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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting circuit leak or disconnection errors on a ResMed Astral ventilator. Symptoms may include alarms indicating “circuit leak,” “disconnection,” or unexpected patient pressure/volume changes. The focus is on external, verifiable checks first, ensuring patient safety and avoiding unnecessary internal interventions.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Move the patient to a backup ventilator if possible.
- Confirm oxygen delivery and ventilation are uninterrupted.
- Circuit troubleshooting should never occur with an active, unmonitored patient.
Check Circuit Connections
- Inspect all tubing connections from the ventilator to the patient interface (mask, tracheostomy, or endotracheal tube).
- Ensure each connector is fully seated and locked.
- Loose or misaligned connections are the most common source of leak errors.
Inspect Circuit Components
- Examine the circuit for kinks, pinches, or bends that may restrict airflow.
- Check for disconnections at Y-pieces, filters, or humidifier connections.
- Replace any damaged tubing or connectors.
Check the Patient Interface (Mask/ET Tube)
- Ensure the mask or ET tube is properly fitted and secured.
- Inspect for worn or torn masks or cushions that can create leaks.
- Verify that any headgear or straps are properly positioned to maintain a seal.
Verify Ventilator Settings
- Ensure the ventilator’s circuit configuration matches the actual patient circuit (single-limb, dual-limb, with/without humidifier).
- Reset alarm thresholds for leaks if previously modified.
- Perform a quick system test if available (e.g., leak test or circuit calibration).
Check Humidifiers or Water Traps
- Remove excess condensation or water from the circuit if present.
- Ensure heated circuits are correctly installed and not damaged.
If the Problem Persists
All external connections, tubing, and patient interfaces have been verified. Internal circuit sensors or ventilator modules may be malfunctioning.
- Remove the device from service.
- Label the ventilator “Out of Service.”
- Send for bench evaluation or repair.
Knowing when to escalate avoids unnecessary patient risk and prevents further device damage.
Clinical Use Tip
- Never troubleshoot circuit leaks with a patient actively on the device without backup support.
- Always confirm oxygenation and ventilation are adequate before disconnecting or adjusting circuits.
- Small leaks can sometimes be tolerated temporarily if patient safety is maintained while preparing a replacement ventilator.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Ventilator alarm indicates circuit leak or disconnection; patient pressure readings unstable.”
Cause
What was observed during troubleshooting.
Example:
“Loose tubing connection detected at patient Y-piece; mask cushion slightly torn.”
Resolution
What action was taken.
Example:
“Reconnected all circuit tubing; replaced mask cushion; verified ventilator circuit test passed; monitored patient for stability.”
Helpful Details to Include
- Circuit checked for kinks and proper routing
- Tubing connections verified and secured
- Patient interface integrity assessed
- Humidifier and water traps inspected
- Leak test or circuit calibration performed
- Final device status: functioning, alarms cleared
Final Thought
Patient safety is the priority—always verify proper ventilation before troubleshooting. Systematic external checks reduce unnecessary repair escalation. Thorough documentation ensures continuity of care and supports proper clinical engineering workflow.
That is successful troubleshooting.