AED Inspection AED Inspection Name of Person Completing InspectionBusiness / OrganizationAddress of AED Location Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Location of AEDOn Site ContactPhoneEmail AED BrandSelect BrandCardiac ScienceDefibtechHeartSinePhilipsPhysio-ControlZollOther (specify)Other Manufacturer and Model Powerheart G5 Powerheart G3 Powerheart G3 Pro Cardiac Science AED ModelSelect ModelPowerheart G5Powerheart G3Powerheart G3 Pro (w/screen) Lifeline Lifeline View Defibtech AED ModelSelect ModelLifelineLifeline View (w/screen) samaritan PAD 350P, 360P, and 450P Heartsine AED ModelSelect Model350P or 360P450P HeartStart OnSite HeartStart FRx HeartStart FR3 Philips AED ModelSelect ModelHeartStart OnSiteHeartStart FRxHeartStart FR3 LIFEPAK EXPRESS LIFEPAK CR Plus LIFEPAK 1000 LIFEPAK 500 Physio-Control AED ModelSelect ModelLIFEPAK EXPRESSLIFEPAK CR PlusLIFEPAK 1000LIFEPAK 500 Zoll Aed Plus Zoll Aed Pro Zoll AED ModelSelect ModelAED PlusAED ProDoes AED have 3-Dimensional Signage?A 3D sign is a triangular marker on the wall above the AED so that its location can be seen from either direction.YesNoIs AED accessible at all times that the building is open?If kept in a locked office, select "No"YesNoIs AED kept in a wall mounted cabinet?Yes, cabinet alarmedYes, cabinet not alarmedNo, but AED is attached to the wallNoDoes wall cabinet alarm work?Yes, alarm functions properlyNoDoes AED have a carrying case?YesNoDoes AED have a response kit?Yes, attached to AEDYes, not attached to AEDNo response kitResponse kit contents: Gloves Gauze or Towel Pocket Mask or Barrier Razor Scissors or shears How many adult pads does AED have?NoneOne setTwo setsAdult Pads Set 1 Expiration Date: MM DD YYYY Adult Pads Set 2 Expiration Date: MM DD YYYY Does AED have pediatric pads?YesNoPediatric Pads Expiration Date: MM DD YYYY Battery Inspection (Cardiac Science)Open the lid. Battery indicator will show a percentage of battery life remaining. Close lid.Green: more than 25% battery lifeGreen: less than 25% battery lifeRed: replace batteryRescue Ready:Several seconds after closing the lid, the Rescue Ready status indicator is green. If indicator does not turn green, open lid again, wait for prompts to begin before closing lid. Indicator should turn green in several seconds. Green: Ready for RescueRed: Not Ready for RescueReady Light:Ready light flashes green every few seconds.Green: Ready for useNot flashing, AED is chirping: Not ready for useNot flashing, AED is not chirping: Battery is either dead or not installed. Not ready for use.Battery Expiration Date:Printed on battery underneath the bar code. MM DD YYYY Battery Expiration Date:Printed on battery above the bar code. MM DD YYYY Battery Expiration Date:Printed on battery under "PN" MM DD YYYY Active Status Indicator:Indicator light flashes green every few seconds.Green: Ready for useFlashing red, AED is chirping: Not ready for useNot flashing, AED is not chirping: Battery is either dead or not installed. Not ready for use.Status Indicator:Indicator light flashes green every 5-10 seconds.Green: Ready for useFlashing red, AED is chirping: Not ready for useNot flashing, AED is not chirping: Battery is either dead or not installed. Not ready for use.Status Indicator:Check display on unit.Green "✓"Red "X"Status Indicator:Check LCD display on unit. If no LCD display, turn AED on, listen for "Battery OK. Self Test""OK"Battery or Service (wrench) indicator displayed: Not OKNotes:
