AED Maintenance Checklist Template

• AED Location
  Address

• AED Serial No.

• AED Brand/Make (Manufacturer)

• AED Model (Device Name)

• Checked on

  Date

• Checked by

• For each failed item, please create an appropriate corrective action by selecting the Action icon.

AED

• AED is visible and unobstructed

  Pass

  Fail

  N/A

• AED sign/symbol is displayed

  Pass

  Fail

  N/A

• Check battery status/installation date

  Pass

  Fail

  N/A

• Check service indicator light

  Pass

  Fail

  N/A

• Visual service alarm is present

  Pass

  Fail

  N/A

• Audible service alarm is present

  Pass

  Fail

  N/A

• AED exterior has no damage or cracks

  Pass

  Fail

  N/A

Supplies

• Two sets of electrode pads in sealed package

  Pass

  Fail

  N/A

• Check expiration date on electrode pad packages

  Pass

  Fail

  N/A

• Pocket mask with one-way valve

  Pass

  Fail

  N/A

• Examination gloves

  Pass

  Fail

  N/A

• Safety razors

  Pass

  Fail

  N/A

• Absorbent gauze or hand towels

  Pass

  Fail

  N/A

• Additional Comments

• Signature

  Sign