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Cardiac Surgery Equipment Maintenance Log Template

Comprehensive Documentation System for Critical Equipment Management

Cardiac Surgery

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Template Content

Last updated: Mar 24, 2025

Equipment Information

  • Device Name/Model: ________________
  • Serial Number: ____________________
  • Location: ________________________
  • Manufacturer: ____________________

Daily Checks

Visual Inspection

  • Equipment exterior integrity
  • Cable conditions
  • Display functionality
  • Warning indicators
  • Emergency backup systems

Performance Verification

  • Self-test completion
  • Calibration status
  • Pressure/flow readings
  • Safety alarms

Maintenance Record

Date Service Type Technician Details Next Due

Critical Parameters

Operating Parameters

  • Temperature Range: ___________
  • Pressure Limits: ____________
  • Flow Rates: ________________

Safety Checks

  • Emergency shutdown
  • Backup power transition
  • Alarm systems

Sterilization Record

Date Method Operator Verification

Incident Report

If Any Issues Observed:

  1. Date/Time: _________________
  2. Nature of Issue: ____________
  3. Action Taken: ______________
  4. Reported By: _______________

Certification

Last Certification Date: ________ Next Due: ___________________

_Reviewed By: ________________ Date: _______________________

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