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BERITA ACARA KALIBRASI MESIN HEMODIALISA

RUMAH SAKIT
NAMA TEKNISI
TGL KALIBRASI

MODEL
NOMOR SERI
JAM KERJA

MINUTE

A. SYSTEM SENSOR ELETRONIK & WATER WAY
TOUCH SCREEN
SENSOR ADAPTER A-B
SENSOR HANSEN DIALYSER
SENSOR WETER EMPTY ALARM
SENSOR BLOOD LEVEL
SENSOR AIR BUBBLE
BLOOD LEAK

(Value ± 1600)

NILAI
TERUKUR

HASI
L
HASI
L
HASI
L
HASI
L
HASI
L
HASI
L
HASI
L

OK
NO
OK
NO
OK
NO
OK
NO
OK
NO
OK
NO
OK
NO

B. WETER INLET PRESSURE
PRE PUMP
POST PUMP

1,2 - 1,4 Kg/cm2

NILAI
TERUKUR
NILAI
TERUKUR

1,3 - 1,5 Kg/cm2

HASI
L
HASI
L

OK
NO
OK
NO

C. ARTERIAL & VENOUS PRESSURE
ARTERIAL
PRESSURE
VENOUS
PRESSURE

0 ± 2 mmHg

NILAI
TERUKUR
NILAI
TERUKUR

0 ± 50 mmHg

HASI
L
HASI
L

OK
NO
OK
NO

D. CONDUCTIVITY
CONDUCTIVITY

13,5 - 14,3 ms/Cm

NILAI
TERUKUR

HASI
L

OK
NO

E. TEMPERATUR
TEMPERATUR

33,5 - 40 ˚C

NILAI
TERUKUR

HASI
L

OK
NO

F. HEPARIN TEST
STROKE

0,49 – 0,54 ml/H

NILAI
TERUKUR

HASI
L

OK
NO

G. TEST & SIMULASI
RUN

1200 cc/H

CATATAN HASIL KALIBRASI

NILAI
TERUKUR

HASI
L

OK
NO

TEKNISI ) ( ) RUMAH SAKIT ( ) .DAPAT DIGUNAKAN TEKNISI ( PERLU DILAKUKAN PERBAIKAN KA.