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Run: Defibrillator Monthly Functional Check Log

Monthly log for checking each defibrillator/AED’s self-test, pads, battery, readiness indicators, and any corrective action. Use it to document device readin...

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Check Details

Date the monthly functional check was completed.
Asset tag, room number, or other internal identifier for the device.
Where the device is installed or stored.
Name or role of the person completing the check.

Functional Check

Select the result shown by the device self-test or readiness indicator.
Confirm the status light or readiness indicator is normal.
Confirm electrode pads are present, sealed, and not expired or damaged.
Confirm the battery is installed and shows acceptable status.
Confirm any required accessories for this unit are present and usable, such as spare pads or rescue kit items.

Issues and Corrective Action

Describe the issue, including the specific field that failed and any visible damage or missing items.
Indicate whether the device remains in service or has been taken out of service.
Record replacement, escalation, maintenance request, or other action taken.

Sign-Off

Select whether maintenance, replacement, or supervisor review is needed.
Add any handoff details, work order numbers, or escalation notes.
Signature confirming the monthly functional check was completed.

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