LIFEPAK® 12 Defibrillator/Monitor
OPERATOR’S CHECKLIST
This is a recommended checklist to inspect and test this defibrillator. Inspection and testing of this defibrillator on a
daily basis is recommended. This form may be reproduced.
Unit Serial No.: ____________________________
Instruction
Location: ______________________
Recommended
Corrective Action
Date
Initials
Insert a ✔ in the box after completing each instruction.
1 Inspect physical condition for:
Foreign substances
Clean the device.
Damage or cracks
Contact a qualified service technician.
2 Inspect batteries for:
Broken, loose, or worn battery pins
Contact a qualified service technician.
Damaged or leaking battery
Discard/recycle battery.
3 Inspect ECG cable for:
Cracking, damage, broken or bent parts or
pins
Replace ECG cable.
4 Check ECG and therapy electrodes for:
Expiration date
Replace if expired.
Spare electrodes available
Obtain spare electrodes.
5 With the battery installed, disconnect the device from AC power adapter, if applicable,
and wait at least 2 seconds*. Then press ON and look for:
Momentary illumination of Self-test
messages and LEDs
If absent, contact a qualified service
technician.
LOW BATTERY or REPLACE BATTERY
message
Replace the battery immediately.
Two fully charged batteries
Replace low battery.
Service indicator illuminated (on device or
power adapter)
Contact a qualified service technician.
6 Perform therapy cable or standard hard paddles check in manual mode:
QUIK-COMBO therapy cable check (if this cable is not used with the defibrillator, go to Standard Paddles User Test)
a Examine cable for cracking, damage,
broken or bent parts or pins.
b Connect therapy cable to defibrillator
and the Test Load.
c Select 200 joules and press CHARGE
button.
d Press SHOCK button.
e Confirm ENERGY DELIVERED message
appears.
Replace QUIK-COMBO therapy cable.
If CONNECT ELECTRODES, PADDLES
LEADS OFF, or CONNECT CABLE
message appears, replace therapy
cable and repeat check. If problem
continues, remove the defibrillator from
use and contact a qualified service
technician.
If message does not appear,
repeat as stated above.
f Remove the Test Load from cable.
* Always allow at least 2 seconds between turning on the device and disconnecting from AC power, regardless of the
order of the actions.
Unit Serial No.: ____________________________ Location: _______________________
Instruction
Recommended
Corrective Action
Date
Initials
Standard (hard) Paddles User Test (if hard paddles are not used with the defibrillator, go to Step 7.)
a Examine cable for cracking, damage,
broken or bent parts or pins.
b Examine for paddle surface pitting or
presence of dried or wet gel.
Replace standard paddles/
cable.
Replace standard paddles/cable, or
clean paddles.
c Select PADDLES lead.
d On paddles, turn ENERGY SELECT dial to If a PADDLES LEADS OFF or CONNECT
CABLE message appears, replace
10 joules.
e With paddles in paddle wells, press
CHARGE button on paddles.
therapy cable and repeat check. If
problem continues, remove the
defibrillator from use and contact a
qualified service technician.
f Press only one discharge button and
release. Confirm energy was not
If energy discharges with one button
discharged.
press, repeat as stated above.
g Press the other discharge button and
release. Confirm energy was not
discharged.
h Confirm screen message after pressing
If message does not appear, replace
both discharge buttons:
ABNORMAL ENERGY DELIVERED
(biphasic defibrillator)
--or-ENERGY NOT DELIVERED
(monophasic defibrillator)
i Remove paddles from wells, and
confirm artifact on screen.
j Place paddle surfaces together, and
confirm flat line on screen.
therapy cable and repeat check. If
problem continues, remove the
defibrillator from use and contact a
qualified service technician.
If task fails, replace therapy cable and
repeat check. If problem continues,
remove the defibrillator from use and
contact a qualified service technician.
7 Perform User Test (press OPTIONS button):
Confirm test results printed.
If User Test fails, contact qualified
service technician and remove
defibrillator from use.
8 If applicable, reconnect the defibrillator to AC power adapter and look for:
Broken, loose, or worn power-adapter
cables
Replace damaged or broken parts.
Power adapter LEDs and defibrillator Batt
Chg LEDs are lit
Contact a qualified service technician.
9 Check ECG printer for:
Adequate paper supply
Add new paper if necessary.
Ability to print
If not working, contact a qualified
service technician.
10 Turn off the defibrillator.