EMCrit 239 – Vent Alarms = Code Blue - a podcast by Scott D. Weingart, MD FCCM

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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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