2. Precautions that would reduce
troubles
I. Power:
Plug into a grounded AC power with
correct voltage receptacle.
Secure the power cord properly.
Battery Back up:
Check the battery level before connecting.
Charging should be carried out regularly.
Remember it is for short term use.
3. II. Gas Source
Preferable to have centralised supply.
If cylinders used, should be full
Spare cylinders should be available
4. III. Personnel
Properly trained personnel should only use.
Familiarizing staff with operator’s manual before using on
a patient.
(One manufacturer’s manual may not exactly match with
other brands).
Appropriate monitoring the functioning state of the
ventilator while in use. Familiarizing staff with alarm
system.
Do not place ventilators in a combustible or explosive
environment.
5. IV. Servicing and Testing
Qualified personnel should undertake servicing.
Follow specifications mentioned in service
manual
General servicing at regular intervals
Run prescribed tests and calibrations before using
ventilator on a patient.
Ensure that ventilators pass all the tests before
putting them in to clinical use.
7. • VC mode – High Pressure alarm
• PC mode – Low TV alarm
• PSV/CPAP – Apnea alarm
ALARMS
8. Points to remember
Never ignore an alarm.
Find out for yourself what alarm is on.
Check the patient.
Silence the alarm.
Never mute the alarm on regular
basis.
9. Do not be like this !
But hear the alarm and respond
See the problem and
Ask if you do not know what to do
10. Troubleshooting
• Is it working ?
– Look at the patient !!
– Listen to the patient !!
– Pulse Ox, ABG, EtCO2
– Chest X ray
– Look at the vent (PIP; expired TV; alarms)
11. CASE
• 18 yr old man intubated for
organophosphorus poisoning and
intermediate syndrome was stable for 3 days
• He suddenly devlops distress.You notice that
his resp rate is 35/min, heart rate is 120/min,
BP is 90/70mmHg.
• What would you do?
12. Troubleshooting
• When in doubt, DISCONNECT THE PATIENT
FROM THE VENT, and begin bag ventilation.
• Ensure you are bagging with 100% O2.
• This eliminates the vent circuit as the source
of the problem.
• Bagging by hand can also help you gauge
patient’s compliance
13.
14.
15. ALARMS
• LOW PRESSURE / LOW TIDAL VOLUME
• HIGH PRESSURE
• APNEA
• HIGH TIDAL VOLUME
16. • Pt is on VCV mode of ventilation, post op after
lap choleycystectomy. Suddenly you heard a high
peak pressure alarm. What will you do?
Ask sister to silence the alarm
Go yourself and silence the alarm
Change peak pressure alarm setting
Keep let it be ring
Sedate the pt
Give vecuronium
17. • Pt is on VCV mode of ventilation, post op after
lap choleycystectomy. Suddenly you heard a high
peak pressure alarm. What will you do?
Ask sister to silence the alarm
Go yourself and silence the alarm
Change peak pressure alarm setting
Keep let it be ring
Sedate the pt
Give vecuronium
19. Solution
Evaluate cuff pressure at regular intervals
Reinflate if leak
Ruptured is noticed change ET tube
Check circuit, junctions tighten or replace
Check water traps
Check ET tube placement Position it properly
Reconnect ventilator
Patient may require higher flow.
20. High Pressure Alarm
The measured peak inspiratory pressure is
great than set level because of Increased
airway resistance or decreased compliance
21. • If your Pplat is high, you are faced with a
COMPLIANCE problem
• If your Pplat is N, you are faced with a
RESISTIVE problem
• DD?
27. Solution
Suctioning, Irrigation
Release tubing
Bite block insertion
Empty the tubings and water traps
Reposition ET tube
Reposition patient
Re assurance
Sedation & medication (pain)
28. • Pain
• Anxiety
• Metabolic acidosis
• Hypoxia
• Neurogenic hyperventilation
• Excessive trigger
• Water in tubing
High MV alarm
29. Solution
Check the patient Arouse if needed
Activate back up facility if it was not
done already.
Consider switching over to any
mandatory mode
Set trigger level appropriately
30. Apnoea
No breath was delivered for the operator set
apnoea time in spont, SIMV, AC, CMV & NIV
modes
patient effort is too minimal
Trigger level set improperly.