Figure 2-2. Completed DA Label 175.
c. Required Equipment. In addition to a blank form and ink pen, you will need
a defibrillator and a defibrillator tester to complete this task.
(1) Preparer. DA Label 175 is normally prepared by the person performing
the output certification.
(2) Indicated energy or control setting. Enter the energy level selected on
the defibrillator control setting.
(3) Energy delivered to a 50-ohm load. Measure and record the delivered-
energy levels in joules (watt-seconds) adjacent to the corresponding control setting in
paragraph (2) above.
(4) Other output levels. Repeat steps (2) and (3) for all output levels
indicated on the defibrillator control.
Dates. Enter the date of certification and the expiration date.
Inspector. Legibly record the name of the person performing the output