Free · Unbranded · Compliance & logs
A one-month checklist that sits on the anesthesia machine. Ten checks down the side, every day of the month across the top, so the morning machine check takes two minutes and anyone can see it was done.
Unbranded: no logo or linksNo account neededPrint at 100% on US LetterUpdated
What’s on the form
Machine and location, vaporizer agent, the month, and the date of the last service.
Ten checks from oxygen supply to scavenging, with a box for every day of the month.
Who checked the machine each day.
What was wrong, what was done, and whether the machine was taken out of use.
Fill in online
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Using it well
Run the check every morning before the first anesthetic, and again if the machine is moved or the circuit is changed.
A closed APL valve after the leak test is a known cause of dangerous pressure in the patient’s lungs. It is on the list for a reason.
If a check fails, put a “do not use” tag on the machine and write it below until it is fixed.
Printing, editing, and what the form does and doesn’t cover.
A common method is to close the APL (pop-off) valve, occlude the patient end of the circuit, fill it with oxygen to about 30 cm H2O on the manometer, turn off the flow, and check the pressure holds. Then open the APL valve. Follow your machine manufacturer’s procedure.
When it is exhausted, shown by color change or by hours of use, and as recommended by the manufacturer. Color can revert when the machine sits, so record the date changed and the hours used.
A full check every morning, plus a quick circuit and leak check whenever the circuit is changed between patients.
No. Daily checks catch everyday problems. Vaporizers and machines still need servicing as recommended by the manufacturer.
2 pages, US Letter, landscape
A landscape anesthesia record built the way monitoring actually happens: pre-anesthetic checks and every drug on page one, then a 5-minute vitals grid, the procedure timeline, and recovery on page two.
1 page, US Letter, landscape
One place to track the clinic’s equipment: what you have, its serial number, how often it needs servicing, and a history of every service, calibration, and repair. Useful for budgeting, warranty claims, and inspections.
2 pages, US Letter, portrait
An admission consent form for anesthesia and surgery. It captures the procedure and estimate, fasting and medications, the client’s decisions on bloodwork, fluids and resuscitation, and what to do if something unexpected is found.
A starting point, not legal or clinical advice. VetStack’s forms are general templates. Requirements for medical records, consent, and controlled substances vary by state and practice, so review the wording with your practice’s attorney and check your state veterinary board’s rules before adopting a form as standard.