ROADBRIDGE AED MONTHLY CHECK

• AUDIT TITLE:

• DOCUMENT NUMBER:

• SITE:

• CONDUCTED ON:

  Date
• LOCATION:
  Address

• AUDIT TEAM:

• PREPARED BY:

• Is the AED unit located in its designated area? Identify serial number of unit below.

  Yes

  No

  N/A

• Is the AED unit clean, undamaged and if applicable in its carry case or cabinet?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are all electrode packages sealed and within the expiration date?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the batteries within the expiration date?

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

Additional Photos

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Signature

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