Cayuga-Onondaga BOCES - District Office

• Location of AED
  Address
• AED Type: CARDIAC SCIENCE POWERHEART G5
  Address
• Model Number : G5S-80P1
  Address
• Cayuga - Onondaga BOCES Tag # CAY400734
  Address

• AED Serial No.:D00000258150

• Checked on

  Date

• Checked by

• Manufacturer Date: OCTOBER 4, 2022

• Is the AED secure in its container?

  Yes

  No

  N/A

• Check AED is on standby mode - green flashing light

• If AED is not on standby mode, verify AED operation

Verify AED Operation

• Open AED lid / Turn on AED

• Voice Prompts

• Wait for status indicator to change from RED to GREEN after five seconds

• Close AED lid / Turn off AED

• Wait for status indicator to change from RED to GREEN after five seconds

• Are the electrode pads in the AED container?

  Yes

  No

  N/A

• Check expiration date of electrode pads: FEBRUARY 28, 2025

• Electrode Pads Expiration Date:

  Date

• Is there an extra set of electrode pads?

  Yes

  No

  N/A

• Electrode Pads Expiration Date: DECEMEBER 28, 2024. (ADULT)

  Date

• Is there an extra set of electrode pads

  Yes

  No

  N/A

• Electrode Pads Expiration Date:DECEMBER 28, 2024 (CHILID/INFANT)

  Date

• Check expiration date of AED battery

• The AED battery is expired if 4 years have passed since its installation.

• AED Battery Installation Date: SEPTEMBER 8, 2022

  Date

• Battery Status Indicator (remaining life/charge)

Check PPE/Ready Kit

• Gauze Pads/ Absorbent Towel

• Scissors

• Razor

• Gloves

• Resuscitation Mask

• Test AED container tamper alarm

• Signature

  Sign