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Preventive Maintenance (PM) Checklist
The preventive maintenance (PM) checklist #PL-F-33 should be completed by responsible
individuals of healthcare center. It should be noted that PM checklist only is used to perform
systematic inspection of the equipment and will not guarantee their correct function.
SAADAT Co.
Form No. : PL-F-33
PM Form ( Electrocardiograph )
State: City:
Healthcare center:
Ward:
Device model: Serial number:
Installation date: Inspection date:
N/A
NOK
OK
Test and Inspection Item
No.
No damage or breakage in the case
Visual
inspection
1
Correct function of the touch screen
Correct function of the keyboard
Cleaning and disinfection according to the user manual
Correct display of Waveform area and information
Display screen
2
Unplugging the system (check the battery function)
Battery
3
Periodic usage of the battery
Saving date& time settings
4
Saving system settings
5
Check ECG cable (clamps, leadwires, trunk)
Accessories
6
Check ECG clip clamp and suction bulb (visual and
sulfation test)
Cleaning and disinfection according to the user manual
Correct function of the recorder
Recorder
7
Appropriate size of the recorder paper
Check the eject key function on the recorder door
Check the paper holder
Check the recorder error messages
Check Review window periodically
Review
8
Final result: Pass □ Fail □
Expert recommendation: