UTAS AED Condition Audit V2

AED - Automatic External Defibrillator Audit

• Document No:

• AED Audit at: ( example of entry: AED + Building Name + Room No or Name )

• Client / Site: (example of entry: Campus or Site + Grid Reference )

• Asset No: ( or Barcode No )

• Conducted on:

  Date

• Audit undertaken by:

  Select Barry Russell Alan Mason Troy Finearty Roger Wallis Greg Chandler Andrew Southorn Other Person

  • Barry Russell
  • Alan Mason
  • Troy Finearty
  • Roger Wallis
  • Greg Chandler
  • Andrew Southorn
  • Other Person

• Enter name of auditor here:

Audit

• Is the AED unit located in its designated area? Identify serial number of unit below. TAP here to enter data.

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

  Yes

  No

  N/A

• Are the electrodes attached to the unit?

  Yes

  No

  N/A

• Are the batteries within the expiration date?

  Yes

  No

  N/A

• Are you re-installing new electrodes or batteries?

  Yes

  No

• 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?

  No

  Tested OK

• Enter reason not tested:

Additional Photos

• Add media

  Media

Signature

• Select the Name of person signing and then select "Sign"

  Select Barry Russell Alan Mason Troy Finearty Roger Wallis Greg Chandler Andrew Southorn Other Person

  • Barry Russell
  • Alan Mason
  • Troy Finearty
  • Roger Wallis
  • Greg Chandler
  • Andrew Southorn
  • Other Person

• If Other Person, then enter name of that person in the space below then select "Sign"

• Add signature

  Sign