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What This Guide Helps With
Troubleshoots exhalation-valve and PEEP problems caused by installation, contamination, circuit leakage, obstruction, accessories, or service-level expiratory-control faults.
Step-by-Step Troubleshooting
1. Protect the Patient Before Evaluating Expiratory Control
Do not troubleshoot unreliable PEEP or an exhalation-valve fault while a patient depends on the affected ventilator. Transfer the patient to another verified ventilator.
Expected outcome: Patient ventilation and PEEP are maintained by reliable alternate equipment.
2. Confirm the Reported Condition
Determine whether:
- The ventilator reports an exhalation-valve problem
- PEEP is lower than expected
- PEEP is unstable
- Expiration appears restricted
- The issue occurs only with a particular circuit or valve assembly
Record any displayed message exactly.
Expected outcome: The fault can be reproduced under controlled test conditions.
3. Inspect Exhalation-Valve Installation
Verify the accessible exhalation-valve assembly is fully seated, assembled correctly, and appropriate for the device.
Do not force components into place or perform internal disassembly.
Expected outcome: The exhalation valve is correctly installed. If reseating it resolves the fault and PEEP becomes stable, proceed to final verification.
4. Inspect for Contamination and Moisture
Remove the exhalation component according to approved handling procedures and inspect it for:
- Condensation
- Secretions
- Cleaning residue
- Debris
- Physical damage
Use only approved cleaning, reprocessing, or replacement procedures.
Expected outcome: The component is clean, dry, and undamaged. If contamination caused improper movement or sealing, correct it and repeat testing.
5. Inspect the Expiratory Circuit
Check the expiratory limb, filters, water traps, adapters, and connectors for:
- Kinks
- Blockage
- Water accumulation
- Loose connections
- Damaged tubing
Expected outcome: Expiratory flow is unrestricted and the circuit is leak-free.
6. Check for System Leakage
Perform the applicable leak evaluation and inspect the entire breathing system for leakage that could prevent PEEP from being maintained.
Expected outcome: No external leak significant enough to affect PEEP is present. If a leak is corrected and PEEP becomes stable, proceed to final verification.
7. Substitute a Known-Good Exhalation Component
When permitted and available, install a known-good compatible exhalation-valve component and repeat the functional check.
Expected outcome: PEEP is maintained and the fault clears with the known-good component. If so, remove the original component from use and stop troubleshooting after verification.
8. Verify Ventilator Settings
Confirm the selected ventilation mode and PEEP setting correspond to the intended bench test. Check that no unintended setting or test configuration is affecting expiratory behavior.
Expected outcome: Settings are correct and appropriate for the test being performed.
9. Verify PEEP With Approved Test Equipment
Connect an appropriate ventilator analyzer and test lung. Observe PEEP over multiple breaths and compare the measured value with the ventilator indication using applicable acceptance criteria.
Expected outcome: PEEP remains stable and agrees with the independent measurement. Troubleshooting can stop.
10. Escalate Persistent Exhalation or PEEP Failure
If known-good external components and a leak-free circuit do not restore reliable expiratory control, remove the ventilator from service.
Expected outcome: The ventilator is either verified to maintain PEEP correctly or escalated for service-level evaluation.
If the Problem Persists
External exhalation components, circuit leaks, restrictions, accessories, and settings have been ruled out. Remaining causes may involve internal exhalation control, pressure sensing, pneumatic regulation, actuator control, 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
Following repair, verify PEEP, airway pressure, flow, volume, alarms, and complete ventilation performance before return to service.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Unstable PEEP can significantly alter patient ventilation even when other displayed values appear normal, so do not rely on the device clinically until verified.
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 would not maintain the selected PEEP during a pre-use test."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the exhalation-valve assembly was not fully seated."
Resolution
What action was taken.
Example:
"The exhalation valve was properly reseated and the ventilator maintained stable PEEP during analyzer and test-lung verification."
Helpful Details to Include (If Known)
- Exact displayed message
- PEEP behavior
- Exhalation-valve condition
- Moisture or contamination
- Expiratory-limb condition
- Leak-test result
- Known-good substitution result
- Analyzer measurement
- Results after correction
- Final device status
Final Thought
PEEP and exhalation faults require careful evaluation of the valve, circuit, leakage, and test setup before an internal fault is assumed. Verify performance objectively and remove unreliable equipment from service when the cause remains unresolved.
That is successful troubleshooting.