PPM CHECK LIST - Format 1
PPM CHECK LIST - Format 1
PPM CHECK LIST - Format 1
1
Maintenance Check Sheet/List
4.0 Documentation
4.1 Prepare a job card
4.2 Attach a service sticker
Date:
PPM carried out by:
Name:
Contact:
Sign:
Verified By: Date:
Name:
Contact:
Sign:
2
Maintenance Check Sheet/List
5.0 Documentation
5.1 Prepare a job card
5.2 Attach a service sticker
PPM carried out by: Date:
Name:
Contact:
Sign:
Verified By: Date:
Name:
Contact:
Sign:
4
Maintenance Check Sheet/List
5
Maintenance Check sheet/List
6
Maintenance Check Sheet/List
7
Maintenance Check Sheet/List
9
Maintenance Check Sheet/List
10
Maintenance Check Sheet/List
11
Maintenance Check sheet/List
12
Maintenance Check Sheet/ List
13
4.6 Verify operation of unit in all functional modalities (using
breathing circuit, airbag, vent/bag switch etc.)
4.7 Calibrate the Oxygen sensor at 21% and 100%, replace if
necessary
5.0 Documentation
5.1 Prepare a job card
5.2 Attach a service sticker
PPM carried out by: Date: …………………
Name:
Contact:
Signature:
14
Maintenance Check sheet/List
16
1. Maintenance Check Sheet/List
17
1. Maintenance Check sheet/List
18
Maintenance Check Sheet/List
19
Maintenance Check Sheet/List
20
Maintenance Check Sheet/List
5.0 Documentation
5.1 Prepare a job card
5.2 Attach a service sticker
PPM carried out by: Date:
Name:
Contact:
Sign:
Verified By: Date:
Name:
Contact:
Sign:
21
Maintenance Check Sheet/List
23
Maintenance Check Sheet/List
24
PPM Check sheet for ventilator
Health Facility Name:
Date: / /
Description of Procedure Pass Fail Remarks
1.0 Physical inspection
1.1 Check for any physical damage
1.2 Check for damage on electrical power cord
1.3 Check the Medical supply of O2 and air
1.4 Check for any damage on the tubing, water traps,
expiration and inspiration valves, Nebulizer, Humidifier, O2
sensor
1.5 Check filters for damage
1.6 Check Pipeline hoses for damage
1.7 Check the control monitor battery, AC supply, Modes
Check the compressor of Air