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AED incident report form

AED incident report form

Document and analyze AED incidents effectively with our comprehensive AED incident report form, designed to streamline reporting and improve response strategies.

Use this template
or download pdf
AED incident report form

Document and analyze AED incidents effectively with our comprehensive AED incident report form, designed to streamline reporting and improve response strategies.

Use this template
or download pdf

About the AED incident report form

An AED incident report form template is vital for ensuring that every detail of an incident involving an automated external defibrillator (AED) is accurately recorded. Thorough documentation is crucial for understanding the event while improving your future emergency responses.

A template allows you to systematically capture crucial details, such as the date, time, location of the incident, patient condition, and actions taken. This structured format ensures no important information is overlooked, providing a comprehensive record for future reference.

By using an AED incident report form template, you can simplify the reporting process, making it more efficient and less burdensome. This uniformity ensures all incidents are documented consistently, which is key for reliable data collection and analysis.

Moreover, a template provides a standardized format that can be easily reviewed by healthcare professionals and regulatory authorities. This helps ensure compliance with health and safety guidelines and enhances the overall quality of emergency response.

In conclusion, an AED incident report form template helps you maintain accurate records, ensures regulatory compliance, and offers valuable insights to improve emergency procedures.

Key elements of an AED incident report form template

An AED incident report form template includes several crucial elements to ensure comprehensive documentation of any AED-related event. Understanding these components helps you optimize your reporting process and maintain accurate records.

  1. Incident details: This section captures the date, time, and location of the incident. Recording these details is essential for tracking and analyzing patterns over time.
  2. Patient information: Include fields for the patient’s age, gender, and medical history if known. This information helps medical professionals understand the context and potential underlying conditions.
  3. Event description: Provide a detailed account of what happened, including the sequence of events leading up to the incident and the actions taken during the emergency. This narrative helps identify areas for improvement in emergency response.
  4. Device status: Document the AED’s status before, during, and after the incident, including battery life, electrode pad condition, and any error messages. This ensures the device was functioning correctly and helps identify any technical issues.
  5. Outcome and follow-up: Record the outcome of the incident, such as the patient’s condition after AED use, and any follow-up actions taken. This section helps evaluate the effectiveness of the response and informs future training.

Tips for using an AED incident report form template

To get the most out of your AED incident report form template, follow these best practices. Implementing these tips ensures accurate and effective documentation.

First, be thorough and detailed. Ensure all sections of the form are completed with as much detail as possible. Accurate and comprehensive documentation helps in evaluating the incident and improving future responses.

Second, train your team. Make sure all team members are familiar with the template and understand the importance of each section. Regular training sessions can also help maintain consistency and accuracy in reporting.

Third, review and update the template regularly. Periodically review the template to ensure it meets your needs and incorporates any new regulatory requirements or best practices. Updating the template keeps it relevant and effective.

Lastly, use the data collected. Analyze the collected data to identify patterns or recurring issues. This information can help you improve your emergency response protocols and training programs.

By following these tips, you can optimize the use of your AED incident report form template, ensuring comprehensive documentation and continuous improvement in your emergency response efforts.

Related categories

  • Health and safety management templates
  • Risk management and compliance templates
  • Health care templates
  • Emergency preparedness templates
  • Maintenance templates
Preview of the template
Incident Details
Date and Time of Incident
Location of Incident
Name of Person Using the AED
Patient Condition
Was the Patient Conscious?
Was the Patient Breathing?
What was the Patient's Pulse?
What was the Patient's Skin Color?
AED Performance
Was the AED Turned On?
Did the AED Deliver a Shock?
Did the AED Prompt for CPR?

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

How to write an incident report: Your complete guideISO 13485: A guide to quality management in medical devicesA beginner's guide to MDSAP auditsLaser safety: A complete guide to incident prevention
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Template collections

See comprehensive collections of best practice templates related to this topic.

Best 6 AED checklist templates for readiness4 free workplace incident report templates4 free MDSAP audit checklist templates 4 free ISO 13485 audit checklists for medical devices
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Use cases

Check out how the Lumiform software can be utilized for related use cases.

Incident report softwareSafety Incident Reporting SoftwareMaintenance softwareIncident management software
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Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

5 types of incident reportsHow to perform safety inspectionsHow to write a workplace safety policy5 ways workflow automation streamlines healthcare administration

Frequently asked questions

Why is documenting AED incidents important?

Documenting AED incidents is crucial for evaluating the effectiveness of the emergency response and identifying areas for improvement. Accurate records help ensure compliance with health and safety regulations and provide valuable insights for training and protocol enhancements, while improving patient outcomes.

How can I ensure accurate AED incident reporting?

To ensure accurate AED incident reporting, use a comprehensive template, train your team on its importance and proper use, and review the reports regularly. Regularly document thoroughly and conduct training sessions to maintain consistency and accuracy, while ensuring you capture all critical details.

What common mistakes should I avoid when documenting AED incidents?

Common mistakes include incomplete forms, lack of detail, and failure to update the template regularly. Complete all sections thoroughly, provide detailed information, and periodically review and also update the template to incorporate new best practices and regulatory requirements.

How can AED incident data improve emergency response?

Analyzing AED incident data helps identify patterns and recurring issues, allowing you to refine your emergency response protocols and training programs. By understanding what works and what doesn’t, you can make informed decisions that will also improve the effectiveness of your emergency response efforts.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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