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What This Guide Helps With
This guide helps troubleshoot the CONTINUOUS PRESSURE alarm on a Drager Apollo anesthesia machine. This alarm indicates that breathing pressure has exceeded the set limit for more than 15 seconds. Possible causes include sustained high airway pressure, circuit obstruction, restricted exhalation, breathing system restriction, scavenging restriction, or an incorrect pressure alarm limit.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Confirm the patient is being ventilated safely.
- Notify anesthesia staff immediately if the alarm occurs during active patient use.
- Be prepared for manual ventilation or transfer to another anesthesia machine if ventilation is affected.
- Do not continue relying on the anesthesia machine if pressure remains elevated or ventilation appears unsafe.
Verify the Reported Alarm and Behavior
- Confirm the displayed alarm is CONTINUOUS PRESSURE.
- Verify whether the alarm occurs during startup, mechanical ventilation, manual/spontaneous ventilation, only with a patient connected, only with a test lung connected, or intermittently during certain cases.
- Look for high airway pressure readings, reduced exhalation, abnormal bellows or piston behavior, ventilator cycling problems, or pressure buildup in the breathing bag or scavenging path.
Remove From Patient Use if Pressure Does Not Clear
- If the alarm remains active or pressure does not return to normal, have clinical staff ventilate the patient by an alternate safe method.
- Remove the anesthesia machine from patient use if safe ventilation cannot be confirmed.
- Do not continue clinical use until the cause is corrected and proper operation is verified.
Check Ventilation and Patient Breathing Conditions
- Have anesthesia staff assess the patient’s ventilation and spontaneous breathing.
- Confirm whether the patient is coughing, bearing down, obstructed, or breathing against the ventilator.
- Check whether the alarm occurs only during patient connection and clears with a test lung.
Check the Breathing Circuit and Hoses
- Inspect the inspiratory and expiratory breathing hoses.
- Look for kinked hoses, crushed tubing, incorrect hose routing, blocked filters, water accumulation, obstructed connectors, or improperly seated circuit components.
- Replace the breathing circuit, filter, HME, or questionable accessory if needed.
- Confirm breathing gas can flow normally through the circuit without restriction.
Check the Breathing System Assembly
- Verify that the breathing system is assembled correctly and fully seated.
- Check the breathing bag, absorber, valves, and visible breathing system components for obvious blockage, improper installation, contamination, or damage.
- Confirm the absorber canister is properly installed and not restricting flow.
Check the Gas Scavenging System
- Inspect the anesthetic gas scavenging line and connection.
- Check for kinked scavenging tubing, blocked scavenging lines, improper connections, restricted wall scavenging connections, or an obstructed scavenging interface.
- Correct obvious scavenging restrictions only if allowed by local procedure and safe to do so.
- Confirm waste gas can exit the system without causing back pressure.
Check Alarm Limit Settings
- Have anesthesia staff verify the pressure alarm limit is appropriate for the patient, ventilation mode, and clinical situation.
- Confirm the alarm limit was not set too low for the intended ventilation settings.
- Do not raise alarm limits simply to silence the alarm unless clinical staff determine the setting is appropriate.
Test With a Known-Good Breathing Circuit or Test Lung
- After patient care is no longer dependent on the unit, connect a known-good breathing circuit and test lung.
- Run ventilation using appropriate test settings.
- Observe whether the CONTINUOUS PRESSURE alarm returns.
- If the alarm clears, the issue was likely related to the patient circuit, accessory, scavenging setup, patient condition, or settings.
- If the alarm returns, the issue may be internal to the anesthesia machine or breathing system.
Stop When Resolved
- If the alarm clears after correcting a hose, filter, breathing system issue, scavenging restriction, or alarm setting, confirm ventilation operates normally.
- Confirm pressure readings return to expected values.
- Confirm no additional alarms are present.
- Return the anesthesia machine to service only after it passes the appropriate clinical engineering checkout or facility-approved operational check.
- Document the corrected cause clearly in the work order.
If the Problem Persists
If the CONTINUOUS PRESSURE alarm continues after checking patient condition, ventilation settings, breathing hoses, breathing system setup, gas scavenging system, external accessories, and alarm limits, remove the anesthesia machine from service.
Label the unit Out of Service.
Send the anesthesia machine for repair, bench evaluation, or vendor service.
Persistent continuous pressure alarms may indicate an internal breathing system, valve, sensor, ventilator control, pressure monitoring, or pressure-relief-related failure.
Clinical Use Tip
Never troubleshoot a sustained pressure alarm for an extended time while the patient remains dependent on the anesthesia machine. Move the patient to a backup device or alternate ventilation method first if safe ventilation cannot be confirmed quickly.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Drager Apollo anesthesia machine reported CONTINUOUS PRESSURE alarm. Staff stated breathing pressure exceeded the alarm limit during ventilation and the alarm did not clear normally."
Cause
What was observed during troubleshooting.
Example:
"Breathing circuit inspection found a kinked expiratory hose causing restricted exhalation and sustained breathing pressure above the set alarm limit."
Resolution
What action was taken.
Example:
"Removed kinked circuit tubing, installed proper breathing circuit setup, verified ventilation with test lung, confirmed pressure returned to expected range, and confirmed CONTINUOUS PRESSURE alarm did not return. Unit returned to service."
Helpful Details to Include (If Known)
- Alarm behavior
- Accessories swapped
- Power behavior
- Environmental factors
- Indicator lights
- Final device status
Final Thought
A CONTINUOUS PRESSURE alarm should be treated as a real ventilation safety concern until proven otherwise. Start with the patient, then check the breathing circuit, breathing system, scavenging path, and alarm limits before assuming internal machine failure. If the alarm persists after external causes are ruled out, remove the device from service and escalate appropriately. Clear documentation protects the patient, the clinical team, and the technician.
That is successful troubleshooting.