• Titolo

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • L'unità DAE si trova nella sua posizione designata? Identificare il numero di serie sotto l'unità.<br>Is the AED unit located in its designated area? Identify serial number of unit below.

  • L'unità DAE è pulita, intatta e se applicabile conservata nella Custodia e/o Armadio?<br>Is the AED unit clean, undamaged and if applicable in its carry case or cabinet?

  • Is the AED rescue kit present and either stored on the carry case or cabinet or attached to the AED unit?

  • Does the AED rescue kit include: gloves, prep razor, scissors, towel, moist towelettes, CPR mask?

  • Tutte le confezioni degli elettrodi sono sigillati ed entro la data di scadenza?<br>Are all electrode packages sealed and within the expiration date?

  • Does alarm on AED cabinet in working order? Note: Batteries should be replaced annually.

  • Is the Status Indicator showing a green check mark or the word 'OK'?

  • Are the electrodes attached to the unit?

  • Are the batteries within the expiration date?

  • State reinstallando nuovi elettrodi o nuove batterie? Are you re-installing new electrodes or batteries?

  • If re-installing new electrodes or batteries, did you turn unit on to allow it to complete a full self-test to confirm a visible green check mark?

  • È presente il Manuale d'uso in doppia lingua Italiano e Inglese?

  • È presente la Check List di verifica settimanale?

  • La Check List è correttamente compilata?

Foto Addizionali / Additional Photos:

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Firma / Signature:

  • Firmare qui

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