Al-Waseet Medical Complex

Waseet Industrial Remote Area Clinic Unit

WIRACU
WIRACU Form # 2
RO CHAIN AED Daily Checklist

Device Name or Serial Number: Clinic: SHIFT: AM / PM

Month & Year:

Items to check 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Ready for use (RFU) Indicator -

blinking black hourglass

Blinking red -Plug into AC/DC

power or insert charged battery

If solid red -Insert charged battery

or AC/DC power. If condition
persists, call for service.

Cables/connectors- present and

inspected
Paddles/Therapy cable- present
and inspected, including Therapy
Connector pins and Therapy Port

Pads- present, sufficient supply - #2

Monitoring electrodes- present,
sufficient supply - #2 packs

Charged batteries- one in device, &

One spare

AC/DC power cord- plugged in,

green light on
Printer paper- present,
sufficient supply - one in use &
one spare

* Inspect the Ro chain AED Device, accessories, and supplies at the change of every shift, per AHA guidelines. Place a check mark in the box as you check each item in the
list
above or place a dash (-) or N/A if not applicable. Then, initial the list to indicate the check was performed for that shift.
 Al-Waseet Medical Complex
Waseet Industrial Remote Area Clinic Unit
WIRACU
WIRACU Form # 2
RO CHAIN AED Daily Checklist

Data Card- present, sufficient

supply - #1
SpO2 sensors- present and
inspected
NBP cuffs and tubing- present
and inspected
CO2 Filter Line- present,
sufficient supply
Invasive Pressure
transducers/adapter cables-
present and inspected
Temperature sensors and
adapters cables- present and
inspected.
Badge #
Initials

Name:

Badge No.

Signature: Date:

* Inspect the Ro chain AED Device, accessories, and supplies at the change of every shift, per AHA guidelines. Place a check mark in the box as you check each item in the
list
above or place a dash (-) or N/A if not applicable. Then, initial the list to indicate the check was performed for that shift.