LTV ventilator controls and alarms (1215)

Key points below

What does the ventilator do?

The ventilator gives extra breaths or pressure to help your child breathe easier.

What do the displays mean?

Airway pressure

Display window/screen/menu

Display window readings

VTE (exhaled tidal volume) This is the size of the breath that the ventilator recognizes is coming back to the machine through the tubing. This number may change from breath to breath.
VTI (inhaled tidal volume) This is the size of the breath that the ventilator is delivering.
PIP (Peak Inspiratory
Pressure)		 This is the actual amount of pressure it takes to deliver the breath (airway pressure).
PEEP (Positive End Expiratory Pressure) This is how much air, or pressure, is left in the lungs before taking in a breath.
Ve/MVe (exhaled minute volume) and/or Vi/MVi
(inhaled minute volume)		 This is a measurement of the volume of air that moves in and out of the lungs in one minute.
f (frequency) or RR
(respiratory rate)		 This is the total number of breaths the machine is giving plus what your child is taking.
MAP (Mean Airway
Pressure) or Avg. P		 This is a number representing the average pressure in the lungs while on the ventilator.
I:E This is a ratio of how long the child is breathing in, and breathing out.
Vcalc or PIF This is the highest flow it takes to deliver the ventilator breath.
Leak This is a calculation of how much air is not returning to the ventilator through the tubing from the amount that was originally delivered.
FiO2 This is the percentage of oxygen going through the
ventilator.

What do the lights mean?

 Patient effort  Lights up briefly when your child triggers a breath.
 External power Green: The external battery is fully charged.
Yellow: The external battery is low. Plug ventilator in a wall socket. Put the battery on the charger.
Battery Symbol: Green color represents the percent of the battery charged.
Charge status

Charge status (continued)
 

Green: The internal battery is fully charged.

Yellow:

– If solid, the internal battery is being charged.  
– If flashing, the battery Is being checked.

Red:

– The internal battery cannot be charged.
– Contact DME supplier.

Battery Symbol: A lightning bolt shows the battery is actively charging. The battery will be all green when fully charged.  
Battery level (internal battery only) Green:  Full charge  
Yellow:  Half charged   
Red: Will be empty in about 7 minutes.
Battery Symbol: Green color represents the percent of battery charged.

Note: When the ventilator is unplugged from a wall outlet, the external battery source (if in place) will be used first, and then the internal battery.  When plugged back into a wall outlet, the internal battery will charge first, then the external battery (if in place).

How are the settings done?

All prescription settings and alarms are doctor-ordered. They will be set by your child’s respiratory healthcare provider. If the doctor changes the orders, the settings are to be changed only by the respiratory healthcare provider. 

Ventilator settings ordered for your child 

Settings definition

 Ventilation type Either pressure or volume ventilation will be ordered. 
 Mode AC (Assist/control) – Your child can take more breaths than the ventilator gives, each breath delivered has the same volume/pressure.
SIMV – Your child can take more breaths than the ventilator gives, each volume breath delivered has a different pressure.
CPAP – Your child takes breaths on own with a set end pressure.
 
 Breath rate The number of ventilator breaths given in 1 minute. This will be the minimum amount of breaths delivered by the ventilator.
 Tidal volume The set volume that determines the size of breath the ventilator gives.
Pressure control The set pressure that determines the size of the breath the ventilator gives.
Inspiratory time  How fast a breath goes in.
Sensitivity  How hard or easy it is to trigger the ventilator.
Pressure support An amount of pressure used only with spontaneous breaths. This decreases the work it takes to breath with the ventilator tubing connected.
PEEP Pressure left in the lungs at the end of the breath, before starting the next breath.  It holds the lungs open all of the time.
Alarms High pressure – Something is blocking the breath being given. You child may be coughing, crying or hiccupping. The tubing could have water in it, or be kinked. Low pressure – Leak in the system, either around the trach tube or in the ventilator tubing.  Low minute volume – The ventilator is not getting enough air flow back, over the course of one minute, letting you know there is a big leak or decannulation. Circuit Disconnect – Uses resistance in the tubing and trach tube to measure and indicate a large leak and/or decannulation.
 
Silence/Reset Silences the ventilator for one minute. Resets alarm messages.
On/Standby Turns the ventilator on and off.

Using the Control Lock

The Control Lock is a safety feature. The setting cannot be accidentally changed if the ventilator is bumped or touched by others who have not been trained.  The home care company will teach you how to lock and unlock your ventilator. 

Using Manual Breath 

What do the alarms mean?

An audible alarm sounds and a message shows in the display window.  The Trilogy and Astral Ventilators have 3 types of alarms.
 Message  Meaning  Action
Vent Inop The machine shuts down if it can’t safely operate, or operates at a limited level. If this alarm goes off while on your child, take your child off the ventilator and give breaths with the resuscitator bag until another vent is set up. 
Any Alarm Alert   If the alarm continues:
1. Take your child off the ventilator and hand ventilate with the resuscitator bag.
2. Contact the home care company.
3. Put your child on a back-up ventilator.
Silence/Reset   Once the problem is corrected, press
the Silence/Reset button twice to clear the message in the display window.
Disc/Sense/ Circuit Disconnect  Is the circuit disconnected? 
Is the airway pressure line occluded, pinched, wet, or disconnected?
 
 Check all connections.
Contact the home care company and/or your health care provider if this continues.
Low Min Vol
(Low minute
volume)		 Does your child have a leak around the trach? Is your child disconnected from the ventilator? Is the trach tube in your child’s neck? Check all connections.
Try repositioning your child, by turning the head or rolling to other
side to decrease leak at the trach tube. Inflate cuff if available. Check if there is water in one of the
small clear tubes.
High Pres
(High pressure
alarm)		 Something is in the way of the breath being delivered. Is your child coughing, crying, hiccupping, or upset?
Is there water in the
tubing? Does your child have a large amount of
secretions? Is it hard to get the catheter in?
Do you think the trach tube is plugged?		 Empty water from the tubing. If there is a large amount of secretions,
suction your child.
If it is hard to get the catheter in or you
think the trach tube is plugged, change the trach tube.
Low Pres
(Low pressure
alarm)		 There is a leak.
Can you hear air leak
around your child’s trach? Are all the connections tight?
Did you disconnect and
reconnect the tubing?		 If you can hear air leak around your
child’s trach, reposition your child.
Do a leak test if alarm continues. (LTV)
Check Circuit/
Circuit Fault		 Is there water in the circuit? Is the circuit kinked? Are there leaks in the circuit? Check circuit for water or leaks. Perform a Learn Circuit (Astral)
If alarm continues, replace the circuit.

Other teaching sheets that may be helpful

ALERT

Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has special health care needs that were not covered by this information.