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What This Guide Helps With
Troubleshooting failed checkout or leak testing caused by circuit connections, breathing-system assembly, vaporizers, absorbers, sampling components, or test setup.
Step-by-Step Troubleshooting
1. Ensure Patient Safety First
Do not perform a system checkout, leak test, or extended troubleshooting while the Avance is connected to an active patient.
If a leak or checkout failure occurs during clinical use:
- Notify the anesthesia provider immediately.
- Transfer ventilation and anesthesia delivery to another verified anesthesia machine or approved backup method.
- Maintain independent patient monitoring.
- Follow the facility’s anesthesia-equipment failure procedure.
Expected: Patient care is no longer dependent on equipment with an unresolved leak or checkout failure.
If the device is safely removed from patient use, continue troubleshooting.
2. Confirm the Exact Test Failure
Review the displayed checkout results and record:
- The specific test that failed
- Any displayed leak value
- Whether the failure involves the machine, breathing circuit, or vaporizer
- Whether the failure occurs consistently or intermittently
- Any accompanying alarm or advisory message
The Avance low-pressure leak check evaluates the gas path before the breathing system, while other checkout portions evaluate the breathing circuit and ventilation system.
Expected: The failed portion of the checkout is clearly identified before components are disturbed.
3. Verify the Test Setup
Confirm that:
- No patient is connected.
- The machine is in the required checkout or standby condition.
- The breathing circuit is configured as instructed by the checkout prompts.
- The circuit outlet or patient connection is properly occluded when requested.
- The reservoir bag and test lung are connected only when required.
- Fresh-gas controls and vaporizers are positioned as directed by the screen.
An incorrect setup can create a failure even when the machine is functioning normally.
Expected: The checkout is repeated using the correct configuration.
If the test passes, document the setup error and return the device to service after completing the full checkout.
4. Inspect the Breathing Circuit
Check the inspiratory and expiratory limbs for:
- Loose connections
- Cracked tubing
- Damaged cuffs
- Open sampling ports
- Missing plugs or caps
- Incorrectly installed filters, adapters, or elbows
- Water traps or accessories that are not fully seated
Replace questionable disposable components with known-good compatible items.
Expected: The breathing circuit is complete, securely connected, and free of visible damage.
Repeat the failed test. If it passes, stop troubleshooting.
5. Check the Patient Y-Piece and Test Occlusion
Inspect the Y-piece and the device used to occlude the patient connection.
Confirm that:
- The Y-piece is not cracked.
- The occlusion plug seals completely.
- No small monitoring port remains open.
- The test plug is the correct size and is undamaged.
GE identifies properly sized, undamaged plugs as necessary for isolating breathing-system sections during leak testing.
Expected: The patient connection remains completely sealed during the test.
6. Inspect the Bag, Bag Hose, and Bag/Vent Connections
Check:
- Reservoir bag for pinholes, splits, or a loose neck
- Bag hose for cracks or loose fittings
- Bag arm connection
- Bag/vent switch position
- Manual breathing-system components for incomplete seating
Substitute a known-good reservoir bag and hose when available.
Expected: The manual breathing path is securely assembled and does not introduce leakage.
Repeat the checkout. If the test passes, replace the failed accessory and stop.
7. Verify the Breathing-System Module Is Fully Seated
Inspect the externally removable breathing-system assembly.
Confirm that:
- The module is fully inserted and latched.
- No tubing or cable obstructs its seating.
- Accessible seals are present, clean, and undamaged.
- The inspiratory and expiratory flow-sensor areas are correctly assembled.
- The adjustable pressure-limiting valve and breathing-system controls move normally.
Do not force the assembly or remove internal covers.
Expected: The breathing system sits flush and locks securely into position.
8. Check the Absorber Canister Assembly
Inspect the carbon-dioxide absorber assembly for:
- Canister not fully locked
- Loose disposable absorber
- Cracked canister
- Missing or damaged accessible seal
- Debris on the sealing surface
- Incorrectly assembled bypass or condenser components, if equipped
- Excessive moisture around the mounting area
Reseat the absorber according to normal operator-accessible procedures.
Expected: The absorber is securely installed with clean, intact sealing surfaces.
Repeat the leak test. If the test passes, document the seating or absorber issue.
9. Inspect Sampling and Gas-Monitoring Connections
Check the gas-sampling path for:
- Loose sample line
- Cracked sample tubing
- Open sampling connection
- Water trap not fully inserted
- Damaged water-trap seal
- Incorrectly connected scavenging or exhaust tubing
- Unsupported accessories creating tension on fittings
Temporarily replace suspect sampling accessories with known-good compatible parts.
Expected: All gas-monitoring connections are secure and properly sealed.
10. Inspect Vaporizers and Mounting Positions
Ensure all installed vaporizers are:
- Approved for the machine
- Fully seated on the manifold
- Locked into position
- Turned off for checkout when instructed
- Free from obvious mounting damage
- Not tilted, loose, or overfilled
If permitted by facility procedure, remove and reseat one vaporizer at a time while the machine is out of service. Repeat the appropriate test after each change.
Do not open or internally service a vaporizer.
The machine checkout may identify leakage within the vaporizer or low-pressure gas path before the breathing system.
Expected: Vaporizers are securely mounted and do not cause the test failure.
11. Check External Gas and Auxiliary Connections
Inspect accessible connections for:
- Auxiliary common gas outlet not fully closed or connected
- Open auxiliary oxygen outlet
- Loose pipeline hoses
- Cylinder yokes not correctly secured
- Missing cylinder washers
- External accessories connected to the fresh-gas path
- Damaged externally visible fittings
Use a known-good pipeline source when a supply problem is suspected.
Expected: External gas connections are secure and are not creating an unintended leak path.
12. Power-Cycle and Repeat the Full Checkout
After correcting any external issue:
- Turn the machine off using the normal shutdown process.
- Wait for shutdown to complete.
- Restart the Avance.
- Allow initialization to finish.
- Perform the complete manufacturer-directed checkout.
Do not bypass or accept a failed mandatory checkout solely because ventilation appears functional.
Expected: All required checkout tests pass without recurring messages or abnormal leakage.
If the checkout passes repeatedly, complete a functional verification and return the device to service according to facility policy.
If the Problem Persists
If the Avance continues to fail checkout after the circuit, absorber, sampling components, vaporizers, test setup, and external connections have been verified, common external causes have been ruled out.
The problem may involve an internal valve, manifold, pressure sensor, pneumatic connection, breathing-system seal, or ventilation component.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for qualified repair or bench evaluation
- Evaluated using the current GE Healthcare service documentation and required test equipment
Do not repeatedly clear or bypass a failed checkout for clinical use. Knowing when to stop and escalate is proper troubleshooting.
Clinical Use Tip
Never perform leak testing or system checkout on an active patient. Move the patient to verified equipment first, then troubleshoot the Avance in a controlled environment.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that the GE Healthcare Avance failed the pre-use system checkout with a breathing-system leak message."
Cause
What was observed during troubleshooting.
Example:
"Inspection found the absorber canister was not fully seated, creating leakage during the checkout."
Resolution
What action was taken.
Example:
"Reseated and locked the absorber canister, inspected the circuit connections, and completed the full system checkout successfully."
Helpful Details to Include (If Known)
- Specific checkout test that failed
- Displayed leak value
- Complete alarm or advisory text
- Breathing circuit inspected or replaced
- Reservoir bag and bag hose tested
- Absorber seating and condition
- Sampling line and water trap condition
- Vaporizers installed and tested
- Test plug or occlusion method verified
- Pipeline and cylinder status
- Failure repeated with known-good accessories
- Full checkout result
- Final device status
Final Thought
A failed anesthesia-machine checkout must be handled with patient safety first and a logical examination of external leak paths. Careful documentation and timely escalation help prevent unsafe return to service.
That is successful troubleshooting.