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Incident and first aid records · IN-06

Defibrillator Check Record

A free printable defibrillator check record — the unit and its location, then a row per check for the status indicator, pad and battery dates, case and faults reported.

First page of the Defibrillator Check Record — Give a wall-mounted unit a written history, so the pad and battery dates are known without unbolting anything and a reported fault can be traced.
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One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Give a wall-mounted unit a written history, so the pad and battery dates are known without unbolting anything and a reported fault can be traced.

Who it is for

Anyone who looks after a defibrillator — a workplace, a village hall, a club, a gym, a school or a community cabinet keyholder.

How to use it

  1. Fill in the make, model, serial number and exact location once at the top.
  2. Each time the unit is looked at, write the date and what the status indicator is actually showing.
  3. Copy the expiry dates printed on the pads and note whether spare pads are there.
  4. Record the battery status as displayed, and whether the case and signage are intact.
  5. If anything is wrong, write who it was reported to and when.

What is on the sheet

One page, top to bottom:

Printed under the title: A running record of each look at a defibrillator — what the status indicator was showing, the dates printed on the pads and battery, and anything reported as a fault.

What it shows, not what it should show. Write down what the unit itself displays and what is printed on the pads and battery — not what they ought to say. How often the unit is looked at, and what counts as ready, are set by the manufacturer's own instructions and by whoever looks after the unit.

Write-on lines: Unit make & model · Serial no. · Location

Check record — one row each time the unit is looked at

Table, 12 rows: Date · Indicator shown · Pads expiry · Spare pads · Battery status · Case & seal · Checked by · Fault reported

Questions

Why does the sheet not say how often to check it, or what the indicator should show?

Because that is set by the manufacturer of your particular unit and by whoever is responsible for it. Units differ in what they display and how they signal a problem. Write down what yours shows and compare it with its own instructions.

Should the pads and battery dates be copied every time?

It is worth it. Copying them each check means a glance down the column shows the date coming up, rather than having to open the case to find out.

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