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What This Guide Helps With
Troubleshooting AutoCAT 2 timing, assist ratio, trigger, waveform, or setup issues before removing the pump for repair.
Step-by-Step Troubleshooting
Ensure Patient Safety First
Confirm whether the AutoCAT 2 is actively supporting a patient.
If timing appears incorrect, assist ratio is unstable, augmentation is poor, or the pump is triggering inconsistently, notify clinical staff immediately.
Expected outcome: The patient remains safely supported while the issue is evaluated.
Do not disconnect patient cables, pressure lines, ECG leads, or IAB catheter connections unless clinical staff confirm it is safe. If therapy is unsafe or unreliable, have staff transfer support to another verified IABP per facility policy.
Confirm the Reported Timing or Assist Issue
Ask clinical staff what they observed.
Look for:
- Incorrect inflation or deflation timing
- Assist ratio not matching selected setting
- Pump skipping beats
- Irregular triggering
- Poor diastolic augmentation
- Trigger alarms
- Auto timing not responding as expected
- Issue occurring only with ECG or arterial pressure trigger
Expected outcome: The issue is identified as a timing, trigger, assist ratio, or signal-quality problem rather than a general pump failure.
Check the Selected Trigger Source
Verify whether the AutoCAT 2 is using ECG, arterial pressure, or another available trigger source.
Confirm that the selected trigger source matches the patient condition and clinical setup.
Expected outcome: The pump is using a valid trigger source with a clear signal.
If switching to a different clinically appropriate trigger source resolves the timing issue, stop and document the original trigger source problem.
Inspect ECG Lead Placement and Signal Quality
If ECG trigger is being used, inspect the ECG leads, trunk cable, electrodes, and patient connection.
Check for loose electrodes, dried electrodes, poor skin contact, artifact, low amplitude QRS complexes, or intermittent lead-off conditions.
Expected outcome: A clean ECG waveform is present and the pump detects the trigger consistently.
Why this matters: Poor ECG quality can cause incorrect trigger detection, which may appear as a timing or assist ratio problem.
Inspect the ECG Cable and External Connections
Check the ECG cable connection at the pump and at the patient lead set.
Look for bent pins, loose connectors, damaged cable jackets, intermittent movement-related dropout, or strain on the cable.
If available, swap with a known-good compatible ECG cable.
Expected outcome: ECG trigger detection becomes stable with a secure or replaced cable.
If the issue resolves after swapping the cable, stop and document the defective accessory.
Check Arterial Pressure Signal Quality
If arterial pressure trigger or pressure-based timing is being used, inspect the arterial pressure cable, transducer setup, pressure tubing, and monitor interface.
Confirm that the arterial waveform is not dampened, over-dampened, under-dampened, flat, noisy, or intermittently lost.
Expected outcome: A clear arterial pressure waveform is available for reliable timing.
If the arterial pressure waveform is poor, Clinical Engineering should verify external cables and connections while clinical staff evaluate the pressure line setup.
Verify Pressure Cable and Monitor Interface Connections
Confirm that the pressure cable is fully seated at the AutoCAT 2 and any connected bedside monitor or transducer interface.
Inspect the cable for damage, loose locking connections, or intermittent signal loss when gently repositioned.
If available, test with a known-good compatible pressure cable.
Expected outcome: The pressure waveform remains stable and the pump triggers consistently.
If the issue follows the cable, remove the cable from service.
Review Assist Ratio Setting
Confirm the selected assist ratio, such as 1:1, 1:2, or 1:3, against the clinical team’s intended therapy setting.
Verify that the displayed assist behavior matches the selected ratio.
Expected outcome: The pump assists according to the selected ratio and does not skip or add unexpected cycles.
If the assist ratio was set incorrectly and correcting the setting resolves the issue, stop and document the setting discrepancy.
Check for Irregular Rhythm or Poor Trigger Conditions
Ask clinical staff whether the patient has arrhythmias, frequent ectopy, pacing, low ECG amplitude, or unstable arterial pressure.
These conditions may affect trigger recognition and timing behavior even when the pump is functioning correctly.
Expected outcome: Clinical conditions that can affect timing are identified before the pump is blamed.
Clinical Engineering should not interpret therapy timing independently. Work with qualified clinical staff when evaluating timing behavior.
Confirm Timing Controls and Display Response
Verify that timing controls, menus, knobs, buttons, or touchscreen functions respond normally when adjusted by authorized staff.
Look for delayed response, frozen control input, inconsistent displayed settings, or settings that do not hold.
Expected outcome: The user interface responds predictably and timing/assist settings remain stable.
If controls are unreliable, remove the device from service after patient safety is secured.
Check for Active Alarms or Advisory Messages
Review any displayed alarms, advisories, or status messages related to trigger loss, timing, ECG, pressure, augmentation, or assist delivery.
Record the exact wording of the message.
Expected outcome: Alarm behavior is documented and used to narrow the cause.
If the alarm clears after correcting an external lead, cable, pressure, or setting issue, stop and document the correction.
Test the Pump Off Patient When Safe
Once the device is removed from patient use, perform a controlled external check using approved accessories and facility test methods.
Confirm power-up, display response, control response, cable recognition, and simulated or test signal behavior if available.
Expected outcome: The pump either responds normally during bench evaluation or the issue is reproduced without involving a patient.
Do Not Perform Internal Timing or Drive System Repair at Bedside
Do not open the pump, adjust internal timing circuitry, bypass alarms, or attempt board-level repair during clinical troubleshooting.
Expected outcome: Troubleshooting remains focused on safe external checks and proper escalation.
If the Problem Persists
If ECG leads, ECG cable, arterial pressure signal, pressure cable, trigger source, assist ratio setting, alarms, and control response have been checked and the timing or assist ratio problem remains, common external causes have been ruled out.
The AutoCAT 2 should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
A persistent timing or assist problem may involve internal signal processing, control interface failure, pneumatic timing control, or other internal pump faults. Knowing when to stop is proper troubleshooting, especially on life-support equipment.
Clinical Use Tip
Do not troubleshoot timing problems casually on an active patient. Incorrect IABP timing can reduce augmentation, increase cardiac workload, or create unsafe therapy. Patient support should be stabilized first, and Clinical Engineering should only continue when the clinical team confirms it is safe. Move the patient to a backup device first when needed so therapy continuity is maintained.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported the Teleflex AutoCAT 2 was not maintaining the selected assist ratio and appeared to skip assisted beats during therapy."
Cause
What was observed during troubleshooting.
Example:
"Troubleshooting found intermittent ECG trigger loss caused by a damaged ECG patient cable; timing stabilized when a known-good cable was installed."
Resolution
What action was taken.
Example:
"Replaced the defective ECG cable, verified stable ECG trigger and assist ratio operation with clinical staff, and returned the AutoCAT 2 to service."
Helpful Details to Include (If Known)
- Patient removed from device or alternate IABP used
- Trigger source selected
- Assist ratio selected
- ECG waveform quality
- Arterial pressure waveform quality
- ECG cable swapped
- Pressure cable swapped
- Lead-off or trigger alarms observed
- Exact alarm or advisory message
- Whether issue occurred during transport or movement
- Whether controls responded normally
- Indicator lights or status messages observed
- Environmental factors such as movement, transport, cable strain, or bedside setup
- Final device status
- Device removed from service or returned to service
Final Thought
Pump timing and assist ratio problems should be approached carefully and logically. Start with patient safety, then verify trigger source, signal quality, cables, settings, and alarms before assuming an internal failure. Clear CCR documentation helps show what was checked, what was corrected, and why the final device status was appropriate.
That is successful troubleshooting.