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What This Guide Helps With
Troubleshoot abnormal airway-pressure readings caused by circuit leaks, obstruction, condensation, sensors, accessories, settings, or test configuration before internal service.
Step-by-Step Troubleshooting
1. Protect the Patient From Unreliable Pressure Delivery or Monitoring
If airway pressure appears incorrect or unstable during patient use, transition the patient to another verified ventilator or backup ventilation method. Do not continue therapy while troubleshooting questionable pressure delivery or measurement.
Expected outcome: Patient ventilation and pressure monitoring are maintained using reliable equipment.
2. Confirm Whether the Problem Is Delivered Pressure, Displayed Pressure, or Both
Record the reported pressure behavior, active alarms, ventilation mode, and relevant settings. Under controlled non-patient conditions, compare ventilator pressure indications with appropriate independent test equipment.
Expected outcome: The complaint is defined as an actual delivery problem, a measurement discrepancy, or a circuit/setup issue. If independent testing shows stable compliant performance, continue only as needed to identify the original external cause.
3. Inspect the Circuit for Obstruction
Check tubing, filters, connectors, valves, humidification components, and patient interfaces for kinks, occlusion, accumulated secretions or test contamination, water, or incorrectly assembled components.
A restriction may produce unexpectedly high pressure.
Expected outcome: The circuit is unobstructed. If removing or replacing an obstructed external component restores normal pressure behavior, proceed to final verification.
4. Inspect for Circuit Leaks and Disconnections
Trace the full circuit for loose fittings, open ports, damaged tubing, disconnected sampling connections, or improperly seated accessories.
Leaks may cause low pressure, failure to reach target conditions, or misleading measurements.
Expected outcome: The circuit is intact and leak-free. If correcting a leak resolves the pressure abnormality, repeat required tests and stop troubleshooting.
5. Check Condensation and Pressure-Related External Pathways
Inspect accessible circuit components, sensing connections, water traps, and related accessories for accumulated moisture or improper positioning that could interfere with pressure measurement or gas flow.
Do not access internal pressure tubing or sensors without authorized service procedures.
Expected outcome: External pathways are dry, correctly positioned, and unobstructed. If correcting moisture or positioning restores normal readings, proceed to final testing.
6. Verify Flow Sensor and Exhalation Components
Ensure external sensing and exhalation-valve components are correctly oriented, fully seated, clean enough for use, and recognized by the ventilator. Replace suspect disposable or approved external components when appropriate.
Expected outcome: External flow and exhalation components are correctly installed. If a known-good component restores pressure accuracy, replace the defective component and stop after verification.
7. Verify Settings and Test Configuration
Confirm that the selected ventilation mode and authorized clinical settings correspond to the intended evaluation. Check the test lung, circuit, and accessory setup for a configuration that could create an apparent pressure fault.
Expected outcome: Settings and test conditions are appropriate. If incorrect setup caused the abnormal pressure, correct it and repeat testing.
8. Compare Pressure With Independent Test Equipment
Use approved ventilator test equipment to compare generated pressure with the ventilator's displayed value through the required operating conditions.
Apply current manufacturer criteria rather than assuming a tolerance.
Expected outcome: Delivered and indicated pressures meet applicable acceptance criteria. If they do, and external causes have been corrected, troubleshooting is complete.
9. Verify Pressure Alarms
Confirm applicable high- and low-pressure alarm behavior using approved testing procedures. Verify both visual and audible alarm annunciation.
Do not intentionally challenge alarm functions on a patient.
Expected outcome: Pressure-related alarms respond properly and pressure performance remains stable. The ventilator may proceed to return-to-service testing.
10. Escalate Persistent Pressure Error
If the circuit, external sensors, exhalation components, accessories, settings, and test setup are correct but pressure remains inaccurate or unstable, remove the ventilator from service.
Expected outcome: A potentially unsafe pressure-control or measurement problem is escalated rather than masked or bypassed.
If the Problem Persists
External obstruction, leaks, moisture, circuit components, sensors, settings, and test conditions have been ruled out. The remaining fault may involve internal pressure sensing, pneumatic regulation, valves, calibration, software, or another service-level condition.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using approved Vyaire documentation and appropriate pressure/ventilator test equipment.
- Repaired or calibrated only by qualified personnel.
- Required to pass applicable pressure-delivery, monitoring, alarm, and overall ventilator testing before return to service.
Knowing when pressure performance cannot be trusted and stopping external troubleshooting is proper troubleshooting.
Clinical Use Tip
When displayed airway pressure conflicts with patient condition or independent measurement, treat the ventilator as unreliable until the discrepancy is resolved.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Respiratory Therapy reported the bellavista 1000 displayed unexpectedly high airway pressure during pre-use testing."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found accumulated condensate in an external circuit component creating excessive resistance."
Resolution
What action was taken.
Example:
"Clinical Engineering replaced the affected external component, repeated pressure and alarm testing with approved equipment, verified normal performance, and returned the ventilator to service."
Helpful Details to Include (If Known)
- High, low, unstable, or inaccurate pressure complaint
- Ventilation mode and relevant settings
- Associated alarms
- Circuit obstruction or leak findings
- Condensation or water-trap condition
- Flow sensor and exhalation component condition
- Known-good substitutions
- Independent pressure measurements
- Alarm-test results
- Final device status
Final Thought
Pressure abnormalities can originate in the circuit, accessories, sensing pathway, setup, or ventilator itself. Protect the patient, eliminate external causes first, confirm performance independently, and escalate whenever accurate pressure delivery and monitoring cannot be demonstrated.
That is successful troubleshooting.