TE-331/332 INSPECTION RECORD

INFUSION PUMP TE-172

INSPECTION RECORD

NoCheck itemResult

YesNo

1Is there any damage, etc in the main unit or pole clamp

2Can it be operated with battery power

3Is normal self-check is provided when the power switch is ON

4If the AC power cable is connected, does the BATTERY indicator go ON

5Was the [AC/DC] indicator lit when AC power was turned on ?

6With the door open, did the MIDPRESS finger section move momentarily

7If the door is closed and then opened. Is the tube clamp closed

8Does the START/STOP/SILENCE button function normally?

9Is the tube firmly clamped

10Does the air-in-line sensor work normally

11Was the Occlusion alarm activated in the following range ?

Upstream : - 30 ~ - 80 kPa ( - 0.3 ~ - 0.8 kgf/cm2 )

Downstream : 30 ~ 90 kPa ( 0.3 ~ 0.9 kgf/cm2 )

Setting on Pump:

Flow rate : 120 mL/h

Delivery Limit : 100 mL

Distance from pump to pressure gauge :

50 cm for Upstream Occlusion Sensor

100 cm for Downstream Occlusion Sensor

Value:

Upstream:.........................Downstream:........................

12Was the [ FLOW RATE ] accuracy within the following range ?

9-11 mL

Setting on Pump :

Flow Rate : 300 mL/h

Delivery Limit : 5 mL

Test Time : 1 minutes

Value:

........................

Remarks:

.......................................................................................

..cription:

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Serial Number:Date:Checked by:Signature: