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What This Guide Helps With
Troubleshoots low or unstable flow or volume caused by gas supply, circuit leaks, obstruction, accessories, settings, sensors, or configuration.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Ventilation
Do not continue using the Flow-c for a patient if delivered ventilation or gas flow is unreliable. Transition ventilation and anesthesia delivery to another verified method before troubleshooting.
Expected outcome: The patient receives stable ventilation and anesthetic care independently of the affected machine.
2. Confirm the Reported Condition
Determine whether the complaint involves fresh-gas flow, ventilator-delivered volume, displayed measured volume, or an intermittent fluctuation. Record the active mode, relevant displayed values, alarm behavior, and whether the problem occurs continuously or only under certain conditions.
Expected outcome: The symptom is clearly defined as a delivery, measurement, or intermittent stability problem.
3. Verify Gas Supplies
Confirm required pipeline connections and cylinder supplies are available and properly connected as applicable. Inspect accessible hoses and fittings for kinks, loose connections, damage, or incorrect attachment.
Expected outcome: Adequate external gas supply reaches the anesthesia machine.
4. Inspect the Patient Circuit for Leaks or Obstruction
Trace the breathing circuit and inspect hoses, connectors, filters, adapters, patient-interface components, and reservoir components. Look for disconnections, leaks, crushed tubing, kinks, fluid accumulation, or obvious blockage.
Expected outcome: The breathing path is patent, correctly assembled, and free of significant external leaks. If correction restores stable delivery, stop after functional verification.
5. Check External Accessories and Consumables
Inspect filters, sampling adapters, airway accessories, and other removable components that can increase resistance or create leaks. Replace questionable disposable components with approved equivalents when appropriate.
Expected outcome: External accessories are not restricting or destabilizing delivered flow or volume.
6. Verify Controls and Ventilation Settings
Confirm that the selected ventilation mode and user-adjustable settings match the intended test condition. Compare the machine's configuration with the reported clinical setup without making unauthorized configuration changes.
Expected outcome: Apparent low delivery is not caused by an unintended setting or operating-mode selection.
7. Use Approved Test Equipment or a Known-Good Comparison
With the machine out of patient use, connect appropriate anesthesia or ventilation test equipment and evaluate delivered parameters according to approved procedures. Where appropriate, substitute a known-good patient circuit or removable sensor/accessory.
Expected outcome: Delivery is either confirmed normal or the discrepancy is reproduced independently of the original patient circuit.
8. Perform Final Functional Verification
After correcting an external cause, verify stable ventilation, appropriate displayed measurements, alarm operation, and required pre-use checks over repeated cycles.
Expected outcome: Flow and volume remain stable and the Flow-c passes applicable return-to-service testing.
If the Problem Persists
If gas supplies, circuit integrity, obstruction, accessories, consumables, settings, and external test conditions have been ruled out, the problem may involve internal flow control, pneumatic delivery, valves, sensing, calibration, or another service-level condition.
Remove the machine from service, label it Out of Service, and send it for repair or bench evaluation. Evaluate the system using appropriate manufacturer documentation and approved anesthesia test equipment. Internal pneumatic or electronic repairs should be performed only by qualified personnel.
Do not return the machine to use until delivered ventilation and measurement accuracy have been verified through applicable functional testing. Stopping when safe external troubleshooting is exhausted is proper troubleshooting.
Clinical Use Tip
A displayed volume problem may represent either true delivery failure or measurement error; until verified, treat unreliable ventilation as a patient-safety issue.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"OR staff reported unstable delivered tidal volumes from the Getinge Flow-c during pre-use setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a loose connection at the patient-circuit Y-piece causing an intermittent breathing-system leak."
Resolution
What action was taken.
Example:
"Clinical Engineering secured the connection, repeated ventilation testing with approved test equipment, and verified stable delivered volume and normal alarms."
Helpful Details to Include (If Known)
- Whether flow, volume, or both were affected
- Ventilation mode and settings observed
- Pipeline and cylinder status
- Breathing-circuit condition
- Filters and accessories installed
- Presence of kinks, obstruction, or fluid
- Known-good substitutions
- Test-equipment results
- Alarm behavior
- Results before and after correction
- Final device status
Final Thought
When flow or volume is unreliable, protect the patient and work from gas source and circuit outward before considering internal delivery problems. Verify the correction objectively, escalate unresolved performance issues, and document the complete troubleshooting path.
That is successful troubleshooting.