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Ultrasound Scanners Form

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Ultrasound Scanners

IPM Form 474-20140701


Status
WO No.: Date: Inspector: Passed
Mfr: Model: Loc: Service Required
CTRL No.: SN: IPM Time: . hr Removed From Use

Test Apparatus Required


Description Control / Serial no.
Multipurpose tissue-mimicking phantom
Doppler ultrasound phantom
Blood flow simulator
ECG simulator

Qualitative Tasks
P F P F
Chassis/Housing Filters
Mount/Fastener Controls/Switches
Casters/Brakes (Acceptance) Fans
AC Plug/Receptacles Indicators/Displays
Line Cord User Calibration
Strain Reliefs Audible Signals
Circuit Breaker/Fuse Labeling
Cables System Performance
Fittings/Connectors ECG
Transducers Accessories

Quantitative Tasks P F
Ground Resistance (≤0.5 Ω) Ω
Chassis Leakage Current (≤ 500 μA) μA

Transducer-Specific Quantitative Tasks P F


Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
Transmit Focal Range/Point cm Doppler Gate Positioning

Transducer-Specific Quantitative Tasks P F


Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
MS14398

Transmit Focal Range/Point cm Doppler Gate Positioning


©2014 ECRI Institute
Transducer-Specific Quantitative Tasks P F
Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
Transmit Focal Range/Point cm Doppler Gate Positioning

Transducer-Specific Quantitative Tasks P F


Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
Transmit Focal Range/Point cm Doppler Gate Positioning

Transducer-Specific Quantitative Tasks P F


Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
Transmit Focal Range/Point cm Doppler Gate Positioning

Transducer-Specific Quantitative Tasks P F


Transducer ID Scanner Settings Dead Zone
Type Frequency MHz Axial Resolution
Serial No. Power dB Lateral Resolution
Frequency (Range) MHz Gain dB Vertical Distance
Selected Frequency MHz Dynamic Range dB Horizontal Distance
Preprocessing Doppler Flow Velocity
Postprocessing Doppler Discrimination
Transmit Focal Range/Point cm Doppler Gate Positioning

Preventive Maintenance Tasks


Description and Comments Done
Clean exterior (and interior, if needed)
Clean/replace air filter
Lubricate moving parts
Notes

©2014 ECRI Institute Ultrasound Scanners IPM Form 474-20140701

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