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EMCrit 239 – Vent Alarms = Code Blue


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Vent Alarms should be Regarded as Code Blue
If you cannot instill this into your culture, patients will die

If they are crashing, do DOPES
ETCO2 on any Vented Pt
This is what the real alarm should be
High (Peak) Pressure
from the Resus Crisis Manual
Dyssynchrony
Peak Only

* Check the circuit

* fluid pooling in circuit
* fluid pooling in filter
* kinking of circuit


* Tube too small or biofilmed
* Bronchospasm
* Biting on ETT
*

Peak & Plat High

* Tube in Mainstem
* Pneumothorax
* Bad Lungs >> Turn down the Vt
* Abd Compartment

Low Peak Pressure

* Disconnect
* ETT Cuff Deflated
* Pt effort

Low Ve/Vt

* Cuff Issues (See EMCrit Wee )
* Bronchopleural Fistula

Low O2 Alarm

* Not hooked Up
* Gases Messed Up
* Sensor Messed up

What to Do with Continued Alarms Despite Sedation, Equipment Check, Suctioning

* Consider Bronchoscopic Assessment
* If Patient begins to crash, consider tube exchange if bronch not available

Breakdown on Alarm Types
Article on Vent Alarm Stats 1


See More
High-Peak on ALIEM




1.
Cvach M, Stokes J, Manzoor S, et al. Ventilator Alarms in Intensive Care Units: Frequency, Duration, Priority, and Relationship to Ventilator Parameters. Anesth Analg. September 2018. [PubMed]



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EMCrit FOAM FeedBy Scott D. Weingart, MD FCCM

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