Cite this post as:
Scott Weingart, MD FCCM. EMCrit 239 – Vent Alarms = Code Blue. EMCrit Blog. Published on January 26, 2019. Accessed on January 19th 2022. Available at [https://emcrit.org/emcrit/vent-alarms/ ].
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Unless otherwise noted at the top of the post, the speaker(s) and related parties have no relevant financial disclosures.
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How do you feel about clamping the ETT with patients on high PEEP before disconnecting the vent?
Do you mean when switching to a portable vent?
if PEEP > 10, we clamp for any circuit disconnects
Do you paralyse prior to tube-clamping? Seems to me that an inspiratory effort against a clamped tube would lead to more negative pressure than if left open to air.
In my mind, part of the problem is that the vent does not distinguish between alarms. For example, I’d rather not turn off alarms for high respiratory rate – somebody should take a look. But this has the exact same sound as the disconnection or obstruction alarms. Which means the only way to prevent alarm fatigue is to make yourself unaware of more common, but less serious threats. On the topic of alarms in general, I feel 2 buttons are missing from the monitor : – button A: this is the patient ‘s known acute physiology. For the next hour,… Read more »
Hi Maarten,
Many ventilators have the ability to set various priorities of alarm (eg level 1, level 2, level 3) with different volumes and colour alerts for each. So you could set you disconnect and high peak alarms to high priority, high resp rate for middle and ‘needs service’ alarm to a low level, for example. It’s really very useful!! You could inquire with your product rep.
In my mind, part ff the problem is that the vent does not distinguish between alarms. For example, I’d rather not turn off alarms for high respiratory rate – somebody should take a look. But this has the exact same sound as the disconnection or obstruction alarms. Which means the only way to prevent alarm fatigue is to make yourself unaware of more common, but less serious threats. On the topic of alarms in general, I feel 2 buttons are missing from the monitor : – button A: this is the patient ‘s known acute physiology. For the next hour,… Read more »
Thanks for another great podcast! I loved the idea of vent alarms being taken as seriously as a code! Indeed some of these situations could very quickly become codes if simple but for a simple remedy in a timely manner. I do wonder if a systematic approach was a little lacking in the presentation. In anaesthesia (at least in Aus) we teach sustematic approaches to some of these alarms that ensure rapid optimisation of safety (eg FiO2 1.0) and then systematic troubleshooting. Possible causes should be ranked in order of likelihood and importance. For example, a bronchoplueral fistual should be… Read more »