GCE EASE II Manual De Instrucciones página 159

14. SAMPLE ANNUAL INSPECTION RECORD SHEET
Please copy this form to help with your EASE II annual checks.
See section 8.3 for details of the annual inspection procedure.
COMPANY
VISUAL CHECK
Check serial number legibility
Check demand valve is less than 10 years
old
Check hose condition
Check body condition
Check label condition
Check the three recap screws are in place
Check patient port condition
Check exhalation valve fl ap condition
Check inhalation plate (with pin) condition
Check inhalation valve fl ap condition
LEAK CHECKS
Hose to hose fi tting joints (use leak
detection fl uid)
Hose to demand valve body joint (use
leak detection fl uid)
Leak test Demand valve (listening for
leak with patient port and inhalation disc
removed)
OPERATION CHECKS
Test button operation
Tested By:
Demand Valve SERIAL NUMBER
TICK COMMENTS / ACTION TAKEN
TICK Comments / Action Taken
TICK Comments / Action Taken
Date:
159/208
NL