Respironics BiPAP Vision Service Manual page 139

Use this form to record the results of the performance verification.
Ventilator serial no.
Model no.
Results:
Vent Inop alarm
Exhalation port test
Test alarms
Monitoring screen parameters
Spontaneous breath
High pressure alarm
Low pressure alarm
Apnea alarm
Earth Resistance and Leakage Current Test
Test
Earth resistance
Normal pole, no earth, L2
Reverse pole, no earth, L2
Reverse pole, no earth, no L2
Normal pole, no earth, no L2
Tested by:
(Print name)
1062788
BiPAP Vision Performance Verification Form
Test
(Signature)
BiPAP Vision Service Manual © Respironics, Inc.
Service notification
(Respironics use only)
Total operating time
Pass/Fail (circle one)
Pass Fail
Pass Fail
Pass Fail
Pass Fail
Pass Fail
Pass Fail
Pass Fail
Pass Fail
DMM reading Specification
< 0.20 Ohms
< 300 uA
< 300 uA
< 1000 uA
< 1000 uA
Chapter 7
Testing and Calibration
Pass/Fail
Pass Fail
Pass Fail
Date:
7-19