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What This Guide Helps With
Troubleshoots suspected PAP pressure errors caused by leaks, restrictions, tubing, accessories, therapy configuration, or device performance.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Therapy
If delivered pressure is suspected to be incorrect or unstable, discontinue use on the patient and provide another verified device according to the prescribed therapy plan.
Expected outcome: The patient is protected from unreliable pressure delivery.
2. Confirm the Pressure Complaint
Determine whether pressure was perceived as too high or too low, measured externally, associated with excessive leak, or changed unexpectedly during therapy.
Record the active therapy mode and displayed settings without altering prescribed values.
Expected outcome: The reported pressure problem and current configuration are clearly documented.
3. Inspect the Circuit for Leakage
Inspect tubing, connectors, mask/interface components, humidifier seating, and accessible seals for unintended leaks.
Excessive leakage can create apparent pressure-delivery problems and should be corrected before evaluating device accuracy.
Expected outcome: No unintended external leak is present.
4. Check for Restrictions
Inspect tubing for kinks, crushing, condensation accumulation, or blockage. Check the air intake and filters for obstruction.
Verify the intentional patient-interface exhaust path is not blocked.
Expected outcome: Both inlet and outlet airflow paths are unobstructed.
5. Verify Connected Accessories and Configuration
Confirm the installed tubing and external accessories correspond to the device configuration. Review accessible therapy settings for unintended changes while preserving the prescribed parameters.
Do not reprogram clinical settings without appropriate authorization.
Expected outcome: Device configuration and connected accessories are consistent with the intended therapy setup.
6. Compare With Known-Good Accessories
Substitute known-good compatible tubing and patient-interface components as appropriate.
Expected outcome: Pressure behavior normalizes if an external component was creating the problem. Replace the defective component and stop troubleshooting after verification.
7. Measure Device Output
Use appropriate respiratory test equipment and applicable Philips service documentation to objectively evaluate delivered pressure.
Do not calibrate or adjust the device merely because a subjective bedside assessment suggests the pressure feels wrong.
Expected outcome: Measured pressure behavior is appropriate for the tested configuration. If objective testing is satisfactory, the device-side pressure complaint is not reproduced.
8. Perform Final Functional Verification
Operate the system through an appropriate non-patient functional test and confirm stable output, responsive controls, secure circuit connections, and absence of abnormal indications.
Expected outcome: Therapy pressure remains stable and appropriate. If so, troubleshooting can stop.
9. Escalate Confirmed Pressure Error
If objective testing confirms inaccurate or unstable pressure after external causes and configuration are ruled out, stop troubleshooting at the external level.
Expected outcome: The unit is removed from clinical use for qualified service.
If the Problem Persists
Common external leaks, restrictions, accessory problems, and configuration errors have been ruled out. Remaining causes may involve internal pressure/flow sensing, the blower, pneumatic components, software, or calibration requiring service-level access.
Remove the DreamStation 2 from service, label it Out of Service, and send it for repair or bench evaluation using appropriate Philips documentation and approved test equipment. Internal adjustment or calibration should be performed only by qualified personnel.
Complete appropriate output verification before return to service. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Treat a confirmed PAP pressure discrepancy as a therapy-delivery problem and move the patient to another verified system before further testing.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Staff reported that the DreamStation 2 appeared unable to maintain the expected therapy pressure."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a loose breathing-tube connection at the humidifier outlet causing significant leakage."
Resolution
What action was taken.
Example:
"Secured the tubing connection and verified stable pressure delivery with appropriate test equipment."
Helpful Details to Include (If Known)
- Reported high, low, or unstable pressure
- Therapy mode and settings observed
- Circuit leak findings
- Filter and inlet condition
- Tubing and interface condition
- Humidifier seating
- Known-good accessory substitutions
- Objective pressure-test results
- Final device status
Final Thought
Pressure complaints should be verified objectively only after external leaks, restrictions, accessories, and configuration are checked. Protect the patient, avoid unauthorized setting changes, escalate confirmed device errors, and document the measured outcome.
That is successful troubleshooting.