Checklist for managing ventilator alarms.

1. 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

2. 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

3. 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

4. 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