Do you know how to deal with the ventilator alarm?
Principles for releasing the ventilator alarm: The ventilator alarm must be taken seriously and immediately lifted! Otherwise, serious medical accidents such as suffocation and death of patients may occur. During the use of the home ventilator, a caregiver must be present for monitoring when the home ventilator is used. There should be necessary monitoring equipment, such as x-ray machine, oxygen meter, manometer, blood gas analysis, etc. Certain risks, when an alarm occurs, it is not only to simply eliminate the alarm signal, but more importantly, to correctly handle the cause of the alarm. Common causes of home ventilator alarms include ventilation, pressure, power, oxygen concentration, and suffocation alarms. The processing steps are roughly the same.
1. The patient triggers the upper limit of ventilation alarm: it is more common in patients with strong spontaneous breathing. When using imv, psv, simv, cpap, etc., due to the increase of spontaneous breathing frequency and the increase of breathing depth, Increase the patient’s spontaneous ventilation, trigger the ventilation alarm, such as high fever, pain, irritability or other stimuli, the patient can breathe faster. At this time, symptomatic treatment is mainly given, such as necessary cooling, pain relief, sedation, etc. Improper setting of the ventilator will trigger the high limit alarm; the upper limit of the ventilation volume alarm is set too low; at this time, the patient has no discomfort, and the alarm upper limit should be set again; if the tv or mv setting is too large, the ventilation conditions should be re-checked; trigger the sensitive setting Improper, reset; when using sigh, there is no need to deal with the short-term alarm; the mv measurement table shows an error, and the ventilation scale should be used for correction at this time.
2. Ventilation alarm: the patient’s reason triggers the lower limit of ventilation alarm: the patient has poor spontaneous breathing ability. Insufficient breathing of the patient due to reasons such as low tidal volume and low tidal volume, which reduces the minute ventilation and triggers an alarm. At this time, the frequency or pressure or tidal volume of controlled ventilation should be appropriately increased on the basis of the original ventilation method. Some patients should change to controlled ventilation if their spontaneous breathing is too weak; obvious. Obstruction should be removed in time, and secretions should be sucked out: if it is blocked by viscous sputum, it should be fully humidified, and the sputum should be discharged regularly to ensure the airway is unobstructed; if it is caused by tracheal spasm, the constant pressure can be changed to constant volume, and Active drug treatment can be given to relieve bronchospasm, and appropriate ventilation pressure can also be increased on the basis of the original volume to ensure adequate ventilation.
The ventilator or catheter facility triggers the ventilation low limit alarm:
1. Excessive dead space: Additional ventilator tubing is added under the condition that the mechanical ventilation conditions have not changed, or There is too little liquid in the humidification bottle, etc. The extra dead space should be minimized, the tracheal tube that is too long outside the nasal cavity should be removed (2-3 cm should be reserved for small babies), the tube fixed by the ventilator itself should be used, the extension tube should be removed, and the liquid level of the humidification bottle should be checked frequently.
2. Air leakage: including air leakage caused by too thin tracheal tube or cannula, looseness between the connecting pipes of the ventilator, rupture of the connecting pipe, insufficient sealing of the humidification bottle and air leakage inside the ventilator . The pipeline should be connected tightly, and the pipeline should be replaced if it is broken or not tight; if the cannula or cannula is slightly thin and leaks from the cannula, the tidal volume and inspiratory pressure can be appropriately increased; if it is too thin, the cannula should be replaced or replaced. Casing; tubing should be replaced even with minor leaks when applying cpap or peep.
3. Disconnection: It is a common and serious complication of mechanical ventilation. It can be divided into three types according to the location of disconnection: First, it is located in the lower part of the pharynx: it is manifested by the sound of air leakage during aspirating. , the position of the prolapse can be seen directly with a laryngoscope. The other is in the esophagus: the symptoms are abdominal distention, breath sounds in the stomach, and no aerosol formation in the intubation during exhalation. The third is to come out of the mouth. Disconnection has been established and the trachea should be reintubated immediately. In addition, low air source pressure and insufficient mechanical working pressure can also cause a low limit alarm for ventilation. The air source should be replaced and the working pressure adjusted.
4. The amount of ventilation given is small: if the set tv is small or the pressure is insufficient or the frequency is slow; in the ventilator with constant pressure and continuous airflow, the small flow rate and short breathing time can cause every minute Low ventilation (mv) triggers an alarm. Ventilation conditions should be re-checked to increase tv, pressure or frequency, flow or inspiratory time, etc.
5. The lower limit alarm device is too high and the ventilation scale display is inaccurate: the patient is well ventilated at this time, and there is no manifestation of hypoventilation. The alarm limits should be reset, or the mv should be recalibrated with a tidal gauge.
Do you know how to handle the ventilator alarm? In the clinical application of home ventilators, due to patient or mechanical reasons, sound or light alarms are often heard or seen. These signals are to remind the personnel present that the patient or machine must be checked and treated. This can lead to aggravation of the patient’s dyspnea, worsening of the condition, and even death of the patient. Therefore, correctly handling the alarm of the home ventilator is an indispensable link in the use of the home ventilator.
