Emergency Power System - ICU Checklist
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System Activation & Transfer
Verification of automatic and manual transfer to emergency power.
Time of Emergency Power System Activation
Activation Method
Transfer Time (seconds)
Transfer Success?
Notes on Transfer Process (if any issues)
Synchronization Status
Voltage Level (Emergency Power)
Generator Performance
Assessment of generator operation during test run, including load acceptance and stability.
Generator Voltage (Volts)
Generator Frequency (Hz)
Load Acceptance Time (Seconds)
Generator Speed (RPM)
Engine Oil Pressure (PSI)
Coolant Temperature (Degrees F)
Observations & Anomalies
Time of Load Acceptance
Critical Equipment Verification
Confirmation that essential ICU equipment remains operational during and after transfer.
Ventilator Status
ECG Monitor Battery Level (%)
Infusion Pump Status
Patient Monitoring System (PMS) Status
Oxygen Concentrator Output (LPM)
Medical Air Pressure
Any observed abnormalities or issues with critical equipment
Lighting & HVAC
Verification of adequate emergency lighting and heating/cooling in the ICU.
Emergency Lighting Status
Emergency Lighting Lumens (average)
HVAC System Status
Room Temperature (°C) - measured
Room Temperature (°F) - measured
HVAC Airflow (observed)
Comments/Observations regarding Lighting and HVAC
Fuel Supply & Monitoring
Confirmation of sufficient fuel levels and proper monitoring systems.
Initial Fuel Level (Gallons/Liters)
Fuel Consumption During Test (Gallons/Liters)
Remaining Fuel Level (Gallons/Liters)
Fuel Type Verified?
Fuel Gauge Functionality
Last Fuel Delivery Date
Notes on Fuel Condition (e.g., cleanliness, odor)
System Shutdown & Return to Utility Power
Procedure for safely returning to normal utility power and system shutdown.
Time Utility Power Restored
Voltage Level (Utility Power)
Transfer Method to Utility Power
Observations During Return to Utility Power (e.g., voltage fluctuations, equipment behavior)
System Stability Upon Return
Date of Return to Utility Power
Any deviations from standard procedure during return to utility power? If so, describe.
Engineer Signature Verifying Return to Utility Power
Post-Test Documentation & Reporting
Recording of test results, anomalies, and corrective actions.
Date of Test
Start Time of Test
End Time of Test
Generator Load Acceptance (kW)
Transfer Time (Seconds)
Transfer Success?
Observations & Deviations
Equipment Functionality Verified (Select All That Apply)
Generator Data Log
Technician Signature
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