Pump Check Form

Pump Check Form

Open Heart Surgery

A form used to track the maintenance of the Sigmamotor pump used to pump blood during open heart surgery.

C. Walton Lillehei

"Pump Check Forms, 1956-1965," Box 97, C. Walton Lillehei papers, uarc2000-7, University of Minnesota Archives

University of Minnesota

19-Dec-56

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Document

eng

oh0231

Open Heart Surgery

file
Dr. C. Lillehei
Assoc. Prof. Surgery
Mayo C504 - Ext. 2508

| | Jan. | Feb. | March | April |
| Pump Number | | | | |
| Electrical Cord & Plug | | | | |
| Motor Attachment | | | | |
| Switch | | | | |
| Oil Levels, Motor | | | | |
| Revco | | | | |
| Gear Boxes | | | | |
| Pumps | | | | |
| Couplings, Tighten Bolts | | | | |
| Check for Wear | | | | |
| Tighten Mounting Bolts | | | | |
| Grease Motor Every 6 Mos.| | | | |
| Change Couplings & Electrical | | | | |
| Cord Every 6 Mos. | | | | |

| | May | June | July | Aug. |
| Electrical Cord & Plug | | | | |
| Motor Attachment | | | | |
| Switch | | | | |
| Oil Levels, Motor | | | | |
| Revco | | | | |
| Gear Boxes | | | | |
| Pumps | | | | |
| Couplings, Tighten Bolts | | | | |
| Check for Wear | | | | |
| Tighten Mounting Bolts | | | | |
| Grease Motor Every 6 Mos.| | | | |
| Change Couplings & Electrical | | | | |
| Cord Every 6 Mos. | | | | |

| | Sept.| Oct. | Nov. | Dec. 19, 1956 |
| | | | | 1 2 3 4 5 |
| Electrical Cord & Plug | | | | v v v v v |
| Motor Attachment | | | | v v v v v |
| Switch | | | | v v v v v |
| Oil Levels, Motor | | | | v v v v v |
| Revco | | | | v v v v v |
| Gear Boxes | | | | v v v v v |
| Pumps | | | | v v v v v |
| Couplings, Tighten Bolts | | | | v v v v v |
| Check for Wear | | | | v v v v v |
| Tighten Mounting Bolts | | | | v v v v v |
| Grease Motor Every 6 Mos.| | | | v v v v v |
| Change Couplings & Electrical | | | | |
| Cord Every 6 Mos. | | | | |

checked by
M. Huff
A. Berglund

[Handwritten notes on bottom margins: "double space", "PICA TYPE", "TO EXTEND", "Form #62", "TRY TO LEAVE REMAINING EMPTY", "craz/vill"]

Paper