Mechanical Ventilation Troubleshooting

A TROUBLESHOOTING GUIDE
ON MECHANICAL
VENTILATOR
The following are the alarm codes, cause of alarms and the possible
solutions for Adult mechanical ventilator troubleshooting:
Alarm Code Cause of Alarm Solution/s
High Pressure Patient coughing, Check the high pressure limit setting;
secretions, water or suction the patient; drain the water in
Limit kink in the tubings, the tubings; check the tubings for
mucus plugging in the possible kinking; clea the inner
tracheal tube, cannula of the tracheal tube.
obstruction
Low Pressure Leak Check the patient connection; check

the low pressure limit setting; check
Limit the pilot balloon if deflated, inflate
with 10ml of air, check the tubings if
properly connected
Low Leak Check the patient connection; check

the low insp. pressure limit setting;
Inspiratory check the pilot balloon if deflated,
Pressure inflate with 10ml of air; check the
tubings if properly connected
Low PEEP / Leak Check the patient connection; check
the low PEEP/CPAP pressure limit
CPAP setting; check the pilot balloon if
Pressure deflated, inflate with 10ml of air,
check the tubings if properly
connected
Low Exhaled Leak Check the patient connection; check
the low exhaled tidal volume limit
VT setting; check the pilot balloon if
deflated, inflate with 10ml of air,
connected
Low Exhaled Leak Check the patient connection; check
the low exhaled minute volume
Minute setting; check the pilot balloon if
Volume deflated, inflate with 10ml of air,
connected
High Tachypnea, Check respiration of the patient; if
tachypneic check for presence of
Respiratory Vent over secretions; suction the patient; check
Rate sensitive the high respiratory rate setting;
check the sensitivity setting, setting
should be 1-3cm H2O
Inverse I : E Check patient’s breathing pattern;

adjust flow, back-up rate or
I:E ratio; Leak sensitivity
Apnea Apnea parameter Check the patient’s breathing if

time setting negative manually ventilate the
patient; check the pulse and call the
reached, cessation ROD immediately; if the respiration
of breathing, leak is present, check the volume apnea
parameter setting and check the
tubing connections for possible leak.
Low pressure Empty O2 / Air Replace the tank immediately, if the

tank is still full and the alarm is still
O2 / Air inlet tank present, check the psi gauge; check
the compressor, if not working call
the attention of Eng’g Dept.
Exhalation Internal Manually ventilate patient and
replace ventilator immediately.
Valve Leak Malfunction
Alarms for neonatal and pediatric
mechanical ventilators are almost the
same with the adult, the following are
additional alarm codes, cause of alarms
and the solution/s for neonatal and
pediatric mechanical ventilator:
Obstructed Secretions, Drain the water in the tubings; check
the tubings for possible kinking;
tube water or kink check the level of ET Tube and
in the tubings adjust the ET Tube upward
Insufficient Wrong settins Set the Inspiratory time to .40 to .50
Expiratory in Inspiratory
Time Time
The following are the Endotracheal
Tube size according to age of a patient
Oral and Nasal Airway
Oral Airway
Nasal Airway
Oropharyngeal / Nasopharyngeal Airway
- Are usually made of plastic or rubber. As their name implies, they are inserted
through the mouth / nose, with the posterior tip resting in the patient’s
pharynx.
- Orophrayngeal Aw is placed over the tongue and shaped so that the
curvature of the Aw forces the patient’s tongue forward, away from the
posterior pharyngeal wall, the most common site of Aw obstruction.
Dimensions of Oral Airway
Portex Hudson
(Berman Type) (Guedel Type)
Age Size Length (mm) Size Length (mm)
Neonate 1 40 - -
Infant - - 0 55
Small Child 2 60 1 61
Child - - 2 71
Small Adult 3 80 3 81
Medium Adult 4 90 4 97
Adult 5 100 5 105
Large Adult 6 100 6 115
Endotracheal Tube
Endotracheal Tube
- Tracheal tube are constructed of metal, natural rubber, polyvinyl

chloride (PVC), and silastic materials (silicon rubber, nylon and teflon).
1) The key to selecting a tracheal tube is to pick a tube that will cause the
least tissue rxn, yet still maintain its shape and lumen as it warms to
body temperature.
2) Plastic and synthetic tubes are usually more flexible and retain their
shapes with repeated use.
3) Caution must be used to ensure that all tubes are marked “I.T./Z-79”
which means they have been implant-tested for use in human tissue and
conform to standards by the International Z-79 Committee for
Anesthesia tubes
Guide to Choice of Endotracheal Tube
French Size Internal Oral Length Nasal Suction
Diameter (cm) Length Catheter
(mm) (cm) (French)
< 1000 g 12 2.5 8 11 6
> 1000 g 14 3.0 9 12 6
6 months 16 3.5 10 14 8
1 yr 18-20 4.0-4.5 12 16 8
2 yr 22-24 5.0-5.5 14 17 8
2-4 yr 24-26 5.5-6.0 15 18 10
4-7 yr 26-28 6.0-6.5 16 19 10

French Size Internal Oral Length Nasal Suction
Diameter (cm) Length (cm) Catheter
(mm) (French)
7-10 yr 28-30 6.5-7.0 17 21 10
10-12 yr 30-31 7.0-7.5 20 23 10
12-16 yr 32-34 7.5-8.0 21 24 12
Adult (F) 34-36 8.0-8.5 22 25 12
Adult (M) 36-38 8.5-9.0 22 25 14
* Endotracheal tube sizes will vary with body size and height. One
size smaller and one size larger should be available for individual
variations. These data is intended as a guide only.
Endotracheal (ET) Tube size may be estimated for 1 to 12 y/o by:
Internal Diameter of
ET Tube (mm)
Age (year) + 16
=
4
Macintosh Blade
Miller Blade
Macintosh Blade with Handle
Proper intubation position
Proper position of tracheostomy tube
Laryngocsope Blades
Miller Macintosh
Age Size Length (mm) Size Length (mm)
Premature 0 75 - -
Infant
Infant 1 102 1 91
Child 2 150 2 100
Adult 3 190 3 130
Large Adult - - 4 190
Thank you!

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A TROUBLESHOOTING GUIDE

Low Pressure Leak Check the patient connection; check

Low Leak Check the patient connection; check

Inverse I : E Check patient’s breathing pattern;

Apnea Apnea parameter Check the patient’s breathing if

Low pressure Empty O2 / Air Replace the tank immediately, if the

Insufficient Wrong settins Set the Inspiratory time to .40 to .50

Age Size Length (mm) Size Length (mm)

- Tracheal tube are constructed of metal, natural rubber, polyvinyl

> 1000 g 14 3.0 9 12 6

2-4 yr 24-26 5.5-6.0 15 18 10

4-7 yr 26-28 6.0-6.5 16 19 10

Age Size Length (mm) Size Length (mm)

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