Medtronic Capnostream 20p

Asset Type

Capnography Monitor

Manufacturer

Medtronic

Model

Capnostream 20p

What This Guide Helps With

This guide helps troubleshoot RR HIGH ALARM on a Medtronic Capnostream 20p capnography monitor. This alarm indicates the respiration rate is above the upper alarm limit. It may be caused by an actual elevated respiratory rate, patient condition, alarm limit settings, sampling issues, waveform artifact, movement, or false alarm behavior.

Because a high respiration rate can reflect respiratory distress or another clinical change, this alarm should be treated as a patient safety issue first and an equipment issue second.

Step-by-Step Troubleshooting

Ensure Patient Safety First

• Treat the RR HIGH ALARM as a clinical condition until proven otherwise.
• Do not assume the monitor is wrong.
• Notify clinical staff immediately and confirm the patient is being assessed.
• Do not troubleshoot the monitor on an active patient unless clinical staff confirm it is safe to do so.

Verify the Reported Alarm and Behavior

• Confirm the monitor is displaying RR HIGH ALARM.
• Observe whether the alarm occurs continuously, intermittently, during movement, during coughing or talking, or only during certain breathing patterns.
• Check whether the displayed respiratory rate is stable or rapidly changing.

Compare the Displayed Respiratory Rate to the Patient

• Have clinical staff visually assess the patient’s breathing rate and breathing pattern.
• Compare the monitor’s displayed RR value to the patient’s observed respirations.
• If the displayed RR does not match the patient, suspect sampling, waveform, accessory, or artifact-related causes.

Confirm Alarm Limits Are Appropriate

• Review the upper RR alarm limit with clinical staff.
• Confirm the alarm limit is appropriate for the patient type, care area, and clinical condition.
• Only authorized clinical staff should adjust alarm limits.

Check the CO2 Sampling Line or Airway Connection

• Inspect the sampling line, cannula, airway adapter, FilterLine, and tubing setup.
• Look for loose connections, kinks, moisture, blockage, incorrect placement, or patient dislodgement.
• Confirm the sampling path is secure, correctly positioned, and free of obstruction or damage.

Inspect the Capnogram Waveform

• Look for a stable CO2 waveform.
• Check whether the monitor is detecting breaths consistently.
• Watch for noise, movement, talking, coughing, shallow breathing, or irregular waveform patterns that may be counted as respirations.
• If the waveform does not support the displayed RR value, continue checking external setup and accessories.

Check for Patient Movement or Artifact

• Ask staff whether the alarm occurs during movement, agitation, coughing, talking, suctioning, repositioning, or transport.
• Correct positioning or setup issues when possible.
• Recheck whether the RR value stabilizes after the artifact source is removed.

Replace the Disposable Sampling Accessory if False Readings Are Suspected

• If the waveform is poor or the displayed RR does not match the patient, replace the sampling line, cannula, airway adapter, or compatible disposable accessory.
• Use only accessories approved by the facility and compatible with the monitor.
• If the waveform improves and the RR reading stabilizes, document the accessory-related cause.

Check the Monitor Setup and Patient Type

• Confirm the monitor configuration matches the patient population and intended use.
• Verify that neonatal, pediatric, or adult settings are appropriate where applicable.
• Confirm the device is being used in the correct monitoring mode for the patient and care setting.

Test the Monitor Away From the Patient if a Device Issue Is Suspected

• If staff report repeated false RR HIGH ALARM events across multiple patients or accessories, remove the device from patient use.
• Perform a bench check with known-good accessories.
• Verify whether the monitor functions normally with a known-good setup or reproduces abnormal alarm behavior.

Stop When Resolved

• If the alarm was caused by patient condition, inappropriate alarm limits, poor sampling line placement, accessory failure, or artifact, correct the issue and verify stable monitoring.
• Return the device to service only when it is functioning normally and safe for use.
• Document what was checked, what was found, and the final device status.

If the Problem Persists

If the RR HIGH ALARM continues after patient condition, alarm limits, sampling line placement, waveform quality, movement artifact, and known-good accessories have been checked, remove the monitor from service.

Label the unit Out of Service and send it for repair or bench evaluation. Persistent false respiratory rate alarms after external causes are ruled out may indicate a sampling, sensor, processing, or device-related failure.

Clinical Use Tip

Never troubleshoot a capnography alarm on an active patient without clinical staff involved. A high respiratory rate alarm should be treated as a patient condition first, not a device problem. Move the patient to a backup monitor first if the alarm cannot be trusted or if monitoring must continue during troubleshooting.

Work Order Documentation (CCR Method)

CCR = Complaint, Cause, Resolution

Complaint

What was reported by the clinical staff.

Example:
"Capnostream 20p reported RR HIGH ALARM during patient monitoring. Staff stated respiration rate was above the upper alarm limit."

Cause

What was observed during troubleshooting.

Example:
"Verified RR HIGH ALARM. Patient assessment required first. Checked upper RR alarm limit, sampling line position, waveform quality, accessory condition, and movement artifact. Alarm appeared related to patient respiratory rate or alarm limit condition rather than confirmed device failure."

Resolution

What action was taken.

Example:
"Clinical staff notified for patient assessment. Sampling line and connections checked. Alarm limit reviewed by clinical staff. Monitor function verified with stable capnogram waveform. Device returned to service."

Helpful Details to Include (If Known)

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

Final Thought

The RR HIGH ALARM should always be treated as a possible patient condition first. Clinical Engineering should verify the alarm, check simple external causes, confirm waveform quality, and only escalate the device after patient condition, alarm settings, and accessories have been ruled out. Clear CCR documentation protects the patient, the technician, and the equipment history.

That is successful troubleshooting.