AboutKidsHealth

 

 

Ventilator settings and alarmsVVentilator settings and alarmsVentilator settings and alarmsEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z

 

 

Ventilator settings and alarms2939.00000000000Ventilator settings and alarmsVentilator settings and alarmsVEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z<figure><img src="https://assets.aboutkidshealth.ca/akhassets/trach_vent_settings_EN.jpg" alt="Adjusting the settings on a ventilator machine" /><figcaption class="asset-image-caption">A person adjusting the settings on a ventilator.</figcaption> </figure> <h2>Ventilator settings</h2><p>Your child's doctor will prescribe your child's ventilator settings. If the doctor prescribes different settings at a later time, you or your child's healthcare team can adjust the ventilator accordingly.</p><p>Below are the settings that are common in the Trilogy Respironics 200. If your child uses another model of ventilator, please refer to its user manual.</p><h3>Inspiratory positive airway pressure (IPAP)</h3><p>The pre-set pressure to be achieved during inspiration. IPAP applies to S, S/T, T and PC modes only.</p><h3>Peak inspiratory pressure</h3><p>The amount of pressure it takes to fill the lungs when your child breathes in​</p><h3>Expiratory positive airway pressure (EPAP)</h3><p>The preset pressure to be achieved during expiration. EPAP applies to S, S/T, T and PC modes only.</p><h3>Positive end expiratory pressure (PEEP)</h3><p>The pre-set pressure to be delivered during inspiration and expiration to keep the air sacs in the lungs open.</p><h3>Breath rate<br></h3><p>The number of mandatory breaths to be delivered to your child in one minute</p><h3>Pressure support</h3><p>An optional setting that selects the target pressure for the patient’s spontaneous breaths. It helps the child take a larger breath than they might take on their own.</p><h3>Tidal volume</h3><p>The volume of air to be delivered during the volume controlled breaths</p><h3>Inspiratory time</h3><p>The length of time the breath is held in the inspiratory phase (breathing in) during volume-controlled or pressure-controlled mandatory breaths</p><h3>Trigger type: Auto-Trak or Flow Trigger<br></h3><ul><li>With Auto-Trak triggering, the ventilator is set to trigger breaths based on automatic flow thresholds. This improves synchrony between the machine and your child’s breathing. Auto-Trak is only available with passive circuits.</li><li>With a flow trigger, three other settings are used: leak compensation, flow cycle sensitivity and flow trigger sensitivity.</li><ul><li>Leak compensation: The ventilator will automatically compensate for any leaking.</li><li>Flow cycle sensitivity: Determines what percent reduction from peak flow is enough for the ventilator to cycle into exhalation. Adjusting this setting helps with synchrony and managing leaks.</li><li>Flow trigger sensitivity: Determines when the patient’s inspiratory effort (in litres per minute) is enough to trigger a breath to begin.</li></ul></ul><h3>Inspiratory flow rate</h3><p>How fast the air travels during one breath</p><h3>Sensitivity</h3><p>The amount of effort your child needs to make to trigger the ventilator to deliver a mandatory breath or assist them in taking a spontaneous breath</p><h3>Rise time</h3><p>The time it takes the ventilator to change from the expiratory pressure (EPAP) to the inspiratory pressure (IPAP)</p><p>It applies only for S, S/T, T and PC, SIMV and PC-SIMV modes.​</p><h3>Minute ventilation​</h3><p>The amount of air that is delivered to your child’s lungs over the previous minute (a calculation of tidal volume and respiratory rate)</p><h3>I:E ratio (inspiratory to expiratory ratio)</h3><p>The length of time it takes your child to breathe in compared to the time it takes them to breathe out</p><h3>Ramp length</h3><p>The length of time the ventilator takes to go from a starting pressure to the final pre-set pressures</p><h3>Ramp starting pressure</h3><p>The starting preset pressure when the ramp is set to “on”</p> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/trach_vent_alarms02_EN.jpg" alt="Alarms highlighted on the screen of a ventilator machine" /><figcaption class="asset-image-caption">Alarms highlighted on the screen of a ventilator machine</figcaption> </figure> <h2>Ventilator alarms</h2><p>Ventilator alarms are important because they alert you to changes in your child’s settings and measured parameters. The alarm is an important safety measure so that your or your child’s healthcare team can quickly fix any problems. </p><p>Most ventilators offer alarms that you can both see and hear. The following table outlines common alarms, their possible causes and how you can respond to them.</p><table class="akh-table"><thead><tr><th scope="col" style="width:104px;">Alarm​</th><th scope="col" style="width:377px;">Possible causes</th><th scope="col" style="width:211px;">What to do</th></tr></thead><tbody><tr><td> High pressure</td><td style="width:377px;"><ul><li> Kinks in the ventilator tubing</li></ul><ul><li>Mucus plugs or secretions</li><li>Coughing swallowing or hiccupping</li></ul><ul><li>Too much water in the ventilator tubing</li></ul><ul><li>Changes in respiratory status</li></ul><ul><li>Incorrect alarm settings</li></ul><ul><li>Child is fighting the ventilator (for example if they are anxious)</li></ul><ul><li>Exhalation valve not functioning</li></ul></td><td><ul><li>Straighten the ventilator tubing if it is kinked.</li></ul><ul><li>Suction your child to remove secretions.</li></ul><ul><li>Empty water from the ventilator tubing.</li></ul><ul><li>Contact your doctor or the hospital.​</li></ul><ul><li>Correct the alarm settings.</li></ul><ul><li>Encourage your child to let the ventilator breathe for them.</li></ul><ul><li>Check the exhalation valve.</li></ul></td></tr><tr><td> Low pressure</td><td style="width:377px;"><ul><li>Leaks in the ventilator circuit (for example holes in tubing or leaks in the exhalation valve, humidifier or pressure lines)​​​</li></ul><ul><li>Water in the pressure link</li></ul><ul><li>Ventilator circuit has become disconnected from child's tracheostomy or there is a leak around the tracheostomy.​</li></ul><ul><li>Incorrect alarm settings</li></ul><ul><li>Change in child's medical status​</li></ul><ul><li>Incorrect circuit assembly</li></ul></td><td style="width:211px;"><ul><li>Check for leaks.</li></ul><ul><li>Drain the water.</li></ul><ul><li>Reconnect your child's tracheostomy to the ventilator.​</li></ul><ul><li>Correct the alarm settings.​​</li></ul><ul><li>Contact your doctor or the hospital.​​</li></ul><ul><li>Check and test the circuit assembly.</li></ul></td></tr><tr><td>Low minute volume</td><td style="width:377px;"><ul><li>Leaks in the ventilator circuit.​</li></ul><ul><li>The ventilator circuit has become disconnected from child's tracheostomy or there is a leak around the tracheostomy.​​​</li></ul><ul><li>Incorrect alarm settings​</li></ul><ul><li>Change in child's medical status</li></ul></td><td><ul><li>Check for leaks.</li></ul><ul><li>Reconnect child to ventilator.</li><li>Examine exhalation valve.</li></ul><ul><li>Correct the alarm setting.​​</li></ul><ul><li>Evaluate your child. </li><li>Contact your doctor or the hospital.</li></ul></td></tr><tr><td> Power switch over (audiovisual alarm)</td><td style="width:377px;"><ul><li>Power source has changed from AC to an internal or external power source (such as a battery), due to a power outage.</li></ul></td><td><ul><li>Make sure the ventilator is plugged into an AC power outlet.</li><li>Make sure the external batter is prepared, in case there is a long-term power outage.</li></ul></td></tr><tr><td>Low power</td><td style="width:377px;"><ul><li>Internal battery is used up.</li></ul></td><td><ul><li>Plug the ventilator into an AC power outlet.</li></ul></td></tr><tr><td>Ventilator failure</td><td style="width:377px;"><ul><li>Ventilator has malfunctioned.<br></li></ul></td><td><ul><li>Switch your child over to the back-up ventilator and call the Ventilator Equipment Pool for help to replace the ventilator.</li></ul></td></tr></tbody></table><h2>Alarms available on the Trilogy Respironics ventilator</h2><p>Below are the alarms that are available on the Trilogy Respironics ventilator. Those on the left are set by the machine. Those on the right will be set by your long-term ventilation team. </p><p>Note that not all alarms are available in every mode of ventilation. </p><table class="akh-table" border="1" style="width:100%;"><thead><tr><th scope="col" style="width:442px;">Automatically set alarms (machine control)</th><th scope="col">User-set alarms</th></tr></thead><tbody><tr><td style="width:442px;"><ul><li>High/low expiratory pressure<br></li><li>High internal oxygen</li><li>Check circuit</li><li>Low circuit leak</li><li>Power alarms (low battery, replace detachable battery, AC power disconnect, battery discharging stopped due to extreme temperatures, check external battery, battery depleted, battery not charging, external battery disconnected, detachable battery disconnected, ventilator is running on battery)</li><li>Card error</li><li>High temperature alarm</li><li>Keypad stuck</li><li>Ventilator inoperative</li><li>Ventilator service required</li><li>Loss of power</li></ul></td><td><ul><li>Circuit disconnect</li><li>Apnea</li><li>Apnea rate</li><li>High/low respiratory pressure</li><li>High/low respiratory rate</li><li>High/low minute ventilation</li><li>High Vte/low Vte</li><li>High Vti/low Vti</li></ul></td></tr></tbody></table><h2>How to access the settings and alarms menu</h2><p>From the main screen, use the up/down button to highlight the settings and alarms menus. Press the right arrow button to select a menu. Here you will be able to confirm all your child’s settings and alarms. These are only to be changed by your doctor. Changing settings without a doctor’s prescription can be harmful to your child.</p><p></p> <a class="btn btn-primary" href="https://www.aboutkidshealth.ca/trachvent">Return to trach-vent learning hub</a><br>Ventilator settings and alarmsTruehttps://www.aboutkidshealth.ca/Article?contentid=2940&language=Englishhttps://www.aboutkidshealth.ca/Article?contentid=2938&language=English

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.