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Download Data
(pg 9)
Battery Check
(pg 10)
Change Battery
(pg 11)
ActiV.A.C.
®
Therapy System
Required Service Record
Verify Time and
Date (pg 20)
Leak Alarm
(pg 20)
Final Settings
(pg 23)
Service Process complete.
Unit ready for use.
Complete Required Service
Record form and file as a
permanent record for the unit.
Facility:
Unit Serial Number:
Date Service Completed:
Inspector Name (Please Print):
Signature:
340141 Rev A
Unit cleaned and
disinfected.
Perform Infection
Prevention and
Control process
(pg 5)
Inspect Unit For
Damage
(pg 8)
Blockage Alert
(pg 21)
Canister Full
Therapy
Interrupted
(pg 22)
Recharge Battery
(pg 23)
Contact
KCI
(see page
28)
Fail
Fail
Fail
Fail
Fail
Fail
Fail
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
®
permanent record.
To be used in conjunction with the ActiV.A.C.
Therapy Unit Owner Service Manual
Complete this form between each patient use and
maintain as a
Circle any step not passed and return a copy of
this sheet to KCI along with the unit.
Replace Exhaust
Filter
(pg 9)
Pressure Checks
(pg 12)
Canister Not
Engaged & Check
Battery Level
(pg 22)
OK
Charge Battery &
6 Hour Unit
Verification Test
(Page 17)
OK
Fail
Fail
Содержание ActiV.A.C.
Страница 2: ......
Страница 32: ...Manufactured for KCI USA Inc 12930 IH10 West San Antonio Texas 78249 USA www acelity com...