On this page
Asset Type
Manufacturer
Model
What This Guide Helps With
PEEP HIGH ! alarm indicating elevated airway pressure (>8 cmH₂O) in ManSpont mode, which can result in excessive airway pressure, impaired ventilation, and potential patient harm due to improper pressure release.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Immediately assess the patient and airway pressure
- If pressure is elevated or ventilation is unsafe, transition to manual ventilation or alternate anesthesia machine
- Confirm the patient is receiving safe ventilation
Verify the Reported Alarm and Behavior
- Confirm the PEEP HIGH ! alarm is displayed
- Check if the alarm occurs in ManSpont mode
- Observe airway pressure readings (>8 cmH₂O)
- Assess bag compliance (stiff or difficult to compress)
- Look for limited exhalation or pressure not releasing
Check APL Valve Setting
- Inspect the Adjustable Pressure Limiting (APL) valve position
- Ensure it is not set too high or fully closed
- Gradually open the APL valve
- Observe for pressure decrease and alarm resolution
Check Fresh Gas Flow Rate
- Review fresh gas flow settings
- Ensure flow is not excessively high
- Reduce flow to appropriate clinical levels
- Monitor for reduction in airway pressure
Check Breathing Circuit for Obstruction
- Inspect for kinks, blockages, or water accumulation
- Check reservoir bag for overdistention
- Verify proper connections and unobstructed exhalation path
Check APL Valve Function
- Adjust the APL valve and observe pressure response
- Listen for gas release when opening the valve
- Confirm pressure changes correspond to valve adjustments
Stop When Resolved
- Confirm stable airway pressures
- Verify normal bag compliance
- Ensure proper exhalation and no alarm recurrence
- Return device to service if functioning normally
If the Problem Persists
If the alarm continues after external causes such as APL valve setting, fresh gas flow, and circuit obstruction have been ruled out:
- Remove the device from service
- Label the device as Out of Service
- Send for repair or bench evaluation
Clinical Use Tip
Never troubleshoot pressure-related alarms while connected to a patient. Always transition the patient to a backup device before making adjustments.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Unit displaying PEEP HIGH ! alarm in ManSpont mode with elevated airway pressure and stiff reservoir bag."
Cause
What was observed during troubleshooting.
Example:
"APL valve improperly set causing excessive circuit pressure buildup."
Resolution
What action was taken.
Example:
"Adjusted APL valve to appropriate setting and verified normal airway pressure and alarm resolution. 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
High PEEP alarms in manual or spontaneous modes are often caused by simple external factors like APL valve position or excessive gas flow. Always verify these first before escalating to internal issues, and prioritize patient safety at every step.
That is successful troubleshooting.