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What This Guide Helps With
This guide helps troubleshoot the APNEA PRESSURE alarm on a Drager Apollo anesthesia machine. This alarm indicates that breathing or ventilation has stopped, or that airway pressure is not being detected. Possible causes include insufficient fresh-gas supply, a leak or blockage in the tube or hose system, or the patient not being connected to the breathing system.
This should be treated as a patient-critical ventilation alarm. Patient ventilation must be confirmed before troubleshooting the anesthesia machine, breathing circuit, or accessories.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Immediately have clinical staff ventilate the patient manually using an appropriate manual ventilation method.
- Remove the anesthesia machine from active patient use if ventilation cannot be quickly restored or confirmed safe.
- Do not continue relying on the Apollo for ventilation until the cause of the alarm is corrected.
- Confirm the patient is being ventilated safely before continuing any troubleshooting.
Verify the Reported Alarm and Behavior
- Confirm that the displayed alarm is exactly APNEA PRESSURE.
- Ask clinical staff when the alarm occurred: during startup, during case setup, after connecting the patient, during active ventilation, or after a circuit, filter, or hose change.
- Look for no visible chest rise, no delivered breath, no airway pressure waveform, low or flat pressure reading, or ventilator cycling without pressure change.
- Confirm whether the alarm is reproducible or clearly associated with loss of ventilation pressure.
Confirm Manual Ventilation and Backup Ventilation Readiness
- Verify that staff can manually ventilate the patient using a safe alternate method.
- Confirm oxygen flow is available for manual ventilation.
- If the patient remains connected to the anesthesia system, confirm the manual ventilation bag, APL valve setting, and breathing circuit are appropriate for manual ventilation.
- Do not let troubleshooting delay ventilation support.
Check Fresh-Gas Supply and Settings
- Check the fresh-gas flow settings.
- Increase fresh-gas flow if it is too low for the ventilation mode, circuit condition, or patient needs.
- Verify oxygen supply is available from pipeline or backup cylinder as appropriate.
- Confirm gas supply is sufficient to support ventilation.
Check the Patient Connection
- Inspect the patient connection at the airway, mask, endotracheal tube, or breathing circuit connection.
- Confirm the patient is correctly connected to the breathing system.
- Look for a disconnected Y-piece, loose elbow, loose sample line connection, or circuit pulled away from the patient.
- Reconnect any loose or disconnected patient-side connection before retesting.
Inspect the Breathing Circuit for Leaks
- Check the breathing hoses, Y-piece, breathing bag connection, absorber connections, and filter connections.
- Look for disconnected, loose, cracked, misassembled, or damaged components.
- Reconnect or replace any questionable hose, connector, or filter.
- Confirm the breathing circuit is intact with no obvious leak.
Check for Blockage or Kinking in the Tube or Hose System
- Inspect the breathing hoses for kinks, compression, fluid buildup, or obstruction.
- Check the patient tube or airway device for blockage, biting, kinking, or occlusion.
- Verify the microbial filter is not blocked, saturated, reversed, or visibly contaminated.
- Replace the filter if blockage or contamination is suspected.
- Confirm the breathing pathway is open from the machine to the patient.
Check Ventilation Mode and Settings
- Confirm the selected ventilation mode is appropriate for the patient and current setup.
- Check tidal volume, respiratory rate, pressure settings, fresh-gas flow, and alarm limits.
- Verify the machine is not in setup, standby, manual/spontaneous, or another incorrect operating state when automatic ventilation is expected.
- Correct any setting or mode mismatch before retesting ventilation.
Isolate Accessory-Related Causes
- If the alarm continues after reconnecting the patient and checking the circuit, swap suspect external accessories one at a time.
- Check or replace the breathing circuit, Y-piece, microbial filter, sample line or airway adapter if relevant, and bag or hose assembly.
- Use known-good accessories when available.
- If the alarm clears after replacing an accessory, document the failed or obstructed accessory as the likely cause.
Perform a System Check Before Returning to Use
- Once the cause is corrected, run the appropriate machine checkout or leak/system test per facility procedure and manufacturer guidance.
- Confirm ventilation produces expected airway pressure, flow, and waveform behavior.
- Verify alarms clear and do not return during test ventilation.
- Return the Apollo to service only after successful checkout and confirmed ventilation performance.
Stop When Resolved
- If the APNEA PRESSURE alarm clears after correcting fresh-gas flow, reconnecting the patient, fixing a leak, or removing a blockage, confirm ventilation function.
- Verify the alarm does not return.
- Return the device to service only after successful checkout.
- Document the confirmed cause and corrective action.
If the Problem Persists
If the APNEA PRESSURE alarm continues after fresh-gas supply, patient connection, breathing circuit leaks, hose or tube blockage, microbial filter condition, accessories, and ventilation settings have been ruled out, the issue may involve an internal ventilation, pressure sensing, gas delivery, or breathing system problem.
Remove the anesthesia machine from service. Label it Out of Service. Send it for repair or bench evaluation by qualified anesthesia service personnel.
Do not keep troubleshooting on an active patient.
Clinical Use Tip
Never troubleshoot an unresolved APNEA PRESSURE alarm while the patient depends on the anesthesia machine for ventilation. Move the patient to a backup ventilation method first, then investigate the machine, breathing circuit, and accessories.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Drager Apollo anesthesia machine reported APNEA PRESSURE alarm during use. Staff reported ventilation stopped or airway pressure was not being detected."
Cause
What was observed during troubleshooting.
Example:
"Found breathing circuit disconnected at patient Y-piece, preventing pressure buildup during ventilation."
Resolution
What action was taken.
Example:
"Reconnected breathing circuit, verified patient connection, checked fresh-gas flow, inspected hoses and microbial filter, ran checkout, and confirmed ventilation pressure returned with no repeat APNEA PRESSURE alarm. Device returned to service."
Helpful Details to Include (If Known)
- Alarm behavior
- Accessories swapped
- Power behavior
- Environmental factors
- Indicator lights
- Final device status
Final Thought
The APNEA PRESSURE alarm must be treated as a ventilation safety issue first and a troubleshooting issue second. Confirm patient ventilation, then work logically through fresh gas, patient connection, leaks, blockages, accessories, and settings before suspecting internal failure. Clear documentation protects the patient, the clinical team, and the device history.
That is successful troubleshooting.