low pressure alarm if trach comes out?

CRNA1982 · Dec 12, 2011

@CRNA1982..... I am familiar with and responsible for the LTV 950, and my only question was if the alarm would sound if the trach came out of the patient. IT DOESN'T! (reply #11) I know what all the alarms mean. Why is that even in this discussion? I am getting information from people who are familiar with the vents. (CLEARLY it's not you). That's why I asked the question here. Welcome to the world of nursing, where nurses are trained through baptism by fire. If you ever get your hands on a shiley, attach it to an LTV 950 and you'll see there is no alarm. Low pressure setting at 8. SHEESH....
@Perpetual Student....Yes. I also agree that you should not rely on the alarms to notify you of a decannulation, for your reason and the reason I gave in reply #11.

I was trying to help you......by replying to numerous posts from you. Then you started getting ****** with me. Don't turn this around on me..... All ventilators that I work with have low pressure alarms; and they work very well. If I ever have a disconnect, the alarms sound like crazy. The only person that has tried helping you on this thread is me, so good luck finding people on this website who can help you with this matter.

Cuddleswithpuddles · Dec 12, 2011

Errrmmmm.....
Ok, so what I did was just attach a trach to the vent to see if it would alarm. Nothing happened. I put my hand over it and the High Pressure alarm sounded. But, when I let off, no low pressure alarm.
I just wanted to mention that, just in case someone else had the same question.

I don't understand what you just described here.

Did you take an unused Shiley from its box and attach it to the vent?

If...

1. the vent is pushing air into a plain old Shiley (just straight out of the box with nothing blocking the lumen) and...

2. the silence button has not been pushed recently and...

3. the vent is not giving you a low pressure alarm....

...there is something wrong with your ventilator.

Disconnection and decannulation trigger low pressure alarms. It does not matter what ventilator model.

ETA: Even if your silence button was pushed recently, there should still be some sort of visual alarm that indicates low pressure.

Cuddleswithpuddles · Dec 12, 2011

I've noticed on the LTV's it sometimes takes a few breaths before alarms will sound. But the trach should be have ties on it that prevent it from coming out, so you shouldn't have to worry about it anyways!

I've seen decannulation happen with loose trach ties. The ties remained in place but allowed a squishy, flexible Bivona trach to come out and rest on the kid's skin just under the gauze dressing. It looked like it was still in until I lifted up the gauze. If it were not for the vent alarming and whirring like crazy, I could have sworn that everything was OK.

allnurses Guide · Dec 12, 2011

Lots of people manage home vents CRNA82 - including home health aides and one person who couldn't read or write, just so you know--- I guess it's legal because the state pays for an initial training.

If the air doesn't meet resistance the low-pressure alarm will sound depending on the parameters on the ventilator. If it doesn't I wouldn't use it. We had an awesome RT who loved to talk ventilator shop.

Look what I found - videos! Don't know if they cover your issues but I love to put links in my posts. :) They're instructional videos.

nursedelia · Dec 12, 2011

@Cuddleswithpuddles....as far as I can tell, yes, that's exactly what I did. But, I didn't get an alarm. Could have been because the low pressure setting was on 8. That's the lowest I've ever had. Like I said, I got the high pressure alarm, but no indications when I took my hand off....weird....I'll call RT in the morning and ask.

Btw. cuddleswithpuddles, reply #26 was also a good reminder. Very helpful, thank you.

@nursel56....again, maybe my low pressure setting was too low at 8.

@all who replied to this thread and tried to help, I should say that I appreciate the input. You never know what you can learn from someone's post and ideas, whatever that may be. :)

CRNA1982 · Dec 13, 2011

Lots of people manage home vents CRNA82 - including home health aides and one person who couldn't read or write, just so you know--- I guess it's legal because the state pays for an initial training.
If the air doesn't meet resistance the low-pressure alarm will sound depending on the parameters on the ventilator. If it doesn't I wouldn't use it. We had an awesome RT who loved to talk ventilator shop.
Look what I found - videos! Don't know if they cover your issues but I love to put links in my posts. :) They're instructional videos.

I am perfectly aware that lots of people can manage home vents; including home health aides or even a blind person....they are easy to manage. The OP has been posting about this issue since October 2011. I ASSUMED that she was not the one responsible for the operation of this ventilator because she was not aware of how to activate alarm settings for low pressure disconnects.....for 3 months now. That is three months that she is caring for someone who requires ventilatory support without a working "low pressure alarm." Glad its not my grandmother on the other end of that circuit.

allnurses Guide · Dec 13, 2011

I'm sorry if I assumed something about you -- as a CRNA you are the professional with knowledge depth in that particular area of expertise. It wasn't until I started home vent/trach nursing a few years ago that I became aware of their prevalence and user-friendliness. This can (and I stress this does not apply to the OP) lead to a complacency. There are a few accounts in this forum of some near-tragedies that have made my hair stand on end.

Anyway, it sounds like nursedelia now has the input she was seeking, based on her last post.

nursedelia · Dec 13, 2011

"I can't answer these questions for you. I am not familiar with the vent that you are using and it is not in front of me to play with."

Really? You're going to internet bully me on a nursing forum? Get off my thread. I don't need your help. You need to work on your people skills. FYI No one cares how much you know if you don't share it without being a complete jerk about it. I know I don't.

I don't really want to explain this to you, because I don't like going out of my way to explain things to people I don't respect. But, I haven't had this patient for 3 months, and the low pressure setting has just been changed by a doctor at the request of my RT. Furthermore, I was not relying on the alarm, I was watching my patient. Go where you are most needed. You know? Somewhere someone wants to hear your crap.

Oh, and for the sake of your character, stop belittling people for asking questions.

nursedelia · Dec 13, 2011

and the all the alarms are working. I thought I mentioned that.

nursedelia · Dec 13, 2011

ASSUMING is not the best way to get your information.

RescueNinja · Dec 13, 2011

I did not read through all the posts so this may have been posted already, but the very first thing I check when I have a trach patient (okay, second thing after code status) is that I have an extra trach at the bedside so that I can pop that sucker back in in case of emergency. Usually I keep two at the bedside. One that is the size pt has in and one size smaller - you don't want to be fussing with it too much in an emergent situation.

Check your policies. One hospital I worked at required all RNs/RTs to be trained and signed off on emergency insertion before you were ok to do so, but at my current facility there is no training, but you are expected to do so.

nursedelia · Dec 13, 2011

Thank you RescueNinja (LOVE that name). Yes, I've got that covered. Piece o' cake piece o' pie on that one. Luckily I got signed on prn with a company who would show you hands on until you got it right and felt comfortable. No gruff. :) Great input!

Thank you!