SECTION

C HAPT ER

Alarm handling 7 7
This chapter describes how to respond to ventilator alarms. It also lists, in alphabetic order,
messages displayed by the ventilator when it detects alarm conditions.

7.1 Alarm classifications

Alarms in the 840 ventilator are classified by urgency level; this classification determines how
the ventilator responds (Table 7-1). Some alarms are triggered by a ventilator setting or
patient condition, and they can occur in the usual course of patient care. Others are triggered
by the ventilator’s built-in background checks and may indicate that the ventilator requires
service; some of these are called DEVICE ALERTs. When the ventilator declares a DEVICE
ALERT, it not only displays a message and writes to the alarm log, but it also places an
associated diagnostic code into the System Diagnostic Log.

Table 7-1: How the ventilator responds to alarm conditions

Urgency Meaning Displays Audible alarm Notes

High Requires immediate Red high-urgency ! ! ! Sequence of 5 tones that If a high-urgency alarm
attention to ensure indicator flashes rapidly. repeats twice, pauses, goes away
patient safety Alarm message flashes at then repeats again spontaneously
top of upper screen. (autoresets), its indicator
remains lit (not flashing)
until you press the alarm
reset key.

Medium Requires prompt Yellow medium-urgency Repeating sequence of 3

attention ! ! indicator flashes tones
slowly. Alarm message
flashes at top of upper
screen.

Low There has been a change Yellow low-urgency ! 1 tone, non-repeating

in the patient-ventilator indicator lights. Alarm
system message flashes at top of
upper screen.

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7.2 Responding to alarms

1 Silence the audible alarm for 2 minutes (where possible) by pressing the alarm silence
key.
2 Read the alarm message from the top screen (Figure 7-1).
The base message identifies The analysis message gives the root
the alarm. Touch alarm cause of the alarm. May also include
symbol to view definition dependent alarms that have arisen
on lower screen. due to the initial alarm.

3VTE MAND
}
2 of last 4 mand breaths ≤ set limit. Check for leaks, changes in The two highest-
patient's R & C. priority active
alarm messages
11:20 25 Jun 2000 are displayed here.

The remedy
message suggests
how to resolve the
alarm condition.

8-01197

Touch flashing more alarms

button to view messages for up
to six additional active alarms.

Figure 7-1. Alarm message format

3 Correct the condition, if necessary, referring to Table 7-2. You can check the alarm log
(Figure 7-2). You may want to check the contents of the System Diagnostic Log
(accessible through the service menu, Chapter 4) for related diagnostic codes. The
troubleshooting procedures listed are sequenced to correct the most probable
malfunction or to present the most efficient corrective action first. The proposed fixes
listed, however, may not always correct the particular problem.

NOTE:
• You can change alarm settings even when alarms are active.
• Completing a new patient setup or running EST clears the alarm log.
• When more than one alarm is active and their alarm messages vary in their degree of
seriousness, you should assume that the most serious message is applicable.

4 If necessary, clear the message or reset the alarm by pressing the alarm reset key.
For specifics about alarm operation, see the 840 Ventilator System Operator’s and Technical
Reference Manual.

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8-01198

Alarm log button Touch symbols to Touch scroll bar, then

(indicates that log see definition at turn knob to scroll
includes unread entries) bottom of lower through log
Question mark appears on button screen
if log includes event that has not
been viewed yet

Figure 7-2. Alarm log

"Lockable" alarms include all PATIENT DATA and CIRCUIT DISCONNECT alarms and can be
silenced for two minutes by pressing the alarm silence key. A new, high-urgency alarm
cancels the silence. Each time you press the alarm silence key, the silence period resets to two
minutes. Each time you press the alarm silence key (whether or not there is an active alarm),
the keypress is recorded in the alarm log.

Table 7-2: Alarm messages

Analysis Remedy
Base message Description Corrective action
message message

AC POWER Operating on Power switch is on, and AC is not 1. Check integrity of AC

LOSS battery. available, so ventilator is power source.
operating on BPS. (BPS 2. Replace power supply.
operating indicator is on and
power indicator is off.) Resets
when AC power is restored.

Operational Prepare for Two minutes of battery power

time < 2 power loss. remain.
minutes.

APNEA The set apnea interval has Check patient and settings.
(lockable) elapsed without the ventilator,
patient, or operator triggering a
breath. Resets when patient
initiates 2 consecutive breaths.

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Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

CIRCUIT No Check patient/ Ventilator has recovered from 1. Check patient circuit con-
DISCONNECT ventilation. ventilator unintended power loss, detects nections.
(lockable) status. circuit disconnect, and switches 2. Run EST.
to idle mode; upper screen
displays elapsed time without
ventilator support. Resets when
ventilator senses reconnection.

Check patient. Ventilator detects circuit 1. Check patient circuit con-

Reconnect disconnect and switches to idle nections.
circuit. mode; upper screen displays 2. Run EST.
elapsed time without ventilator
support. Resets when ventilator
senses reconnection.

COMPLIANCE Compliance volume required to 1. Check patient circuit con-

LIMITED VT compensate delivery of a volume nections.
(lockable) controlled breath exceeds the 2. Run SST.
maximum allowed for 3 of the
last 4 breaths.

COMPRESSOR Compressor is not operating due 1. Check integrity of AC

INOPERATIVE to low AC. Resets when full AC is power source.
restored. 2. Check mains circuit
breaker.
3. Run EST.

DEVICE ALERT A background check or POST has Check System Diagnostic Log
detected a problem. Resets for any associated error codes.
when ventilator passes EST or Rerun POST/EST.
POST.

1O2% The O2% measured during any Calibrate oxygen sensor.

phase of a breath cycle is 7%
(12% during the first hour of
operation) or more above the
O2% setting for at least 30 s.
(These percentages increase by
5% for 4 minutes following a
decrease in the O2% setting.)
Alarm updated at 1-s intervals.

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Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

1PCOMP 1PPEAK Check for Target pressure 1. Check for leaks.

(lockable) detected but leaks, tube ≥ (1PPEAK - 5 cmH2O) 2. Check for correct tube type
not 1PCOMP type/I.D. and I.D. settings.
setting

Last spont
breath ≥ set
1PPEAK limit
Last 3 spont
breaths ≥ set
1PPEAK limit
Last 4 or more
spont breaths
≥ set 1PPEAK
limit

3VTE SPONT Check patient Exhaled spontaneous tidal

& settings volume ≤ set limit

3VE TOT Check patient Total minute volume ≤ set limit

& settings

1fTOT Check patient Total respiratory rate ≥ set limit.

& settings

1PMEAN Measured airway pressure ≥ set 1. Run SST.

(lockable) limit. Ventilator truncates current 2. Run EST.
breath unless already in
exhalation.

1PPEAK Check patient, 1PPEAK detected and NOT

(lockable) circuit, & ET 1PCOMP.
tube.

1PVENT Inspiratory pressure > 100 1. Run SST.

(lockable) cmH2O and mandatory type = 2. Run EST.
VC. Ventilator truncates current
breath unless already in
exhalation.

1VTE Exhaled tidal volume ≥ set limit. 1. Run SST.

(lockable) Alarm updated whenever 2. Run EST.
exhaled tidal volume is
recalculated.

1VE TOT Expiratory minute volume ≥ set 1. Run SST.

(lockable) limit. Alarm updated whenever 2. Run EST.
an exhaled minute volume is
recalculated.

1VTI MAND Delivered inspiratory volume ≥ Check patient and settings.

(lockable) high inspiratory volume limit
(breath type = VC+)

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7 Alarm handling

Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

1VTI SPONT Delivered inspiratory volume ≥ 1. For TC: Check for leaks,
(lockable) high inspiratory volume limit tube type/I.D. setting.
(breath type = TC or VS) 2. For VS: Check patient and
settings.

1fTOT Total respiratory rate ≥ set limit. 1. Run SST.

(lockable) Alarm updated at the beginning 2. Run EST.
of each inspiration. Reset when
measured respiratory rate falls
below the alarm limit.

INOPERATIVE BPS installed but not Run EST.

BATTERY functioning. Resets when BPS is
functional.

INSPIRATION Inspiratory time for spontaneous 1. Run SST.

TOO LONG breath ≥ IBW-based limit. 2. Run EST.
(lockable) Ventilator transitions to
exhalation. Resets when TI falls
below IBW-based limit.

LOSS OF Power switch is on, but there is Turn power switch off to reset
POWER insufficient AC and BPS power. alarm. Restore AC power.
There may not be a visual
indicator for this alarm, but an
independent audio alarm sounds
for at least 120 s.

LOW AC Ventilator Power Mains (AC) power has dropped 1. Check integrity of AC
POWER currently not interrupt below 80% of nominal for 1 s. power source.
affected. possible. Ventilator continues operation as 2. If ventilator software was
close to settings as possible. recently downloaded or if
Resets when there is no low AC ventilator was moved
power signal for 1 s. between locations with dif-
ferent voltages, check Ser-
vice Mode Setup
NOTE: configuration.
Compressor operation 3. Check connections of AC
may be disrupted during power distribution compo-
low AC events. nents.

LOW BATTERY Operational Replace or Resets when BPS has more than 1. Check integrity of AC
time < 2 allow approximately 2 min of power source.
minutes. recharge. operational time remaining. 2. Check connections of AC
power distribution compo-
nents.

LOW INSP Inspiratory target pressure 1. Check patient.

PRESSURE < (PEEP + 5cmH2O) when 2. Check target volume.
(lockable) mandatory type is VC+

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Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

3O2% Measured Check patient, The O2% measured during any 1. Calibrate oxygen sensor.
O2% < set gas sources, phase of a breath cycle is 7% 2. Run EST.
O2%. O2 analyzer & (12% during the first hour of 3. Replace oxygen sensor.
ventilator. operation) or more below the 4. Inspect oxygen PSOL
O2% setting for at least 30 s, or (PSOL1).
below 18%. (These percentages
increase by 5% for 4 minutes
following an increase in the O2%
setting.) Alarm updated at 1-s
intervals.

3VTE MAND 2 of last 4 Check for Exhaled mandatory tidal volume Run SST.
(lockable) mand. breaths leaks, changes ≤ set limit. Alarm updated
≤ set limit. in patient‘s whenever exhaled mandatory
RSTAT & CSTAT. tidal volume is recalculated.

3 of last 4 Check for

mand. breaths leaks, changes
≤ set limit. in patient‘s
RSTAT & CSTAT.

4 of last 4 Check for

mand. breaths leaks, changes
≤ set limit. in patient‘s
RSTAT & CSTAT.

3VTE SPONT Exhaled spontaneous tidal Run SST.

(lockable) volume ≤ set limit. Alarm
updated whenever exhaled
spontaneous tidal volume is
recalculated.

3V E TOT V. E TOT ≤ set Check patient Total minute volume ≤ set limit. Run SST.
(lockable) limit for ≤ 20s. & settings. Alarm updated whenever
exhaled minute volume is
V. E TOT ≤ set Check patient recalculated.
limit for > 20s. & settings.

V. E TOT ≤ set Check patient

limit for > 40s. & settings.

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Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

NO AIR SUPPLY Ventilation Check air Ventilator delivers 100% oxygen. 1. Check air inlet filter.
continues as source. Resets if air supply connected. 2. Check pressure switch con-
set. Only O2 nections.
available. 3. Run EST.

Compressor Check air Ventilator delivers 100% oxygen. 1. Check air inlet filter.
inoperative. source. Resets if air supply connected. 2. Check pressure switch con-
Ventilation nections.
continues as 3. Run EST.
set. Only O2
available.

Ventilation Check patient Ventilator delivers 100% oxygen 1. Check air inlet filter.
continues as & air source. instead of set O2%. Resets if air 2. Check pressure switch con-
set except supply connected. nections.
O2% = 100 3. Run EST.

Compressor Check patient Ventilator delivers 100% oxygen 1. Check air inlet filter.
inoperative. & air source. instead of set O2%. Resets if air 2. Check pressure switch con-
Ventilation supply connected. nections.
continues as 3. Run EST.
set, except
O2% = 100.

No Provide Safety valve open indicator 1. Check inlet filters.

ventilation. alternate lights. Upper screen displays 2. Check pressure switch con-
Safety Valve ventilation. elapsed time without ventilator nections.
Open. Check both support. Resets if air and oxygen 3. Run EST.
gas sources. supplies are connected.

NO O2 SUPPLY Ventilation Check patient Resets if oxygen supply 1. Check oxygen inlet filter.
continues as and O2 connected. 2. Check pressure switch con-
set. Only air source. nections.
available. 3. Run EST.

Ventilation Check patient Ventilator delivers 21% oxygen 1. Check oxygen inlet filter.
continues as & O2 source instead of set O2%. Resets if 2. Check pressure switch con-
set, except oxygen supply connected. nections.
O2% = 21. 3. Run EST.

No Provide Safety valve open indicator 1. Check inlet filters.

ventilation. alternate lights. Upper screen displays 2. Check pressure switch con-
Safety Valve ventilation. elapsed time without ventilator nections.
Open. Check both support. Resets if air and oxygen 3. Run EST.
gas sources. supplies are connected.

O2 SENSOR O2 sensor out Oxygen sensor requires 1. Calibrate O2 sensor.

of calibration/ calibration or replacement. 2. Replace and calibrate O2
failure. Press Ventilation is unaffected. User sensor.
100% O2 may also disable FIO2 monitor. 3. Disable O2 sensor.
CAL, replace,
or disable.

PROCEDURE Patient Provide Ventilator begins safety Complete patient setup.

ERROR connected alternate ventilation. Resets when
before setup ventilation. ventilator startup procedure is
complete. Complete complete.
setup process.

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Table 7-2: Alarm messages (continued)

Analysis Remedy
Base message Description Corrective action
message message

SCREEN BLOCK Possible Remove Possible blocked beam (GUI) or 1. Remove obstruction.
blocked beam obstruction or touch screen fault. 2. Service ventilator.
or touch service
screen block. ventilator.

SEVERE Little/no Check patient. Ventilator enters occlusion status Run EST.
OCCLUSION ventilation. Provide cycling (OSC) and upper screen
alternate displays elapsed time without
ventilation. ventilator support.
Clear
occlusions;
drain circuit.

VOLUME NOT Last 2 mand Check patient Ventilator cannot deliver target Check patient and settings.
DELIVERED breaths, and setting for volume.
(This alarm pressure > 2PPEAK.
applies to VC+ max allowable
and VS level
breaths.)
Last 10 or
more mand
breaths,
pressure >
max allowable
level

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