ZOLL M Series Defibrillator Rev R - Manual (Page 153)

(Sheet 1 of 2)
ZOLL M Series
Maintenance Test Checklist
Serial No. Location
Tester Signature Date
Use this checklist to
record the results of the
M Series maintenance
tests, and keep it for
your records. 1.0 Physical Inspection 2.0 Front Panel Button
Test 3.0 Leads Test.
4.0 Power Supply Test
5.0 Leakage Current
Test
6.0 Paddles Test
7.0 Heart Rate Display
Test
8.0 Calibrating Pulses
Test
9.0 Notch Filter Test
10.0 Heart Rate Alarm
Test
11.0 Defibrillator
Self Test
12.0 Synchronized
Cardioversion Test
Result of Check:
o No action required
o Minor problems corrected
o Disposable supplies
replaced
o Major problems identified
(unit out of service)
Additional Remarks
Pass Fail N/A
1.1 o o o
1.2 o o o
1.3 o o o
1.4 o o o
1.5 o o o
1.6 o o o
1.7 o o o
1.8 o o o
1.9 o o o
1.10 o o o
1.11 o o o
1.12 o o o
1.13 o o o
1.14 o o o
1.15 o o o
Pass Fail N/A
2.1 o o o
2.2 o o o
2.3s o o o
2.4 o o o
2.5 o o o
2.6 o o o
2.7 o o o
2.8 o o o
2.9 o o o
2.10 o o o
2.11 o o o
2.12 o o o
2.13 o o o
2.14 o o o
2.15 o o o
2.16 o o o
2.17 o o o
2.18 o o o
2.19 o o o
2.20 o o o
2.21 o o o
2.22 o o o
2.23 o o o
2.24 o o o
Pass Fail N/A
3.1 o o o
3.2 o o o
3.3 o o o
3.4 o o o
Pass Fail N/A
4.1 o o o
4.3 o o o
4.4 o o o
4.5 o o o
4.6 o o o
4.8 o o o
4.9 o o o
4.10 o o o
Pass Fail N/A
5.1 o o o
Pass Fail N/A
6.1 o o o
6.2 o o o
6.3 o o o
6.4 o o o
6.5 o o o
6.6 o o o
6.7 o o o
6.8 o o o
Pass Fail N/A
7.1 o o o
Pass Fail N/A
8.2 o o o
Pass Fail N/A
9.3 o o o
Pass Fail N/A
10.1 o o o
10.2 o o o
10.3 o o o
10.4 o o o
10.5 o o o
10.6 o o o
10.7 o o o
10.8 o o o
10.9 o o o
10.10 o o o
10.11 o o o
10.12 o o o
10.13 o o o
10.14 o o o
Pass Fail N/A
11.1 o o o
11.2 o o o
11.3 o o o
11.4 o o o
11.5 o o o
11.6 o o o
11.7 o o o
Pass Fail N/A
12.2 o o o
12.3 o o o