CHECKLIST
All fasteners secure
Siderails move and latch properly
Engage brake pedal and push on the stretcher to ensure all casters lock securely
Steer function working properly
All casters secure and swiveling properly
Body restraints working properly
I.V. pole intact and operating properly
Oxygen bottle holder intact and operating properly
Fowler operating properly
Knee Gatch operating properly
Trendelenburg/Reverse Trendelenburg operating properly
No rips or cracks in mattress cover
Arm boards intact and operating properly
Arm board support levers intact and operating properly
Ground chain intact
No leaks at hydraulic connections
Hydraulic jacks holding properly
Hydraulic drop rate set properly
Hydraulic oil level sufficient
Lubricate where required, including the brake adjuster assembly and brake cam, and the pin and block
("U" joint) on the Fowler assembly
Serial No.______________
______________
______________
______________
______________
Completed By:_________________________________
Preventative Maintenance
1−19
Date:_____________