Ventilator Alarms

Question 1

High pressure

Answer 1

• Inspiratory pressure has exceeded set pressure limit

PATIENT: reduced compliance (consolidation, lung collapse, coughing, gas-trapping, asynchrony

VENTILATOR: incorrect settings, kinked circuit

Question 2

Low pressure

Answer 2

PATIENT: ETT cuff leak, cuff not inflated enough, chest tube

VENTILATOR: loose fittings, disconnected circuit, faulty flow sensory, incorrect settings

Question 3

High minute volume

Answer 3

PATIENT: hyperventilation (pain / acid base disturbance), asynchrony

VENTILATOR: RR and tidal volume set too high

Question 4

Low minute volume

Answer 4

PATIENT: pressure controlled mode has inadequate RR/ Pinsp, decreased lung compliance, fatigue

VENTILATOR: disconnection, air leak, insufficient flow

Question 5

How do you trouble shoot decreasing SpO2?

Answer 5

• Check patient and quality of trace
• Ensure probe adequate attached
• Check bilat chest expansation
• Auscultate chest
• Check tube position @ lips
• Consider suctioning
• Increase FiO2
• Consider PEEP, increase TV
• Retake ABG/VBG

Question 6

How do you trouble shoot ETCO2 derangements

Answer 6

• HIGH ETCO2
  –> Increase resp rate/tidal volume
• LOW ETCO2
  –> decrease resp rate/tidal volume

Question 7

What is the mnemonic for a crashing patient

Answer 7

1. Identify the problem (DOPES)
   - Displaced ET tube / cuff not inflated
   -Obstruction of ET tube
   - PTx
   - Equipment malfunction
   - Stacking
2. Fix problem (DOTTS)
   - Disconnect patient from venilator
   - Oxygenate with BVM - feel for resistance
   - Tube position/function- ETT migration/kinking/plugging
   - Tweak vent - check settings
   - Sonogram - look for PTx or mainstem intubation