When troubleshooting alarms, start with the silence button. Wait another breath or two and look at the bigger picture. Look at your patient, vitals, EtCO2, and ensure the patient is getting breaths. Then try to resolve the alarm.
Have a systematic approach to use every time. I like to start with the lungs and then work my way up the airway, up the ET tube, and then down the circuit to the vent. Use what works for you.
High airway pressure (set 10-15 cmH2O above PIP): Causes include poor lung compliance, bronchospasm, tension pneumothorax, mainstem intubation, poor sedation (over-breathing), tube biting, coughing, mucous plugs, secretions, poor positioning, tubing kinks, or filter issue.
Low peak pressure (set 5-10 cmH2O below PIP): Causes include simple pneumothorax, esophageal intubation, cuff leak, tube migration upward, poor sedation (over-breathing), or loos or disconnected circuit. Never set to 0.
Low/High PEEP: Indicates low or high peep measurements. Defaults to 3 and 11 cmH2O, respectively. To change these alarms, hold down “Select” -> “Alarm Config” -> “Low PEEP” or “High PEEP”
Low exhaled minute volume (Low Min Vol): Defaults to 3 L. Occurs when the exhaled minute volume (VE) is less than the set alarm limit. Patient may not have enough time to exhale. May need to adjust rate or I-time.
Volume limited: Occurs only with PRVC breath type. PRVC delivers target tidal volume with variable pressure. If the pressure of the breath is within 5 cmH2O of the High Pressure Alarm setting, the full breath will not be delivered and the vent will alarm. Increase high pressure alarm slightly or decrease VT if appropriate to resolve.
Apnea: Occurs when the time since the start of the last breath is greater than the set apnea interval. (Patient isn’t getting breaths).
Low O2 pressure: Disconnect in the O2 line. Check O2 supply and tubing. Set FiO2 to 21% if O2 is not needed
Patient Circuit: Issue with the vent circuit. Check all connections to the vent and patient.