Maintenance Test Checklist
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Page 1
ZOLL E Series Maintenance Test Checklist 1.0 Physical Inspection Pass Fail
Result of Check: o No action required
1.1
o Minor problems corrected
1.2
o Disposable supplies replaced
1.3
o Major problems identified (unit out of service)
1.4 1.5 1.6
Additional Remarks
1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15
o o o o o o o o o o o o o o o
o o o o o o o o o o o o o o o
N/A
o o o o o o o o o o o o o o o
Location
Tester
Signature
2.0 Front Panel Button Test Pass Fail 2.1 2.2 2.3s 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.13a 2.13b 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25
9650-1450-01 Rev. A
Serial No.
o o o o o o o o o o o o o o o o o o o o o o o o o o o
o o o o o o o o o o o o o o o o o o o o o o o o o o o
N/A
o o o o o o o o o o o o o o o o o o o o o o o o o o o
2.26
o
o
o
Pass Fail
N/A
7.0 Heart Rate Display Test Pass Fail
3.0 Leads Test 3.1 3.2 3.3 3.4
o o o o
o o o o
o o o o
4.0 Power Supply Test Pass Fail 4.1 4.3 4.4 4.5 4.6 4.8 4.10
o o o o o o o
o o o o o o o
Pass Fail
o
o
7.1
o o o o o o o
N/A
o
Pass Fail 6.1 6.2 6.3 6.4 6.5 6.6 6.7
o o o o o o o
o o o o o o o
N/A
o o o o o o o
N/A
o
o
8.0 Pulse Calibration Test Pass Fail 8.2
o
Pass Fail 11.1
Pass Fail 9.3
o
o
11.4
o
11.5 11.6
N/A
o
10.0 Heart Rate Alarm Test Pass Fail 10.1 10.2 10.3 10.4 10.5 10.6 10.7
10.9 10.10 10.11 10.12 10.13 10.14
o o o o o o o o o o o o o o
o o o o o o o o o o o o o o
11.3
N/A
o
9.0 Notch Filter Test
10.8
6.0 Paddles Test
o
11.0 Defibrillator Self Test
11.2
N/A
5.0 Leakage Current Test 5.1
Date
N/A
o o o o o o o o o o o o o o
11.7
o o o o o o o
o o o o o o o
N/A
o o o o o o o
12.0 Synchronized Cardioversion Test Pass Fail 12.2 12.4
o o
N/A
o o
o o
Pass Fail
N/A
13.0 Shock Test 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10
o o o o o o o o o
o o o o o o o o o
o o o o o o o o o
A-3
ZOLL E Series Maintenance Test Checklist 14.0 Summary Report Test Pass Fail 14.1 14.2 14.3 14.4
o o o o
o o o o
N/A
o o o o
15.0 Advisory Message Test Pass Fail 15.2 15.3 15.4
o o o
o o o
N/A
o o o
16.0 Pacer Test
16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22
o o o o o o o o o o o o o o o o o o o o o o
o o o o o o o o o o o o o o o o o o o o o o
N/A
o o o o o o o o o o o o o o o o o o o o o o
Pass Fail 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10
o o o o o o o o o o
o o o o o o o o o o
Tester
Signature
o o o o o o o o o o
Pass Fail 18.2 18.4 18.6 18.7
o o o o
o o o o
N/A
o o o o
19.0 Barometric Pressure Calibrationt Pass Fail 19.7
o
o
20.8 20.11
o o o
o o o
Pass Fail 21.2 21.3 21.5
o o o
o o o
N/A
o o o
22.0 NIBP Volume Leak Test with Bio-Tek NIBP Analyzer Pass Fail 22.4 22.5 22.6
o o o
o o o
N/A
o o o
23.0 NIBP Volume Leak Test with Fluke Biomedical Cufflink NIBP Analyzer Pass Fail 23.4 23.5 23.6
o o o
o o o
N/A
o o o
24.0 NIBP Transducer Calibration Pass Fail N/A
o
20.0 CO2 Accuracy Test 20.7
Date
21.0 NIBP Monitor Test
N/A
18.0 EtCO2 Monitor Test
Pass Fail
9650-1450-01 Rev. A
Location
17.0 SpO2 Monitor Test
Pass Fail 16.1
Serial No.
N/A
o o o
24.4 24.6 24.8 24.9 24.10
o o o o o
o o o o o
N/A
o o o o o
A-4