AED Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Emergency Equipment

• Location

  Main Entrance

  Building C

  Dialysis

  Diabetic Center Wayaca

• Is the cabinet secure and operating? / <br>E Cabinet ta segura y ta den bon condishon?

  Yes

  No

  N/A

• When you open the cabinet, does the alarm sound? / <br>E alarma ta sona ora bo habri e cabinet?

  Yes

  No

  N/A

• Have you checked that there are no stored materials obstructing view or access to the AED?/ <br>Bo a check cu no tin ningun objeto ta blokea of impidi acsesso na e AED? <br> <br>

  Yes

  No

  N/A

• Is the green light showing ( the green light will be flashing) on the defibrillator?/<br>Bo a observa e lus berde di e AED ta sende y paga? <br>

  Yes

  No

  N/A

• Is the defibrillator silent and no noise being emitted? / <br>E AED no ta hasi ningun sonido (beep)?

  Yes

  No

  N/A

• A pair of exam gloves? / Paar di guante

  Yes

  No

  N/A

• A razor? / Aparato pa feita?

  Yes

  No

  N/A

• A dressing pad? / Gaza

  Yes

  No

  N/A

• A bottle of Alcohol hand gel? / Boter di Gel Desinfecta man?

  Yes

  No

  N/A

• A clinical waste bag? / Sako di sushi?

  Yes

  No

  N/A

• A Rescue Breath Face Mask? / Mask pa duna rosea?

  Yes

  No

  N/A

• Scissors? / Sker

  Yes

  No

  N/A

• I verify that this information is accurate and truthful and my signature is represented by my typed name below: