Page 8 of 10
0156
COMPLIANCE
Electrical Continued
.............................................................................................................................
YES
.......
NO
........
NA
Gooseneck...............................................................................................................................................
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Intercom...................................................................................................................................................
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Fluorescent lights.....................................................................................................................................
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D. 110 volt System
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Inverter.....................................................................................................................................................
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.................................................................................................................................................................
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Shoreline..................................................................................................................................................
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Auto eject.................................................................................................................................................
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Transfer switch.........................................................................................................................................
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Outlets andGFI’s.....................................................................................................................................
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Battery charger ........................................................................................................................................
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Breaker box..............................................................................................................................................
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Heater ......................................................................................................................................................
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E. ECC andbatteries
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All cables tight..........................................................................................................................................
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Batteries secure (factory and conversion) ...............................................................................................
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Electrical schematics................................................................................................................................
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Computer hook-up tight............................................................................................................................
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COMPLIANCE
7. Patient Area Inspection
............................................................................................................
YES
.......
NO
........
NA
A. Oxygen (compartment / bracket)
.........................................................................................................
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Bracket securelymounted
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Secure tank fit
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Retentionstrapssound ( belt or
metal strap)
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Fit and finish.............................................................................................................................................
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Outlets -MCC x___ ................................................................................................................................
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Outlet -squad side....................................................................................................................................
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O2 linecheck
......................................................................................................................................
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Hook up nitrogen tank set at 160psi and let stand for 4hrs –ensure no leaks .......................................
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Test all outletswith flowmeters ...............................................................................................................
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Cap line and outlet ends – install O2 certification tag...............................................................................
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Install regulator and flowmeters ..............................................................................................................
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B. Fitmedical equipment
...........................................................................................................................
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Main cot ...................................................................................................................................................
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Dual cot....................................................................................................................................................
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Portable....................................................................................................................................................
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NOTE: If a step is incomplete circle
O
the initial blank in
red
pen.
Thiswill be thenotification to thedownstreamwork center(s) that this stepstill needs tobe completed.
