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What This Guide Helps With
This guide helps troubleshoot the Puritan Bennett 840 Ventilator alarm INSPIRATION TOO LONG, which indicates prolonged inspiratory time causing improper breath cycling, potential air trapping, or unsafe ventilation timing. This condition can affect normal exhalation and may compromise safe ventilation if not addressed promptly.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Immediately assess the patient if this alarm occurs during active ventilation.
- Be prepared to provide alternate ventilation if needed.
- Confirm the patient remains safely ventilated before continuing troubleshooting.
Verify the Reported Alarm and Behavior
- Confirm the ventilator is displaying INSPIRATION TOO LONG.
- Observe whether the alarm occurs at startup or during ventilation.
- Check for a prolonged inspiratory phase on the waveform.
- Look for delayed or absent cycling to exhalation.
Check Patient Circuit for Obstruction or Flow Restriction
- Inspect the full patient circuit for kinks, water buildup, or blocked filters.
- Check the expiratory limb for obstruction.
- Ensure the HME or filter is not saturated.
- Verify the circuit is clear and unobstructed.
Check Patient Condition and Interaction with the Ventilator
- Assess for patient-ventilator asynchrony.
- Look for breath stacking or active inspiratory effort.
- Coordinate with clinical staff if patient effort may be affecting cycling.
- Confirm patient effort aligns with ventilator cycling.
Verify Ventilator Settings
- Review the set inspiratory time (Ti).
- Check the I:E ratio.
- Confirm settings are appropriate based on patient IBW.
- Verify settings are within the expected clinical range.
Check Flow Sensors and Circuit Components
- Inspect the flow sensor for cleanliness and proper connection.
- Check for moisture or contamination.
- Reseat any related external connections.
- Confirm accurate flow detection is restored.
Run Ventilator Self Tests
- Run the SST (Short Self Test).
- Run the EST (Extended Self Test).
- Verify both tests complete without errors.
Stop When Resolved
- If the alarm clears, verify a normal ventilation waveform.
- Confirm the alarm does not return.
- Return the device to service only after normal operation is confirmed.
If the Problem Persists
If the INSPIRATION TOO LONG alarm continues after circuit obstruction, settings, patient interaction, flow sensor condition, and external component issues have been ruled out, remove the ventilator from service.
Label the device Out of Service and send it for repair or bench evaluation. Persistent timing-related alarms after external checks strongly suggest an internal control or sensing failure.
Clinical Use Tip
Never troubleshoot on an active patient. Move the patient to backup ventilation first before making adjustments or continuing diagnostic steps.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Ventilator alarming 'INSPIRATION TOO LONG' during use with prolonged inspiratory phase observed."
Cause
What was observed during troubleshooting.
Example:
"Restricted circuit airflow and/or inspiratory time setting exceeded expected limits, causing delayed cycling to exhalation."
Resolution
What action was taken.
Example:
"Cleared circuit obstruction, verified settings, cleaned and reseated flow sensor, and ran SST/EST. Alarm cleared and unit returned to service."
Helpful Details to Include (If Known)
- Alarm behavior
- Accessories swapped
- Power behavior
- Environmental factors
- Indicator lights
- Final device status
Final Thought
Alarms like INSPIRATION TOO LONG reflect real ventilation timing problems that should be approached with a logical external-first process. Start with patient safety, confirm the behavior, rule out circuit and setting issues, and escalate when appropriate. Clear documentation supports safe follow-up and repair decisions.
That is successful troubleshooting.