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What This Guide Helps With
Scavenging is inadequate or breathing-system pressure rises because of hoses, facility suction, obstruction, connections, AGSS setup, or internal pneumatic problems.
Step-by-Step Troubleshooting
1. Protect the Patient From Abnormal Breathing-System Pressure
If breathing-system pressure is rising unexpectedly, do not continue troubleshooting while a patient depends on the machine.
Maintain ventilation using a verified alternative method or anesthesia machine and remove the Flow-e from clinical use.
Expected outcome: Patient ventilation is maintained independently, and the affected system is safe to evaluate.
2. Determine Whether the Problem Is Scavenging, Pressure, or Both
Confirm whether staff observed low scavenging flow, excessive breathing-system pressure, poor evacuation of waste anesthetic gas, unusual reservoir behavior, or another specific condition.
Expected outcome: The reported condition is clearly defined and reproducible during controlled testing.
3. Inspect the AGSS Connection to the Facility System
Verify the scavenging hose is correctly connected to the Flow-e and the intended facility disposal connection.
Inspect for loose fittings, disconnected hoses, kinks, crushing, or visible damage.
Expected outcome: The external scavenging pathway is securely connected and unrestricted.
4. Verify the Facility Scavenging Source
Where applicable, confirm the connected facility AGSS or suction source is operating by comparing it with another known-good connection or using appropriate facility-approved test methods.
Coordinate with Facilities when infrastructure is suspected.
Expected outcome: The facility source is available and functioning. If the source is unavailable, document the infrastructure issue and do not attribute it to the anesthesia machine.
5. Inspect the Scavenging Hose and Accessories
Check the hose, adapters, connectors, and externally accessible scavenging components for obstruction, fluid, collapse, incorrect assembly, or incompatible accessories.
Expected outcome: Waste gas can flow freely through the external scavenging pathway.
6. Inspect the Breathing Circuit
Verify inspiratory and expiratory limbs, filters, patient cassette, reservoir components, valves accessible for normal handling, and circuit connectors are correctly assembled and unobstructed.
Expected outcome: No external circuit component is creating abnormal resistance or pressure.
7. Simplify the Test Configuration
Use the manufacturer-approved test configuration and remove unnecessary external breathing or scavenging accessories.
Expected outcome: The system operates normally in the standard test configuration. If it does, reintroduce accessories individually to identify the external cause.
8. Compare With a Known-Good Scavenging Connection
If possible, test the Flow-e using another verified facility AGSS point or known-good approved scavenging setup.
Expected outcome: If the machine performs normally on the alternate source, the original facility connection or infrastructure requires correction.
9. Perform Controlled Pressure and Scavenging Verification
Using appropriate anesthesia test equipment, confirm breathing-system pressure behaves normally and scavenging functions according to applicable approved procedures.
Expected outcome: Pressure remains controlled and waste-gas removal functions properly. If both are verified, complete full checkout.
10. Escalate Persistent Pressure or Scavenging Abnormalities
If external hoses, facility source, breathing circuit, accessories, and test configuration have been ruled out but pressure remains abnormal or scavenging remains inadequate, stop troubleshooting.
Expected outcome: The Flow-e remains removed from service for qualified pneumatic evaluation.
If the Problem Persists
Common external AGSS connections, facility infrastructure, hose obstruction, accessory, and breathing-circuit causes have been ruled out. Remaining possibilities include internal scavenging regulation, breathing-system valves, pneumatic restriction, internal pressure-control components, or other service-level faults.
The machine should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using approved Getinge service documentation and anesthesia test equipment.
- Repaired or adjusted only by qualified personnel.
Facilities or the appropriate infrastructure team should be involved when the building scavenging source is implicated.
Do not return the Flow-e to service until breathing-system pressure, ventilation, scavenging operation, alarms, and full checkout are satisfactory.
Clinical Use Tip
When scavenging problems and rising breathing-system pressure occur together, treat the pressure abnormality as the immediate patient-safety concern.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Anesthesia staff reported low scavenging flow and increasing breathing-system pressure during Flow-e checkout."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the external AGSS hose sharply kinked behind the anesthesia workstation."
Resolution
What action was taken.
Example:
"Repositioned the hose to remove the restriction, verified normal scavenging and breathing-system pressure with approved test equipment, completed checkout, and returned the machine to service."
Helpful Details to Include (If Known)
- Low scavenging flow or high pressure reported
- Facility AGSS connection used
- Hose and connector condition
- Alternate AGSS source tested
- Breathing-circuit condition
- Accessories removed or substituted
- Pressure behavior during testing
- Scavenging verification result
- Checkout result
- Final device status
Final Thought
Protect ventilation first, separate machine problems from facility scavenging problems, inspect the complete external gas path before assuming internal pneumatic failure, and escalate any unresolved abnormal breathing-system pressure.
That is successful troubleshooting.