V4: August 2018
Page 26 of 31
For Review: August 2019
Author: LTV Team/JT
Understanding Alarms
Low VTE/Low MVE
Disconnection/leak
1 Assess child
Accidental
decannulation
(i.e. tracheostomy
has come out)
Action
Immediately insert
tracheostomy
If difficulty follow
emergency
algorithm
1 Assess child
Possible
causes
include:
Blocked
tracheostomy
Action
Emergency
algorithm:
1. Suction
2. Emergency
tracheostomy
change
2 Assess
equipment
Disconnection
within circuit
(follow circuit from
child through to
ventilator and
ensure everything
is connected
–
NB humidifier
connectors etc
may be slightly
loose)
Cause
- some leak may be
tolerated and may
be due to position
of child
–
discuss
with community ±
medical teams, who
can consider need
for cuffed trache or
upsize
2 Assess child
Retained
secretions/
increased
pulmonary
resistance etc
Action
• suction,
consider need
for nebulisers,
physiotherapy
• refer to advanced
treatment plan
• discuss with
community or
medical team
3 Assess child
Possible
causes include:
Leak around
tracheostomy
(particularly when
asleep)
Action
• Reconnect any
loose connections
• Re
-assess
3 Assess
equipment
Circuit
blockage
(Follow circuit
from child through
to ventilator
and ensure it is
not kinked or
obstructed)
1 Assess child
• Correct fault
• Re
-assess
Is the alarm set
appropriately
(i.e. as previously
recorded and
checked at start of
shift)
• Check alarm
settings are as
prescribed and
re-set if any
discrepancies
Is the alarm set
appropriately
(i.e. as previously
recorded and
checked at start of
shift)
• Check alarm
settings are as
prescribed and
re-set if any
discrepancies
If the child is compromised and you can’t resolve the issue rapidly
–
hand ventilate and call for help
