Ventilator circuits: Tests and cleaning

To make sure your child’s ventilator is running smoothly, you will need to test it regularly and follow a set maintenance routine.

Ventilator checkout tests

You will need to test your child’s ventilator:

• if you have not used the ventilator for seven days
• after attaching a new breathing circuit​ and before connecting the ventilator to your child.

Your child’s long-term ventilation team will prescribe the tests and teach you exactly how to do them. Use whichever circuit (active or passive) that you will use when the child is connected to the ventilator.

If any of the tests fail, place your child on the back-up ventilator. Then:

• check the circuit set-up again
• check that all connections are tight
• if you are using an active flow circuit, make sure there is no water in the flow sensing or pressure lines
• remove and replace one piece of the circuit at a time, making sure to tighten each one.

Cleaning ventilator parts

Daily

Wipe down the outside of the tubing circuit, ventilator and humidifier.

Weekly

Change and clean the ventilator circuit to help prevent infection.

Your cleaning supplies will need to include:

• mild dishwashing soap
• white vinegar
• pail #1 with warm soapy water
• pail #2 with a solution of one part vinegar and three parts water
• clean towel
• storage bag
• water
• syringe.

Cleaning the circuit

1. Take apart all tubing and connectors.
2. Carefully immerse tubing, connectors, exhalation valve, pressure-sensing lines, exhalation tubing and humidifier canister into pail #1 solution. Use a syringe to force out any water that has collected inside the pressure-sensing lines and exhalation tubing. Do not put any wires or probes into liquid.
3. Wash all the tubing and connectors well.
4. Rinse the contents from pail #1 in tap water to remove all soapy residue.
5. Transfer all the contents into pail #2. Submerge all of the equipment in the solution for 30 minutes. Make sure everything is filled with the solution during the soak.
6. Rinse all the contents from pail #2 with tap water. Shake off as much excess water as possible.
7. Place all of the equipment on a clean towel to dry or hang to dry.
8. Reassemble tubing as required, visually inspecting it for cracks or tears.
9. When the clean, dry circuit is not in use, keep it in a clean bag or storage container.

Routine for cleaning and replacing ventilator circuit parts

Make sure you have spare supplies on hand for all the items outlined in the table above.

Troubleshooting circuit problems

What do I do if I have too much water in the ventilator circuit?

• Check if the water canister is overfilled.
• Make sure that the room temperature is not too cold (for example, if the air conditioning is set too high) or too hot (for example, if there is an additional heater in the room).
• Check the heater setting of the humidifier and make sure it is not set too high or reading too high.
• Ask your long-term ventilation (LTV) team to check the Humidity Compensation (HC) mode on your MR850 humidifier.
• Check if there are any leaks in the ventilator circuit. If there are, fix them (for example, replace any torn tubing).

How do I empty excess water from the circuit safely?

• Disconnect your child from the ventilator briefly. If your child cannot be off ventilator support for even a short time, have a caregiver use the manual resuscitation bag to manually ventilate your child while you empty the water. Alternatively, you can replace the tubing with new tubing and then empty the water from the old tubing.
• Empty the water into a garbage can, a separate water-collection container or a toilet.
• Never empty the water back into the humidifier canister. That is an infection risk.
• ​If the problem persists, use a water trap.