Tri-County Ambulance Stryker Cot Inspection Date ____________ Manual Release SN: 0901395 _ _ Cot Number _______ Meter hours _______ Ck box Notes Manual release functions properly Release handle returns to the stowed position Base extends/retracts smoothly when manual release is used. With 100 lbs or more on the cot, verify the cot does not lower when the manual release is pulled. Litter Inspect the ambulance cot frame/litter All welds intact, not cracked or broken No bent, broken or damaged components All fasteners secure All warning labels present and legible No damage or tears on cot grips Siderails operate and latch properly Backrest cylinder operates properly Adjust pneumatic cylinder for full range of motion, if required Footrest operates properly Mattress No cracks or tears on cot mattress Restraints Inspect restraints for proper function and excess wear 5 point harness in place Base Inspect cot frame/base All welds intact, not cracked or broken No bent, broken or damaged components All fasteners secure No excessive damage to X-frame guards, replace if necessary. Wheels Wheels free of debris Tires in good condition All wheels secure, rolling and swiveling properly Check and adjust wheel locks as necessary X-Frame Verify smooth operation of X-frame Settings In-fastner shut-off configured properly Ambulance cot and fastener fit and function properly Safety bar engages the vehicle safety hook properly Cylinder All fasteners secure Verify the cylinder is adjusted so the lock nut is tight and the cot stops moving when it hits the dead stops Inspect and verify there are no hydraulic leaks Retract cylinder rod completely and wipe down rod with soft cloth and household cleaner Tri-County Ambulance Stryker Cot Inspection Date ____________ Hydraulics Inspect motor mount and verify all fasteners secure Verify no hydraulic leaks Inspect reservoir and verify no leaks Inspect hoses and fittings for damage or wear Verify hydraulic velocity fuse. Place 50# on cot, raise cot, lift cot with two operators, pull manual release, rapidly set cot down, verify cot does not drop. Electronic Controls Extend cot to raised position, ck load height Verify jog function is operating Verify high speed retract is working Switches No damage or pinching of harness, cable or lines Check routing(s) and connections(s) No damaged connectors Head of Cot Supplies 1 Adult nonrebreather 1 Nasal cannula, adult 5 4 x 4 guaze pad 1 3" kling 1 emesis bag gloves, med, lg, xl oxygen tank key SN: 0901395 _ _ Cot Number _______ Meter hours _______
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