Ventilator Alarm Checklist Paw High

(High airway pressures)

Tube in R main bronchus Bronchospasm Mucous plugs Pneumothorax Air-trapping Pt cough/biting/gagging on

ETT Patient-ventilator

dyssynchrony Pmax set too low PEEP set too high

Paw Low

(Low airway pressures)

ETT Cuff deflation

Oesophageal intubation

TV set too low

Chest wounds/drains allowing air to escape

Disconnection in ventilator circuit

Developed by Kane Guthrie, July 2013

Ventilator Alarm Checklist MV High

(Minute volume high)

Pt initiating own spontaneous breaths – give more sedation/paralysis

Tidal volume too high

Minute volume alarm set too low

MV Low

(Minute volume low)

ETT cuff deflation air leak

Leakage at ETCo2 connection

Tidal volume set too low

Chest wounds allowing air to escape

Developed by Kane Guthrie, July 2013

Ventilator Alarm Checklist

Decreasing Spo2 Check patient & quality of

trace Ensure probe adequately

attached Check bilateral chest

expansion Auscultate chest Check tube position @ lips Consider suctioning Fio2% Consider PEEP, Tidal Volume Retake ABG/VBG

ETCO2

High ETCO2 (>45mmHg)

• Acidotic retaining Co2

Set Resp Rate

Tidal volume

Low ETCO2 (<35mmHg)

• Alkalotic blowing of Co2

Set resp rate

Tidal volmue

Developed by Kane Guthrie, July 2013

Crashing Ventilatored Patient Checklist

Step 1 (D.O.P.E.S.)

Indentify problem:

Displaced ET tube/cuff not inflated.

Obstruction of ET tube

Pneumothorax

Equipment malfunction

Stacking (Breath stacking/auto peep)

Step 2 (D.O.T.T.S)

Fix Problem:

Disconnect pt from ventilator

Oxygen – Oxygenate patient with BVM – feel for resistance

Tube position/function – ETT migration/kinking/plugging

Tweak the vent- check settings

Sonogram- look for pneumothorax, mainstem intubation

Developed by Kane Guthrie, July 2013