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What This Guide Helps With
This guide addresses situations where the GE Avance anesthesia machine:
- Triggers ventilator alarms such as “High Pressure,” “Low Tidal Volume,” or “Apnea”
- Delivers inadequate or inconsistent ventilation
- Shows unexpected changes in airway pressures or volumes
Focus is on external, easily verifiable causes first—before considering internal failure or advanced service.
Step-by-Step Troubleshooting
Verify Patient Circuit Connections
- Check that all tubing, Y-piece, and patient connectors are securely attached.
- Ensure no kinks, twists, or disconnections exist.
Why: Loose or obstructed circuits are a common cause of poor ventilation alarms.
Inspect the Breathing Circuit and Filters
- Look for wet or clogged HME filters, CO₂ absorbent, or bacterial filters.
- Replace if saturated or visibly obstructed.
Why: Resistance from obstructions can trigger high-pressure alarms.
Check Endotracheal Tube (ETT) Placement
- Confirm that the ETT is correctly positioned and not blocked.
- Suction secretions if needed.
Why: Patient-side obstruction often mimics ventilator malfunction.
Assess Ventilator Settings and Mode
- Confirm tidal volume, rate, inspiratory time, and pressure limits are appropriate for patient size and mode.
- Reset to standard adult or pediatric parameters if needed.
Why: Incorrect settings can cause alarms even with a functional machine.
Verify Power and Gas Supply
- Check oxygen, air, and nitrous supply pressures.
- Ensure backup battery is charged if operating on battery power.
Why: Low gas supply or power instability can reduce ventilator performance.
Perform Visual and Audible Alarm Checks
- Look for any warning indicators on the screen.
- Listen for unexpected hissing or leaks.
Why: Early detection of leaks prevents patient harm.
Conduct a Leak Test (Machine Only)
- With the patient disconnected, perform a machine leak test following standard external procedures.
Why: Confirms whether the ventilator and circuit can hold pressure.
If the Problem Persists
Common external causes (circuit, filters, ETT, gas supply, settings) have been ruled out.
Device should be:
- Removed from service
- Labeled Out of Service
- Sent for bench evaluation or GE Healthcare service
Knowing when to escalate is a key part of safe, effective troubleshooting.
Clinical Use Tip
Never troubleshoot ventilation alarms while a patient is actively connected if another ventilator is available.
Move the patient to a functioning anesthesia machine before performing in-depth troubleshooting.
Only use the problematic machine for testing after patient safety is secured.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Ventilator alarmed and patient tidal volumes are low during case.”
Cause
What was observed during troubleshooting.
Example:
“High airway pressures noted; circuit tubing kinked and HME filter partially saturated.”
Resolution
What action was taken.
Example:
“Straightened tubing and replaced filter; ventilator function returned to normal. Device tested and returned to service.”
Helpful Details to Include
- Circuit connections verified
- Filters and absorbent replaced
- Leak test results
- Alarm behavior and screen messages
- Patient size and ventilator settings
- Final device status (operational, removed, or sent for repair)
Final Thought
Patient safety comes first. Always confirm the patient is ventilated effectively before troubleshooting the machine. Logical, stepwise troubleshooting saves time, prevents unnecessary repairs, and ensures proper escalation. Proper documentation captures the cause and resolution for future reference.
That is successful troubleshooting.