Medtronic Capnostream 20p

Asset Type

Capnography Monitor

Manufacturer

Medtronic

Model

Capnostream 20p

What This Guide Helps With

This guide helps troubleshoot a PULSE RATE HIGH ALARM on the Medtronic Capnostream 20p when the displayed pulse rate is above the upper alarm limit. This may represent a real patient condition requiring immediate clinical attention, or it may be caused by alarm limit settings, poor SpO2 sensor placement, motion artifact, a damaged sensor, a faulty cable, poor signal quality, or a monitor-related issue.

Step-by-Step Troubleshooting

Ensure Patient Safety First

• Immediately confirm the patient’s condition with clinical staff.
• Treat this as a patient safety alarm first, not an equipment problem.
• Do not silence, ignore, or troubleshoot the alarm as a device issue until the patient has been assessed.
• If monitoring must continue while troubleshooting is performed, move the patient to a backup monitor first.

Verify the Reported Alarm and Behavior

• Confirm the Capnostream 20p is displaying PULSE RATE HIGH ALARM.
• Ask staff when the alarm occurs.
• Check whether the alarm is continuous, intermittent, related to patient movement, related to sensor placement, or associated with poor SpO2 signal quality.
• Look for abnormal SpO2 readings, weak signal, unstable waveform, or sudden pulse rate jumps.

Confirm the Pulse Rate Against Another Source

• Ask clinical staff to compare the displayed pulse rate against another valid source.
• This may include manual pulse assessment, bedside monitor, ECG monitor, or another pulse oximeter.
• If the high pulse rate is confirmed clinically, stop equipment troubleshooting and leave patient care decisions to clinical staff.
• If the Capnostream reading does not match the patient’s actual pulse rate, continue checking external causes.

Check Alarm Limit Settings

• Verify the upper pulse rate alarm limit is appropriate for the patient and care area.
• Confirm whether the alarm limit was changed, set too low, or carried over from a previous patient setup.
• Only adjust alarm limits under clinical direction and facility policy.
• If correcting the alarm limit resolves the alarm, document the configuration issue and return the monitor to service after confirming normal operation.

Inspect the SpO2 Sensor Placement

• Check that the SpO2 sensor is placed correctly and securely on the patient.
• Look for a loose probe, wrong sensor size, poor site contact, slipping during movement, excessive pressure, or poor perfusion at the sensor site.
• Reposition the sensor if clinically appropriate.
• If repositioning the sensor clears the alarm and the readings become stable, document the finding.

Check for Motion Artifact

• Observe whether the pulse rate spikes during patient movement, tremors, shivering, transport, or staff handling.
• Secure the sensor and cable if appropriate.
• Confirm whether the displayed pulse rate becomes stable when motion is reduced.
• If motion artifact caused the alarm, document the finding and educate staff to secure the probe and cable during monitoring.

Inspect the SpO2 Cable and Connections

• Check the SpO2 cable connection at the monitor and sensor.
• Look for loose connections, bent pins, damaged cable jacket, intermittent readings when the cable is moved, or contamination in the connector.
• Reseat the cable if needed.
• If cable damage is found, remove the cable from use and replace it.

Swap the SpO2 Sensor or Cable

• Use a known-good compatible SpO2 sensor and cable.
• Confirm whether the pulse rate reading stabilizes after the accessory swap.
• If the alarm clears with a known-good accessory, replace the faulty sensor or cable.
• Perform a basic function check before returning the monitor to service.

Check Signal Quality and Waveform

• Review the SpO2 waveform, pulse indicator, or signal quality indicator if available.
• Look for weak signal, erratic waveform, dropouts, sudden pulse rate jumps, or poor correlation with the patient condition.
• A pulse rate number without a reliable waveform should not be treated as a dependable equipment reading.
• Continue troubleshooting accessories and connections before suspecting an internal monitor failure.

Perform a Basic Functional Check

• Verify SpO2 displays properly.
• Verify pulse rate displays properly.
• Verify alarm limits are set appropriately.
• Verify alarm audio and visual indicators function.
• Confirm readings remain stable with known-good accessories.

If the Problem Persists

If the PULSE RATE HIGH ALARM continues after the patient condition has been ruled out, alarm limits are appropriate, sensor placement has been checked, motion artifact has been reduced, and known-good SpO2 accessories have been tested, external causes have been reasonably ruled out.

Remove the Capnostream 20p from service. Label it Out of Service. Send the device for repair or bench evaluation.

Persistent false pulse rate alarms should not be ignored because they can cause alarm fatigue, distract staff, or interfere with recognition of true patient events.

Clinical Use Tip

Never troubleshoot this alarm on an active patient until clinical staff confirms the patient is safe. If monitoring must continue, move the patient to a backup device first before removing accessories, changing cables, or testing the monitor.

Work Order Documentation (CCR Method)

CCR = Complaint, Cause, Resolution

Complaint

What was reported by the clinical staff.

Example:
"Capnostream 20p displayed PULSE RATE HIGH ALARM during patient monitoring. Staff reported pulse rate reading above the upper alarm limit."

Cause

What was observed during troubleshooting.

Example:
"Patient assessment was required first. Equipment checks found unstable SpO2 signal related to poor sensor contact and movement artifact. Alarm limit and cable connection were also checked."

Resolution

What action was taken.

Example:
"Confirmed reported alarm, verified alarm settings, inspected SpO2 sensor placement, checked cable connection, and tested with known-good SpO2 accessory. Readings stabilized after sensor replacement and monitor passed functional check."

Helpful Details to Include (If Known)

• Alarm behavior
• Accessories swapped
• Power behavior
• Environmental factors
• Indicator lights
• Final device status

Final Thought

A PULSE RATE HIGH ALARM should always be treated as a patient safety alarm first. Clinical Engineering should verify the alarm, support clinical staff, rule out external causes, check accessories and settings, and escalate the monitor only after common causes have been eliminated. Clear CCR documentation protects the patient, the technician, and the facility.

That is successful troubleshooting.