A female patient suffers acute respiratory distress syndrome as a consequence of shock. The patient’s condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?
A. Kinking of the ventilator tubing.
B. A disconnected ventilator tube.
C. An endotracheal cuff leak.
D. A change in the oxygen concentration without resetting the oxygen level alarm.
Correct Answer: A. Kinking of the ventilator tubing.
Conditions that trigger the high-pressure alarm include kinking of the ventilator tubing, bronchospasm or pulmonary embolism, mucus plugging, water in the tube, coughing or biting on endotracheal tube, and the patient’s being out of breathing rhythm with the ventilator. If an alarm occurs, the caregiver should always evaluate the patient before checking the ventilator.
Option B: A disconnected ventilator tube would trigger the low-pressure alarm. If the pressure inside the breathing circuit drops below the Low Airway Pressure Alarm limit set on the ventilator, an audible and/or visual alarm activates.
Option C: Some causes for low-pressure alarms are: the patient becomes disconnected from the ventilator circuit; inadequate inflation of the tracheostomy tube cuff; poorly fitting noninvasive masks or nasal pillows/prongs; loose circuit and tubing connections; or the patient demands higher levels of air than the ventilator is putting out.
Option D: Changing the oxygen concentration without resetting the oxygen level alarm would trigger the oxygen alarm. Oxygen concentration is the amount of oxygen delivered to the patient. When the patient is not receiving added oxygen, the oxygen level will be the same as room air (21%).
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