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What This Guide Helps With
Troubleshoots excessive leakage caused by circuit connections, tubing, humidification components, test accessories, exhalation components, or service-level pneumatic faults.
Step-by-Step Troubleshooting
1. Protect the Patient and Remove the Suspect System From Clinical Use
Do not troubleshoot a significant ventilator leak while a patient depends on the affected breathing circuit. Transfer the patient to another verified ventilator or circuit setup before testing.
Expected outcome: The patient is safely ventilated using reliable equipment and the suspect system can be tested off-patient.
2. Confirm the Leak Condition
Determine whether the complaint involves:
- A pre-use leak test that will not pass
- Visible or audible circuit leakage
- Delivered volume not matching expected return
- Loss of airway pressure
- Leak only with a particular circuit or accessory
Repeat the applicable test using an appropriate test lung or test setup.
Expected outcome: The leak is confirmed under controlled conditions or the test passes normally. If the test consistently passes and no leak is found, complete final functional verification.
3. Inspect the Breathing Circuit
Inspect the complete accessible inspiratory and expiratory breathing circuit for:
- Loose connections
- Cracks or tears
- Disconnected branches
- Damaged cuffs or fittings
- Improperly seated components
- Incorrectly assembled tubing
Reconnect each fitting securely without forcing incompatible parts.
Expected outcome: The circuit is intact and securely connected. If correcting a circuit connection resolves the leak and the test passes, troubleshooting can stop after final verification.
4. Check Humidification and Water-Trap Components
Inspect humidifier chambers, water traps, adapters, caps, sampling connections, and other inline components for loose connections, damage, or missing seals.
Use only compatible accessories approved for the clinical setup.
Expected outcome: No accessory or inline component is leaking. If replacement or reseating of an external component resolves the failure, repeat the leak test.
5. Verify the Test Setup
Confirm the leak test is being performed with the correct external setup and required circuit components in place according to current Drager instructions.
An incomplete or improperly occluded test circuit can produce an apparent ventilator leak.
Expected outcome: The test configuration is correct and the result represents the ventilator/circuit system rather than a setup error.
6. Inspect the Flow Sensor and Exhalation Assembly
Verify the flow sensor and accessible exhalation components are correctly installed, fully seated, clean, dry, and undamaged.
Do not disassemble internal pneumatic assemblies.
Expected outcome: The flow sensor and exhalation components are properly installed. If reseating or replacing a damaged external component corrects the leak, repeat the test and stop troubleshooting if it passes.
7. Substitute Known-Good External Components
When available, substitute a known-good compatible circuit, flow sensor, exhalation component, or other suspect external accessory one item at a time.
This helps separate ventilator failure from disposable or reusable accessory failure.
Expected outcome: The leak either follows an external component or remains with the ventilator. If the leak follows a component, remove that component from use and verify the ventilator with the known-good replacement.
8. Check Connections at the Ventilator
Inspect accessible gas-path connections at the ventilator for damaged ports, contamination, cracked fittings, or components that do not seat correctly.
Do not continue using a port that appears physically damaged.
Expected outcome: External ventilator ports are intact and components seat securely. Physical damage requires removal from service.
9. Repeat Leak and Functional Testing
After any correction, repeat the applicable leak test and then operate the ventilator with an appropriate test lung. Verify stable pressure and volume delivery without audible or measured excessive leakage.
Expected outcome: The leak test passes and ventilation remains stable. Troubleshooting can stop.
10. Escalate Persistent Leakage
If a known-good external circuit and accessories are installed correctly but excessive leakage remains, do not continue clinical use.
Expected outcome: The device is either verified leak-free or removed from service for further pneumatic evaluation.
If the Problem Persists
Common external circuit, accessory, flow-sensor, humidification, and connection causes have been ruled out. Remaining possibilities may involve internal pneumatic connections, seals, exhalation control, pressure regulation, or another service-level gas-path 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 configured only by qualified personnel
After repair, repeat applicable leak, pressure, flow, volume, alarm, and complete ventilator performance testing before return to service.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
When changing circuits during troubleshooting, verify the entire patient breathing path before reconnecting a patient.
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 repeatedly failed the pre-use leak check."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a loose connection at an external circuit adapter that allowed excessive leakage."
Resolution
What action was taken.
Example:
"The adapter was reseated, the circuit was inspected, and the ventilator passed the leak check and test-lung functional verification."
Helpful Details to Include (If Known)
- Leak-test result
- Circuit type
- Humidifier or water-trap configuration
- Flow sensor condition
- Exhalation component condition
- Audible leak location
- Known-good substitutions
- Ventilator port condition
- Test result after correction
- Final device status
Final Thought
Treat leakage as a system problem until the circuit, accessories, connections, and test setup are verified. Protect the patient, isolate the leak logically, escalate persistent pneumatic faults, and document the verified correction.
That is successful troubleshooting.