Chapter 8
8-52
Esprit® Ventilator Service Manual © Respironics, Inc.
REF 580-1000-02 G
Performance Verification
Performance
Verification Data
Form
Complete this form at every performance verification.
Make copies of this form
for data collection.
Internal Use Only
Date:
Notification No:
Customer Information
Name:
________________________________________________________________
Address:
________________________________________________________________
City/State:
________________________________________________________________
Account No:
________________________________________________________________
Preliminary Ventilator Cleaning and Inspection
Select One
Was the ventilator damaged?
YES
NO
If yes, provide a brief description of damage and repair:
Cleaned ventilator exterior.
YES
NO
Inspected cooling fan filter.
YES
NO
Inspected blower inlet filter.
YES
NO
Inspected oxygen water trap/inlet filter.
YES
NO
Serial number:
Software (flash) version:
;
Installed Options:
Color
Graphics
Auto
Com1
Mech
Trend
Com2
FTrak
NICO
ALRM
Neonatal
SM
Altitude:
Elapsed time meter:
Test 1: Electrical safety
Circle One
Are cooling fans operating
properly?
PASS FAIL
Passed
Value
Failed
Value
Corrected
(after repair)
Value
Ground resistance: (<0.2 ohm)
ȍ
ȍ
ȍ
Forward leakage current: (<100 uA when connected to 100-120V)
(<300 uA when connected to 100-120V
and an external battery)
(<300 uA when connected to 220-240V)
ȝ
A
ȝ
A
ȝ
A
Reverse leakage current: (<100 uA when connected to 100-120V)
(<300 uA when connected to 100-120V
and an external battery)
(<300 uA when connected to 220-240V)
ȝ
A
ȝ
A
ȝ
A
Test 2: Extended Self Test
Circle One
Did EST pass?
PASS
FAIL
