Caused by power interruption (such as blown fuse, power cord falling off, power failure, etc.), power failure outside the ventilator is easy to find and can be dealt with in time. If it is a circuit failure inside the ventilator, it should be repaired by specialized maintenance personnel But at this time, it should be noted that when the above failure occurs, the patient should be removed from the ventilator first, and then the mechanical maintenance should be carried out.
At this time, symptomatic treatment is mainly given, such as necessary cooling, pain relief, sedation, etc. The patient coughs, pain, hypoxia, secretion obstruction or high temperature of inhaled gas and other stimuli cause discomfort. When agitated, spontaneous breathing and mechanical breathing resist, which can trigger a high-pressure alarm.
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 air 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 casing; when applying CPAP or PEEP, the pipe should be replaced even with a small leak. Therefore, accurately handling the ventilator alarm is an indispensable link in the use of the ventilator.
The air source should be replaced and the working pressure adjusted. The premise of ventilation should be re-checked to increase TV, pressure or frequency, flow or inspiratory time, etc.
Aspirating secretions: If the viscous sputum is blocked, 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 is given, relieve bronchospasm, or increase the appropriate ventilation pressure on the basis of the original volume to ensure adequate ventilation. The treatment is the same as the low ventilation limit alarm for this reason. The patient's airway is obstructed, especially during constant pressure ventilation.
In short, among the above-mentioned alarm reasons, mechanical accidents account for more than 50%, and the factors originating from patients are the most and the most important.
It should be removed from the ventilator immediately, and the balloon should be given oxygen;
The high pressure alarm setting is too low: the patient is often asymptomatic, and the alarm limit needs to be reset;
The ventilator or catheter setting triggers a low-pressure alarm: there are mainly differences in the type of intubation, rupture of the catheter or loose connection resulting in air leakage, accounting for about 1/3 of tracheal complications.
The extra dead space should be minimized, the tracheal tube that is too long outside the nasal cavity should be removed (2~3cm should be reserved for small infants), 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. If the oxygen source is insufficient and the oxygen pressure cannot reach the driving pressure, if the oxygen is exhausted, the working pressure is too low, etc., the pressure should be adjusted or the gas source should be replaced in time.
The low limit alarm device is too high and the ventilation scale display is incorrect: the patient is well ventilated at this time, and there is no manifestation of hypoventilation.
Measures such as ventilator or catheter trigger high-pressure alarm: the intubation is too deep, and the main bronchus is entered on one side (common to enter the right side), and the intubation should be readjusted according to the depth indicated by the chest X-ray.
Water in the catheter or obstruction of secretions: The water in the catheter does not flow back to the patient's respiratory tract and may be asymptomatic.