Contact Signing this Form

Morey Moris

*Date 2024-05-08

Tonto Basin Fire District

Person's Name Completing this Form

James A. Stoltenberg

Organization Name

Tonto Basin Fire District

Complete Mailing Address 46189 N AZ HWY188 Tonto Basin, AZ 85553

Mailing Address: PO Box 48 Tonto Basin, AZ 85553

Email jstoltenberg@tontobasinfire.org

Phone 9282380197

Detail PEDIATRIC Equipment/Medical Supplies to be Purchased

and Its Estimated Cost

We would like to purchase a complete Broselow kit for our ambulance. The kit contains the following items: twenty-eight size-specific procedural modul es in seven pouches, flying carpet, Broselow™ pediatric emergency tape, a nd all other required equipment. All contained in a heavy-duty ALS equipm ent organizer The broselow pediatric emergency system is approved for the PALS education program For children 3 to 36 kg We understand that this is above the limit and may not be approved. Currently we are sitting good with other pediatric supplies, and this is truly a need to assist our paramedics.

Indicate Amount of Funding Requested. Limit is $1,000 $ 2,743.00

Name of Authorized Organization Contact Signing this Form

James Stoltenberg

*Date 2024-05-08

Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.
2024 AEMS Pediatric Requests by Arizona Emergency Medical Systems (AEMS) - Issuu