Difficulty to fix ventilator low peep alarm

Specialties Pulmonary

Published

Hi ,

I had a copd patient who had history of chf and severe cellulitis in both legs. She had an order for bipap prn. Her wheezes was very high that we could her out if her room. Very laboured breathing. I connected bipap, made sure there is no leak anywhere on the connections, around her face. The machine was constantly alarming for low peep every five minutes . I am 100 percent sure there is no leak. Is there any other reason for this alarm... Help me please .. To my knowledge I thought only leak is low peep alarm .

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I know this is the obvious, but was the settings checked to make sure the alarms were in an appropriate range? Also, every once in a great while you will have valve problems with these machines. Hopefully, after you did your troubleshooting they let you replace that machine with a different one. You seemed to have done all that you could to correct/trouble shoot the problem. Mask leaks are usually the problem with the second issue being alarm settings. After that, you have to assume it's the machine that has an issue.

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May be I will do that.... I will make sure machine has no issues ... But is there any other reason other than leak for low peep alarm?

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The reasons could be inappropriate alarm settings, leaks, or a valve problem within the machine. So leaks either in the mask, in the circuit, or in the machine, or alarm settings are the only reasons I can think of for the low peep alarms.

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Great ... I was not able to think alarm settings ... Let me check that... Thanks a lot...

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I will start off by saying I am not a nurse. I am a Registered Respiratory Therapist.

Are you using a ventilator like a BiPAP machine or do you have a BiPAP machine like the Vision or V60?

If you have NO leak you have a problem. The mask is too tight and will do harm to the patient's skin. Leaks are acceptable and the machine compensates especially if you did the proper testing prior to application.

You stated labored breathing. For this you need to look at the graphics. If the patient is pulling a breath in and it goes below the line of PEEP, you will get an alarm and it is an indication the patient is not getting the flow needed for each breath and/or may require sedation. Depending on the machine you are using, you may need a different one capable of delivering more flow. Many transport ventilators get used as BiPAPs and their flow delivery is not always adequate for an acutely ill patient. You might also look at the delivery settings on the BiPAP machine. Is your wave slope, I time or rise set too slow restricting the flow? The graphics are essentially true to the saying "a picture is worth a thousand words".

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I am using ventilator as bipap machine... It says LTV 1200 care fusion

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Do you have the graphics monitor attached?

Are you running off 50 psi Oxygen outlet or using the low flow oxygen port?

Are you utilizing the NIV which eliminates some alarms?

What face mask are you using? The correct mask interface is a major factor.

This ventilator is used primarily for short term BiPAP. It is not the ideal machine for long term or much beyond the emergency room or transport. In the acute phase, other therapies would need to be initiated for the BiPAP to be successful regardless of the machine.

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First three questions I can't really understand I am sorry but I don't have any graphs ...

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Mask I will look and say now

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It just says bipap mask...

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Specializes in Complex pedi to LTC/SA & now a manager.
First three questions I can't really understand I am sorry but I don't have any graphs ...

Does your facility have respiratory therapists? You seem to not have adequate training or orientation to use this equipment? Do you not have senior staff in the ICU to ask for assistance rather than an anonymous message board?

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