savina_alarm_messages_sw_2-0.pdf
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Alarm Messages
Ventilation monitoring
Alarm Messages
Ventilation monitoring
Upper airway pressure limit
First pressure limit
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Cause:
1.
The patient fights the ventilator or is coughing.
2.
The inspiration tube is kinked or obstructed.
3.
One or both pressure sensor(s) deliver(s) too high a measured value.
4.
The pressure source delivers a pressure that deviates from the set pressure.
Detection:
1.
The measured value of the inspiratory pressure sensor Pinsp(t) exceeds the value of the
upper airway pressure limit Paw-high + offset.
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Alarm Messages
2.
Ventilation monitoring
The measured value of the expiratory pressure sensor Pexp(t) exceeds the value of the upper
airway pressure limit Paw-high.
Suppression:
1.
After a cold start and 15 s afterwards (only alarm).
2.
During standby and 15 s afterwards (only alarm).
Reaction:
1.
Generation of event "Paw stenosis 1" (warning "!!! Airway pressure high").
2.
Transmission of event "Paw stenosis 1" to ventilation control to stop inspiration.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Resetting:
1.
As soon as next inspiration starts (= start of inspiration flow).
2.
Five seconds after occurrence of alarm cause.
3.
Value decreases below alarm limit by 5 mbar (ventilation control only).
4.
If a measured value becomes invalid, the detected condition will not be restored as a result.
5.
Second pressure limit (Paw high + 5 mbar)
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Alarm Messages
Ventilation monitoring
Second pressure limit (Paw high + 5 mbar)
Cause:
1.
The patient fights the ventilator or is coughing.
2.
The inspiration tube is kinked or obstructed.
3.
One or both pressure sensor(s) deliver(s) too high a measured value.
4.
Pressure source delivers incorrect pressure.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Detection:
1.
The measured value of the inspiratory pressure sensor Pinsp(t) exceeds the value of the
upper airway pressure limit Paw-high + offset for more than 200 ms.
2.
The measured value of the expiratory pressure sensor Pexp(t) exceeds the value of the upper
airway pressure limit Paw-high for more than 200 ms.
3.
The measured value of the inspiratory pressure sensor Pinsp(t) exceeds the value of the
upper airway pressure limit Paw-high + offset(t) +5 mbar for more than 50 ms.
4.
The measured value of the expiratory pressure sensor Pexp(t) exceeds the value of the upper
airway pressure limit Paw-high +5 mbar for more than 50 ms.
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Alarm Messages
5.
Ventilation monitoring
The input value "Paw (SiSW)" shows an error.
Suppression:
1.
After a cold start and 15 s afterwards (only alarm).
2.
During standby and 15 s afterwards (only alarm).
Reaction:
1.
Generation of event "Paw stenosis 2" (warning "!!! Airway pressure high").
2.
Transmission of event "Paw stenosis 2" to ventilation control in order to relieve the lungs or to
open the electrical safety valve.
3.
Detection 5: Alarm only.
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R5664900FL2.fm 03.12.01
Resetting:
1.
When airway pressure reaches 5 mbar (relief successful), but at the earliest after 500 ms.
2.
Five seconds after occurrence of event cause.
3.
Detection 5: The input value "Paw (SiSW)" does no longer show an error.
4.
If a measured value becomes invalid, the detected condition will not be restored as a result.
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Alarm Messages
Ventilation monitoring
Lower airway pressure limit
Cause:
1.
The hose system or one of the hoses is disconnected or leaky.
2.
The measured value delivered by the expiratory pressure sensor is too low.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Detection:
1.
In all ventilation modes with a PEEPsetting of at least 3 mbar:
If the airway pressure Pexp(t) measured with the expiratory pressure sensor is below the set
PEEP, then the difference between the PEEPsetting and Pexp(t) is integrated in a summation
memory (limited to 4.5 mbar).
An alarm is given when the value in the summation memory exceeds 22.5 mbar*s. The
summation memory is deleted if the measured airway pressure exceeds the PEEPsetting
again. The summation memory is also deleted after changing the operating mode or setting
the PEEP below 3 mbar.
2.
In volume-controlled ventilation (IPPV, SIMV, apnea ventilation) or pressure-controlled
ventilation (BIPAP, AutoFlow modes):
In two subsequent mandatory inspiratory breaths (machine inspiration) the measured value
Pexp(t) does not reach the limit value Pmin for more than the minimum time Tmin in each
case.
The level and derivation of the Pmin threshold depend on the ventilation mode:
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Alarm Messages
Ventilation monitoring
volume controlled: Pmin = PEEPsetting +5 mbar
pressure-controlled: Pmin = 0.5 * (PEEPsetting +Pinsp)
The minimum time is determined by:
Tmin = min (¼ * Tinsp, measured, 100 ms)
Tinsp, measured, is derived from the phase information of the ventilation control.
Suppression:
1.
Detection 1 is activated only at PEEPsetting ≥3 mbar.
2.
After cold start and 15 s afterwards.
3.
During standby and 15 s afterwards.
4.
During a detected disconnection and 15 s afterwards.
Reaction:
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
1.
Generation of event "Airway pressure low" (warning "!!! Airway pressure low"). The warning
is delayed in relation to the event by the adjustable time Tdisconnect.
Resetting:
1.
Detection 1: If the summation memory has been deleted.
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Alarm Messages
Ventilation monitoring
2.
Detection 2: During the next inspiratory breath, the measured value Pexp(t) reaches the limit
value Pmin for more than Tmin.
3.
Detection 2: After switching to pure spontaneous breathing mode.
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Alarm Messages
Ventilation monitoring
Minute volume
MV low
Cause:
1.
Spontaneous ventilation of the patient is insufficient.
2.
Spontaneous ventilation of the patient is sufficient, but the expiratory flow measured is too
low due to leakages in the expiratory tube.
3.
The flow control unit is faulty and therefore delivers too low an inspiratory flow.
4.
The flow sensor is faulty and therefore measured values delivered are too low.
Detection:
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R5664900FL2.fm 03.12.01
1.
The measured value MV(t) is below the lower MV limit value MV low.
Suppression:
1.
After a cold start and 2 minutes afterwards.
2.
During standby and 2 minutes afterwards.
3.
When flow monitoring is off and 2 minutes afterwards.
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Alarm Messages
Ventilation monitoring
4.
During detected disconnection and 2 minutes afterwards.
5.
The alarm can be activated by the user under mask ventilation (NIV).
Reaction:
1.
Generation of event "MV low" (warning "!!! MV low").
Resetting:
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R5664900FL2.fm 03.12.01
1.
The measured value MV(t) exceeds the limit value MV low.
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Alarm Messages
Ventilation monitoring
MV high
Cause:
1.
Spontaneous ventilation of the patient is too high.
2.
The flow control unit is faulty and therefore delivers too high an inspiratory flow.
3.
The flow sensor is faulty and therefore measured values delivered are too high.
Detection:
1.
The measured value MV(t) exceeds the limit value MV high set by the user.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 15 s afterwards.
2.
During standby and 15 s afterwards.
3.
When flow monitoring is off.
Reaction:
1.
Generation of event "MV high" (warning "!!! MV high").
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Alarm Messages
Ventilation monitoring
Resetting:
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
1.
The measured value MV(t) is below the limit value MV high.
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Alarm Messages
Ventilation monitoring
Inspiratory tidal volume
VTi low
Cause:
1.
The setting "FlowAcc" is too low.
2.
The setting "Tinsp" is too low.
3.
The setting "Pinsp" or "Pmax" is too low.
Detection:
1.
The input value "VTi low" displays too low a tidal volume.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 15 s afterwards.
2.
During standby and 15 s afterwards.
3.
During a detected disconnection and 15 s afterwards.
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Alarm Messages
Ventilation monitoring
Reaction:
1.
The event "VTi low (1)" (advisory "! Tidal volume low") is generated after the second
occurrence of the event "VTi low".
2.
The event "VTi low (2)" (caution "!! Tidal volume low") is generated after the fourth
occurrence of the event "VTi low".
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Resetting:
1.
The caution message "!! Tidal volume low" was acknowledged with the "Alarm reset" key.
Only the caution message (event "VTi low (2)") is reset, not the advisory message.
2.
The input value "VTi low" does no longer display too low a tidal volume.
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Alarm Messages
Ventilation monitoring
VTi high
Cause:
1.
Too high a tidal volume is applied due to a change in the state of the lungs.
2.
Spontaneous ventilation of the patient is too high.
Detection:
1.
During a mandatory inspiration (volume-controlled, pressure-controlled) the measured value
VTi(t) exceeds the limit value VTi high set by the user.
2.
During a spontaneous inspiration (pressure-assisted, spontaneous) the measured value
VTi(t) exceeds the limit value VTi high set by the user.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 15 s afterwards (only alarm).
2.
During standby and 15 s afterwards (only alarm).
3.
During a detected disconnection and 15 s afterwards (only alarm).
4.
The alarm can be activated by the user under mask ventilation (NIV).
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Alarm Messages
Ventilation monitoring
Reaction:
1.
After the first breath: Generation of the event "VTi high (1)"
(advisory "! Tidal volume high").
2.
After the third breath: Generation of the event "VTi high (2)"
(warning "!!! Tidal volume high").
3.
Transmission of event to ventilation control to stop inspiration.
There are counters for detection 1 and 2 which lead to reaction 1 or 2.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Resetting:
1.
Detection 1: At the end of a mandatory inspiration, the applied tidal volume is below the set
monitoring limit again.
2.
Detection 1: After switching to pure spontaneous breathing mode.
3.
Detection 2: At the end of a spontaneous inspiration, the applied tidal volume is below the set
monitoring limit again.
4.
Detection 2: There was no spontaneous inspiration between two mandatory inspirations.
5.
Detection 2: After switching to pure mandatory mode.
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Alarm Messages
Ventilation monitoring
Oxygen concentration
FiO2 low
Cause:
1.
The oxygen control cannot reach the correct FiO2 set.
Detection:
1.
The measured value FiO2(t) is below the limit value FiO2 low.
This error detection is provided with an error counter.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 2 minutes afterwards.
2.
During standby and 2 minutes afterwards.
3.
When O2 monitoring is off and 2 minutes afterwards.
4.
During calibration of the O2 sensor and 2 minutes afterwards.
5.
After adjusting the FIO2target value and 2 minutes afterwards.
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Alarm Messages
Ventilation monitoring
Reaction:
1.
Generation of event "FiO2 low" (warning "!!! FiO2 low").
Resetting:
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1.
The error counter is below the limit value of the alarm.
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Alarm Messages
Ventilation monitoring
FiO2 high
Cause:
1.
The oxygen control cannot reach the correct FiO2 set.
Detection:
1.
The measured value FiO2(t) exceeds the limit value FiO2 high. This error detection is
provided with an error counter.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 2 minutes afterwards.
2.
During standby and 2 minutes afterwards.
3.
When O2 monitoring is off and 2 minutes afterwards.
4.
During calibration of the O2 sensor and 2 minutes afterwards.
5.
After adjusting the FIO2target value and 2 minutes afterwards.
Reaction:
1.
Generation of event "FiO2 high" (warning "!!! FiO2 high").
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Alarm Messages
Ventilation monitoring
Resetting:
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R5664900FL2.fm 03.12.01
1.
The error counter is below the limit value of the alarm.
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Alarm Messages
Ventilation monitoring
FiO2 limit values
As described in chapters FiO2 low and FiO2 high, the measured value FiO2(t) is compared to an
upper and a lower limit value. An alarm is generated if there is a deviation. These two limit values
are generated as follows:
Normal operation (concentrator is not active)
− FiO2 low = FiO2 target value -8 vol.%
− FiO2 high = FiO2 target value +8 vol.%
− Fixed alarm limit = FiO2 low ≥18 vol.%
Concentrator is active
− The FiO2 alarm limits set by the user are used.
For internal use only. Copyright reserved.
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Remark: Bronchial suction (oxygenation) changes the set FiO2 concentration to 100%. The limit
value is changed at the same time.
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Alarm Messages
Ventilation monitoring
Change in breathing cycle
Apnea
Cause:
1.
Spontaneous breathing of patient has stopped.
2.
Hose system is disconnected or there is a major leakage.
3.
The flow sensor is defective.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Detection:
1.
If, in all operating modes, the "ExpFlow start" and "ExpFlow end" information is missing for
more than the set apnea alarm time, this will be regarded as apnea.
2.
If, in spontaneous and mixed operating modes, the "ExpFlow start" and "ExpFlow end"
information is missing for more than the set apnea alarm time, this will be regarded as apnea.
3.
The input value "Apnea (SiSW)" shows an apnea condition.
Suppression:
1.
After a cold start and 15 s afterwards.
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Alarm Messages
Ventilation monitoring
2.
During standby and 15 s afterwards.
3.
During a detected disconnection and for the period Tapnea afterwards.
4.
A "Fail to Cycle" alarm has occurred.
5.
An "Airway pressure high" alarm has occurred.
6.
An "Airway pressure low" alarm has occurred.
7.
Hold condition is active (with insp. hold).
8.
Flow monitoring is switched off.
9.
The alarm can be activated by the user under mask ventilation (NIV).
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
When flow monitoring is switched off, only that part of the monitoring is suppressed which detects
the error by using the expiration start and expiration end information from the expiratory flow
sensor.
Reaction:
1.
Generation of the event "Apnea" (warning "!!! Apnea")
2.
Transmission of the event "Apnea" to the ventilation control to switch on apnea ventilation, if
applicable.
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Alarm Messages
Ventilation monitoring
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Resetting:
1.
Detection 1 and 2: At least one part of the information about inspiration (that is, start or end)
and one part of the information about expiration are no longer missing.
2.
The input value "Apnea (SiSW)" no longer shows an apnea condition.
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Alarm Messages
Ventilation monitoring
Fail to Cycle
Cause:
1.
The ventilator does no longer generate control information of the flow-control unit.
2.
Due to device settings, only very low volumes can be applied if the patient’s lungs are hard.
Detection:
1.
If, in pure controlled modes (IPPV, SIMV), the "ExpFlow start" and "ExpFlow end" information
is missing for more than the set apnea alarm time, this will be regarded as "Fail to Cycle".
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Suppression:
1.
After a cold start and 15 s afterwards.
2.
During standby and 15 s afterwards.
3.
During a detected disconnection and for the period Tapnea afterwards.
4.
An "Airway pressure high" alarm has occurred.
5.
An "Airway pressure low" alarm has occurred.
6.
Hold condition is active (with insp. hold).
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Alarm Messages
Ventilation monitoring
Reaction:
1.
Generation of the event "Fail to Cycle" (warning "!!! Fail to Cycle").
Resetting:
1.
At least one part of the inspiration start or inspiration end information is no longer missing.
For internal use only. Copyright reserved.
R5664900FL2.fm 03.12.01
Note: The alarms "Apnea" and "Fail to Cycle" are mutually exclusive because they are only modedependent variations.
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