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PHILIPS MEDICAL SYSTEMS
OPERATOR’S CHECKLIST
The following checklist is for your reference. You may want to photocopy it or
use it as the basis for creating your own checklist.
OPERATOR'S CHECKLIST
HeartStart FR2+ Model No.: ________________________ Serial No.: ________________________________
HeartStart FR2+ Location or Vehicle ID: ________________________________________________________
Date
Scheduled frequency
HeartStart FR2+
Clean, no dirt or contamination; no
signs of damage
Supplies available
• Two sets defibrillator pads,
sealed, undamaged, within
expiration date
• Ancillary supplies (hand towel,
scissors, razor, pocket mask,
gloves)
• Spare M3863A battery, within
“Install Before” date
• Data cards, undamaged, and spare
data card tray
Status indicator
Shows alternating hourglass/square;
selftest passed.
Inspected by
Signature or initials of operator
completing the maintenance
inspection
Remarks, problems, corrective
actions
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