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What This Guide Helps With
Troubleshoot incorrect oxygen concentration or calibration problems involving gas supply, hoses, connections, accessories, sensors, setup, and environmental factors.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Ordered Oxygen Therapy
Do not troubleshoot questionable oxygen delivery while a patient depends on the ventilator. Transfer the patient to another verified ventilator or appropriate oxygen/ventilation system.
Expected outcome: The patient's prescribed respiratory support is maintained using equipment with verified oxygen delivery.
2. Confirm the Reported Oxygen Problem
Determine whether the complaint involves displayed oxygen concentration, independently measured oxygen concentration, calibration failure, unstable values, or inability to achieve the intended setting.
Record any associated alarms and the operating conditions when the problem occurred.
Expected outcome: The oxygen complaint is clearly defined and reproducible under non-patient conditions. If measurements are normal and repeatable, continue only as necessary to identify the prior external cause.
3. Verify the External Oxygen Supply
Check that the oxygen source intended for the ventilator is available and appropriately connected. Inspect the hose and fittings for disconnection, obvious damage, kinks, or connection to the wrong source.
Verify the source using facility-approved methods. Do not disassemble gas fittings beyond authorized external service actions.
Expected outcome: A valid and stable oxygen supply reaches the ventilator. If restoring the external source corrects oxygen delivery, proceed to final verification.
4. Inspect Gas Hoses and Connections
Examine accessible oxygen and other gas-supply hoses for damage, looseness, contamination, crossed connections, or strain. Ensure fittings are secure and appropriate for the intended source.
Expected outcome: External gas connections are correct, intact, and stable. If reseating or replacing an approved damaged hose resolves the issue, repeat oxygen testing and stop after verification.
5. Verify Circuit and Accessory Configuration
Inspect the patient circuit and any oxygen-related external accessories for correct assembly. Confirm humidification, adapters, sampling components, and sensors are installed as intended.
A configuration problem can affect oxygen measurement or delivered concentration.
Expected outcome: The external breathing system matches the intended setup. If correcting the configuration restores normal oxygen behavior, proceed to final testing.
6. Check External Oxygen-Sensing Components When Applicable
Inspect any user-accessible or service-approved oxygen-sensing component for secure installation, contamination, damage, or end-of-service indications. Do not attempt internal sensor repair or unauthorized calibration adjustments.
Use an approved known-good component if substitution is authorized.
Expected outcome: The external sensing component is installed correctly and provides stable readings. If a known-good component resolves the problem, replace the defective component and verify performance.
7. Verify Environmental and Calibration Conditions
Perform oxygen calibration only under the conditions required by approved manufacturer guidance. Ensure the ventilator has a stable gas supply and that the external circuit and test arrangement are appropriate.
Do not repeatedly calibrate merely to force a failing device into acceptance.
Expected outcome: Calibration is performed under valid conditions and completes successfully. If it succeeds and subsequent measurements remain accurate, troubleshooting can stop after verification.
8. Measure Delivered Oxygen Independently
Use an appropriate calibrated oxygen analyzer or approved ventilator test system to compare delivered oxygen concentration with the intended setting across applicable test conditions.
Use current manufacturer acceptance criteria rather than an assumed tolerance.
Expected outcome: Independent measurement agrees with the ventilator's required performance. If it does consistently, continue to final verification.
9. Verify Oxygen-Related Alarms and Overall Ventilator Function
Confirm applicable oxygen-related alarms and general ventilator performance using approved procedures. Verify visual and audible alarm functions.
Expected outcome: Oxygen delivery, indication, calibration status, and alarms are reliable. The ventilator may be returned to service once all applicable requirements are satisfied.
10. Escalate Persistent Oxygen Error or Calibration Failure
If the supply, hoses, connections, circuit, external sensor, calibration conditions, and independent testing have been addressed but oxygen remains incorrect or calibration repeatedly fails, remove the ventilator from service.
Expected outcome: An unresolved gas-control or measurement fault is escalated for qualified service.
If the Problem Persists
Common external oxygen-source, hose, connection, circuit, sensor, and calibration-condition problems have been ruled out. The remaining issue may involve internal oxygen measurement, gas mixing, pneumatic regulation, calibration data, software, or another service-level condition.
The ventilator should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate Vyaire documentation and approved gas-analysis equipment.
- Repaired, calibrated, or configured only by qualified personnel.
- Required to pass oxygen-delivery, alarm, and complete applicable ventilator-performance testing before return to clinical use.
Stopping when oxygen accuracy cannot be confirmed is proper troubleshooting.
Clinical Use Tip
When oxygen delivery is questioned, verify it with an independent calibrated analyzer rather than relying solely on the ventilator's displayed concentration.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Respiratory Therapy reported the bellavista 1000 could not maintain the expected oxygen concentration during setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the external oxygen hose was not fully connected to the supply source."
Resolution
What action was taken.
Example:
"Clinical Engineering secured the oxygen connection, verified oxygen concentration with approved test equipment, confirmed alarm operation, and returned the ventilator to service."
Helpful Details to Include (If Known)
- Reported versus measured oxygen behavior
- Oxygen-related alarm or message
- External oxygen-source status
- Hose and fitting condition
- Circuit and accessory setup
- Oxygen-sensor condition
- Calibration result
- Independent analyzer result
- Known-good substitutions
- Final alarm and ventilator test results
Final Thought
Incorrect oxygen delivery is a patient-safety concern that requires independent verification. Confirm the external source and gas path first, then circuit and sensing components, and escalate whenever calibration or measured oxygen performance remains unreliable.
That is successful troubleshooting.