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3201896_R_PIP_Checklist_LP20.pdf Page 1 of 3

LIFEPAK 20/20e Defibrillator/Monitor

Performance Inspection Procedure Checklist

Model # __________________________________ Department/Location _______________________

Serial # __________________________________ Performed By ______________________________

Type of PIP: Post-Repair  Annual  Date _____________________________________

PIP Checklist

Inspection Pass Fail NA Comments

A Physical Inspection   

Testing
1 Power On
a. Confirm the Service indicator is off.   
b. Confirm the device completes the Power On sequence.   
2 Date and Time
Check/set date and time   
3 ECG Lead Characteristics
a. Confirm leads off screen messages.   
b. Record lead II ECG gain (tolerance 36 to 44 mm) Measured
Value _______________

c. Record lead I ECG gain (tolerance 18 to 22 mm)* Measured
Value _______________

*(Test Equipment other then 215A/217A may have different output)
d. Record lead V1/C ECG gain (tolerance 36 to 44 mm) Measured
Value _______________

(N/A if 3 Lead)
4 Printer Test
Confirm printed test strip and CHECK PRINTER message.   
5 SpO2 Oximeter (if SpO2 option is installed)
Confirm SpO2 reading is between 90% and 100%.   
6 Therapy Impedance Sense
a. Confirm display of PADDLES LEADS OFF message. (248 Ohms)   
b. Confirm no display of PADDLES LEADS OFF message. (182 Ohms)   
7 Therapy User test
Confirm Device passes User Test   
8 Therapy Delivered Energy and Sync
a. Record Sync R-wave delay (maximum 60 ms): Measured
Value _______________

b. 2 J – Record delivered energy (tolerance 1.0 to 3.0 J). Measured
Value _______________

c. 70 J – Record delivered energy (tolerance 65.1 to 74.9 J). Measured
Value _______________

d. 360 J – Record delivered energy (tolerance 334.8 to 385.2 J). Measured
Value _______________

9 Therapy Paddles ECG Gain and AED mode Test
a. Record ECG gain (tolerance 36 to 44 mm) Measured
Value _______________

(Note: 38 to 50 mm with QED-6)
b. AED / Manual modes check   
10 Therapy Remote Sync Test
a. Confirm Remote Sync: Sync LED is flashing   
b. Confirm correct response to energy transfer   

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LIFEPAK 20/20e Defibrillator/Monitor

Testing (continued) Pass Fail NA Comments

11 Pacer Option Characteristics (If Pacer option is installed)
a. Confirm leads off detection.   
b. 10 ma – Record current (tolerance 5 to 15 ma). Measured
Value _______________

c. 100 ma – Record current (tolerance 95 to 105 ma). Measured
Value _______________

d. 200 ma – Record current (tolerance 190 to 210 ma). Measured
Value _______________

e. Record pulse width (tolerance 19.0 to 21.0 ms). Measured
Value _______________

12 Ground Resistance Test
Record Ground Resistance Test (Less than 0.5 Ohms). Measured
Value _______________

13 Chassis Leakage Current
a. Neutral Closed, Polarity Normal Lead-Chassis, N.C. (less Measured
Value _______________

than 90 µA)
b. Neutral Closed, Polarity Normal, Lead-Chassis, S.F.C. (less Measured
Value _______________

than 270 µA @ 120 Vac).(less than 450 µA @ 240 Vac).
c. Neutral Closed, Polarity Reversed, Lead-Chassis, N.C. (less Measured
Value _______________

than 90 µA)
d. Neutral Closed, Polarity Reversed, Lead-Chassis, S.F.C. Measured
Value _______________

(less than 270 µA @ 120 Vac).(less than 450 µA @ 240 Vac).
14 Earth Leakage Current
a. Neutral Closed, Polarity Normal, Earth (less than 450 µA) Measured
Value _______________

b. Neutral Closed, Polarity Reversed, Earth (less than 450 µA) Measured
Value _______________

c. Neutral Open, Polarity Normal, Earth (less than 900 µA) Measured
Value _______________

d. Neutral Open, Polarity Reversed, Earth (less than 900 µA) Measured
Value _______________

15 ECG Lead Leakage Current
a. Neutral Closed, Polarity Normal, Lead-Gnd, N.C. (less than 10 µA) Measured
Value _______________

b. Neutral Closed, Polarity Normal, Lead-Gnd, S.F.C. (less than 50 µA) Measured
Value _______________

c. Neutral Closed, Polarity Reversed, Lead-Gnd, N.C. (less than 10 µA) Measured
Value _______________

d. Neutral Closed, Polarity Reversed, Lead-Gnd, S.F.C. (less than Measured
Value _______________

50 µA)
e. Neutral Closed, Polarity Normal, Lead-Lead, N.C. (RA, LA, LL) (less Measured
Value _______________

than 10 µA)
f. Neutral Closed, Polarity Normal, Lead-Lead, S.F.C. (RA, LA, LL) (less Measured
Value _______________

than 50 µA)
g. Neutral Closed, Polarity Reversed, Lead-Lead, N.C. (RA, LA, LL) Measured
Value _______________

(less than 10 µA)
h. Neutral Closed, Polarity Reversed, Lead-Lead, S.F.C. (RA, LA, LL) Measured
Value _______________

(less than 50 µA)
i. Neutral Closed, Polarity Normal, Lead-Lead, N.C. (RL, C for 5-wire Measured
Value _______________

only) (less than 10 µA)
j. Neutral Closed, Polarity Normal, Lead-Lead, S.F.C. (RL, C for 5-wire Measured
Value _______________

only) (less than 50 µA)
k. Neutral Closed, Polarity Reversed, Lead-Lead, N.C. (RL, C for 5-wire Measured
Value _______________

only) (less than 10 µA)
l. Neutral Closed, Polarity Reversed, Lead-Lead, S.F.C. (RL, C for 5- Measured
Value _______________

wire only) (less than 50 µA)
m. Neutral Closed, Polarity Normal, Lead Iso (less than 45 µA) Measured
Value _______________


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LIFEPAK 20/20e Defibrillator/Monitor

Testing (continued) Pass Fail NA Comments

16 SpO2 Leakage Current (If SpO2 option is installed)
Neutral Closed, Polarity Normal, Lead Iso (less than 90 µA @ 120Vac) Measured
Value _______________

(less than 450 µA @ 240Vac)
17 Therapy Leakage Current
a. Neutral Closed, Polarity Normal, Lead-Gnd, N.C. (less than 10 µA) Measured
Value _______________

b. Neutral Closed, Polarity Normal, Lead-Gnd, S.F.C. (less than 50 µA) Measured
Value _______________

c. Neutral Closed, Polarity Reversed, Lead-Gnd, N.C. (less than 10 µA) Measured
Value _______________

d. Neutral Closed, Polarity Reversed, Lead-Gnd, S.F.C.(less than Measured
Value _______________

50 µA)
e. Neutral Closed, Polarity Normal, Lead-Lead, N.C. (RL, C/V1) (less Measured
Value _______________

than 10 µA)
f. Neutral Closed, Polarity Normal, Lead-Lead, S.F.C. (RL, C/V1) (less Measured
Value _______________

than 50 µA)
g. Neutral Closed, Polarity Reversed, Lead-Lead, N.C. (RL, C/V1) (less Measured
Value _______________

than 10 µA)
h. Neutral Closed, Polarity Reversed, Lead-Lead, S.F.C. (RL, C/V1) Measured
Value _______________

(less than 50 µA)
i. Neutral Closed, Polarity Normal, Lead Iso (less than 90 µA @ Measured
Value _______________

120Vac) (less than 450 µA @ 240Vac)
18 Record Operating Data (optional)
Power Cycle Count
360J shocks Pacing Count (if installed)
225 – 325J shocks Shock Count
100 – 200J shocks Power On Time
0 – 70J shocks Printer On Time
SpO2 Operating Time (if installed)
Total Shocks

19 Contrast Test (optional test)

Confirm contrast test.   
20 Pixel Test (optional test)
Confirm pixel test.   
21 Keypads Test (optional test)
Confirm all control text boxes are highlighted.   
22 Audio Test (optional test)
Confirm voice messages and tones are clear and not distorted.   
23 ECG Analog Output (optional test)
Record signal amplitude (tolerance 0.85 to 1.15 Vp-p). Measured
Value _______________

Comments:

LIFEPAK 20/20e Defibrillator/Monitor Service Manual Page 3 of 3

©2007-2012, Physio-Control, Inc.