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What This Guide Helps With
Alarm: Volume Not Delivered where set tidal volume is not achieved due to pressure limits, circuit issues, or patient resistance, resulting in inadequate ventilation delivery.
Step-by-Step Troubleshooting
1. Ensure Patient Safety First
- Immediately assess the patient
- If ventilation is inadequate, remove from ventilator and provide alternate ventilation (e.g., bag-valve mask)
- Prepare backup ventilator if needed
2. Verify the Reported Alarm and Behavior
- Confirm the “Volume Not Delivered” alarm is active
- Observe if it occurs during inspiration
- Check if delivered tidal volume is lower than set value
- Look for high airway pressure readings
3. Check Breathing Circuit for Obstruction or Kinks
- Inspect tubing for kinks, compression, or blockage
- Check for water accumulation in circuit
- Inspect filters and humidifier for obstruction
- Ensure tubing is not pinched under equipment
4. Check Airway Interface (ET Tube or Mask)
- Confirm ET tube is patent and not kinked
- Check for secretions or mucus plugs
- Verify proper mask seal if using non-invasive ventilation
5. Assess Patient Condition
- Check for coughing, biting, or fighting the ventilator
- Assess lung compliance (e.g., stiff lungs, ARDS)
- Look for bronchospasm or increased airway resistance
6. Review Ventilator Settings
- Check pressure limit (Pmax / alarm limits)
- Verify tidal volume settings
- Review ventilation mode (volume vs pressure control)
7. Check for Circuit Leaks or Disconnections
- Ensure all connections are secure
- Check for audible leaks
- Verify expiratory valve is properly seated
8. Stop When Resolved
- Confirm tidal volume is being delivered correctly
- Ensure alarm clears
- Return device to service if functioning properly
If the Problem Persists
If all external causes, patient factors, and settings have been ruled out, persistent “Volume Not Delivered” alarms may indicate internal ventilator control or sensor failure.
- Remove device from service
- Label Out of Service
- Send for repair or bench evaluation
Clinical Use Tip
Never troubleshoot ventilation delivery alarms while relying on the device for patient support. Move the patient to a backup device before continuing.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Ventilator alarming 'Volume Not Delivered'; low tidal volume observed during use."
Cause
What was observed during troubleshooting.
Example:
"Breathing circuit obstruction causing increased airway pressure and preventing volume delivery."
Resolution
What action was taken.
Example:
"Cleared obstruction in circuit, verified airway patency, and confirmed normal tidal volume delivery. 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
Alarms like “Volume Not Delivered” represent true ventilation failure conditions. Focus first on airway, circuit integrity, and pressure limits, and escalate appropriately when unresolved.
That is successful troubleshooting.