Defibrillator Maintenance Record (Weekly)

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location of defibrillator
  Address

Defibrillator

• Your defibrillator should self-test regularly. Check for any visible or audible warnings on the device that something is wrong.

  Pass

  Fail

  N/A

• Your defibrillator should be in standby mode.

  Pass

  Fail

  N/A

• Check that your device is clean and there is no damage

  Pass

  Fail

  N/A

• Check the battery indicator

  Pass

  Fail

  N/A

• Ensure the pads and batteries are present and correct and not expired

  Pass

  Fail

  N/A

• Check any accessories are present and in date; such as gloves or AED Prep Kits

  Pass

  Fail

  N/A

Storage and Access

• Check for damage to cabinets, brackets or other storage unites

  Yes

  No

  N/A

• Check that the AED can be easily accessed in an emergency and that the keys or access codes are working as intended if present

  Yes

  No

  N/A

• Check signage is up to date, clearly visible and defibrillators can be easily located and identified

  Yes

  No

  N/A

Expiry Dates

• Expiry dates of pads

• Expiry dates of batteries

Sign off of checks

• Name and Signature of person completing check

  Sign