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What This Guide Helps With
Troubleshoots unexpected airway pressure caused by circuit obstruction, leaks, test-lung conditions, sensors, exhalation components, settings, or pneumatic faults.
Step-by-Step Troubleshooting
1. Protect the Patient From Unreliable Pressure Delivery
Do not troubleshoot abnormal airway pressure while a patient depends on the affected ventilator. Transfer the patient to another verified ventilator or approved ventilation method.
Expected outcome: The patient is safely supported while the ventilator is evaluated independently.
2. Confirm the Pressure Complaint
Determine whether airway pressure is:
- Higher than expected
- Lower than expected
- Unstable
- Different from an external analyzer
- Abnormal only in a specific mode or circuit configuration
Record the selected settings and displayed pressure values.
Expected outcome: The pressure abnormality is reproducible under controlled conditions.
3. Verify the Test Lung and Analyzer
Use a known-good test lung and approved ventilator analyzer. Check test tubing and adapters for leaks, obstruction, or incorrect connection.
A damaged or improperly adjusted test lung can imitate a ventilator pressure fault.
Expected outcome: The test equipment provides a reliable reference. If replacing a faulty test accessory resolves the discrepancy, complete final verification.
4. Inspect the Circuit for Obstruction
Inspect the inspiratory and expiratory limbs for:
- Kinks
- Water accumulation
- Occluded filters
- Pinched tubing
- Blocked adapters
- Incorrectly installed components
Expected outcome: The circuit is open and unrestricted. If removing an obstruction restores expected pressure, verify operation and stop troubleshooting.
5. Inspect the Circuit for Leakage
Check connections, tubing, humidification components, water traps, and caps for leakage.
Low or unstable airway pressure may result from an external leak rather than pressure-generation failure.
Expected outcome: The breathing system is leak-free. If correcting a leak normalizes pressure, perform final verification.
6. Verify Exhalation Components
Confirm the exhalation valve or accessible expiratory assembly is properly installed, clean, dry, and undamaged.
Improper exhalation control can affect both airway pressure and PEEP.
Expected outcome: Exhalation components are correctly installed and functioning without obvious external defects.
7. Verify Flow and Pressure-Related Sensors
Confirm the flow sensor is recognized and operating normally. Review displayed values for obvious instability and note whether pressure abnormalities correspond with sensor errors.
Do not perform unauthorized internal calibration.
Expected outcome: Sensor operation appears stable and does not explain the pressure discrepancy.
8. Review Ventilation Settings
Confirm the selected ventilation mode, pressure targets or limits, PEEP, trigger settings, and other relevant controls correspond to the intended bench test.
Expected outcome: The pressure response is appropriate for the selected settings. If an unintended setting caused the complaint, restore the approved test configuration and verify operation.
9. Compare Displayed and Measured Pressure
Using approved test equipment, compare ventilator airway pressure with the independent measurement under several controlled breaths.
Apply current manufacturer acceptance criteria rather than invented tolerances.
Expected outcome: Displayed and independently measured pressures agree within applicable limits and remain stable. Troubleshooting can stop.
10. Escalate Persistent Pressure Abnormalities
If known-good circuit components, test equipment, sensors, and settings do not resolve the issue, remove the ventilator from clinical service.
Expected outcome: The unit is either verified to regulate and measure pressure correctly or escalated for bench evaluation.
If the Problem Persists
External circuit, test-lung, leak, obstruction, exhalation-component, and configuration causes have been ruled out. Remaining possibilities may include internal pressure sensing, pneumatic regulation, turbine operation, control electronics, or another service-level fault.
The ventilator should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate Drager documentation and approved ventilator test equipment
- Repaired or calibrated only by qualified personnel
After service, verify pressure regulation, PEEP, volume, flow, alarms, and overall ventilator performance before return to use.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Always confirm abnormal ventilator pressure against the circuit and a known-good test lung before assuming the pressure-control system has failed.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Respiratory Therapy reported that the Savina 300 produced unexpectedly high airway pressure during a test-lung check."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the expiratory limb was partially obstructed by accumulated condensate."
Resolution
What action was taken.
Example:
"The circuit was corrected, the ventilator was retested with a known-good test lung and analyzer, and airway pressure returned to normal test behavior."
Helpful Details to Include (If Known)
- High, low, or unstable pressure
- Ventilation mode
- Circuit condition
- Filters and water accumulation
- Exhalation-component condition
- Test-lung condition
- Analyzer result
- Relevant displayed settings
- Results after correction
- Final device status
Final Thought
Airway-pressure troubleshooting begins with the entire breathing path, not the internal ventilator. Protect the patient, eliminate leaks and restrictions, compare against independent test equipment, escalate unexplained discrepancies, and document verified performance.
That is successful troubleshooting.