it's inevitable that while working with a mechanical ventilator you will eventually
experience a problem this is when ventilator troubleshooting comes in handy by knowing the
most common problems that can occur and how to troubleshoot them you can ensure that your
patient is receiving the ventilatory support that they need in this video we will discuss some of
the most common problems that occur during mechanical ventilation and how to promptly
solve them so if you're ready let's get into it as previously mentioned ventilator troubleshooting is
the process of identifying and solving a problem that occurs in the patient ventilator connection
this is important because when a problem occurs it can cause the patient to experience discomfort or
even put their life at risk the goal of ventilator troubleshooting is to quickly identify the problem
and then take the necessary steps to solve it this process requires extensive knowledge and
understanding of the principles of mechanical ventilation in a perfect world the delivery of
mechanical ventilatory support would be Flawless and we would never experience any problems
however of course this is not the case there are various problems that can occur during mechanical
ventilation including the following the first that I should mention is respiratory distress
when a patient on the ventilator experiences a problem one of the first signs you'll see is
respiratory distress this includes signs and symptoms such as tachypnea tachycardia nasal
flaring diaphoresis paradoxical thoracic movement arrhythmias dyspnea on exertion accessory muscle
usage and purse slip breathing when you notice one or more of these symptoms especially when
accompanied by the sounding of a ventilator alarm is a sure sign that something is wrong and you
take action and that leads perfectly to the next problem which is ventilator alarms
ventilator alarms serve as a safety mechanism and use a set of parameters to provide alerts whenever
a problem arises in the patient ventilator interaction the alarms may be audible visual
or both depending on the vents lighter mode and settings there are several different types of
alarms that may sound whenever a problem arises including high pressure low pressure low volume
high frequency apnea High Peep and Low PEEP we have a separate video that covers all of the
alarms in detail so definitely check that out if you want to learn more but another common problem
during mechanical ventilation is system leaks a system leak occurs when there is a disconnection
a problem with the circuit or a problem with the artificial Airway some signs of a leak during
mechanical ventilation include the sounding of the low pressure alarm low volume alarm
the low minute ventilation alarm or if you see abnormal ventilator graphics if the leak is due
to a disconnection you'll simply need to reconnect the circuit if the problem is with the artificial
Airway you may need to check the cuff pressure and add more air to the cuff otherwise you'll
need to replace the artificial Airway the next problem that may occur is inadequate oxygenation
if the patient is not receiving enough oxygen the low spo2 alarm will sound in this case an
arterial blood gas should be analyzed to confirm that hypoxemia is present then you can adjust the
fio2 or peep settings accordingly depending on the patient's needs refractory hypoxemia
is another oxygenation problem that can occur during mechanical ventilation in severe cases
this is when the patient's spo2 does not increase despite a high fio2 setting this is often a sign
of acute respiratory distress syndrome and requires treatment with high levels of beep
the next problem that I want to mention is patient ventilator asynchrony or a dissynchrony whichever
one you prefer ventilator dissynchrony is characterized by inappropriate timing of
a delivered breath between a patient and the mechanical ventilator this increases the work
of breathing and makes it more difficult for the patient to breathe comfortably while on
the machine correcting ventilator to synchrony depends on the specific cause of the problem
it usually involves inappropriate ventilator settings therefore making proper adjustments is
the best treatment method for example you may need to adjust the flow sensitivity or inspiratory time
or you may consider using a different ventilator mode in general the less control the ventilator
has on the patient's respiratory pattern the less likely they will experience ventilator
to synchrony moving right along next up on the list is artificial Airway problems
several problems can occur during mechanical ventilation when using an artificial Airway
some examples include disconnection cuff leak obstruction incorrect placement a malfunctioning
valve tube kinking and Tube biting by the patient if a severe problem arises with an artificial
Airway the patient should be disconnected and manually ventilated with a bag valve
mask however if the tube is fully obstructed it must be removed to deliver manual breaths this
requires reintubation with a new endotracheal dupe next up on this list is secretion buildup
Airway suctioning is required during mechanical ventilation to avoid the accumulation of excess
mucus and secretions this typically involves the use of an inline suction catheter that
is connected directly to the endotracheal tube copious secretions may occur in conditions such
as pulmonary edema cystic fibrosis bronchiectasis and respiratory infections suctioning should only
be performed when indicated and the patient may also benefit from receiving warm humidified air
other types of Airway clearance therapy such as chest physiotherapy may also be used to
help clear secretions another common problem to be aware of is auto peep
Auto peep is a complication of mechanical ventilation that occurs when a positive pressure
remains in the alveoli at the end exhalation phase of the breathing cycle this can result in patient
ventilator asynchrony making it uncomfortable for them to breathe while on the machine
a high PEEP alarm may sound whenever Auto peep or air trapping is present
in general this can be corrected by prolonging the patient's expiratory time
and another major problem that can occur during mechanical ventilation is an accidental excavation
this occurs when the endotracheal tube is inadvertently removed from the patient's trachea
this also includes self-extubation which is the deliberate removal of the tube by the patient
an unplanned extubation is a severe complication in patients who are reliant on high levels of
ventilatory support however this can be prevented by properly securing the artificial Airway in
place with tape or a tube holder the patient should also be monitored closely for any signs
of agitation or distress so just to give a quick recap some of the most common problems that can
occur when a patient is on the ventilator include respiratory distress ventilator
alarms system leaks circuit disconnection inadequate oxygenation patient ventilator
asynchrony artificial Airway problems secretion buildup Auto Peep and an accidental extubation
just to name a few but of course there are many other problems that can arise depending on the
type of ventilator mode settings artificial Airway or the patient's condition these are just some of
the most common problems that respiratory therapists and students must be aware of
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think you will enjoy it just a quick reminder we are not doctors this video is for informational
purposes only thank you so much for watching have a blessed day and as always breathe easy my friend