Question

During volume control ventilation, the mechanical ventilator reads a high inspiratory pressure that is above the predetermined P-max, causing the ventilator to stop delivering positive pressure and sound an alarm. Which of the following should be done?

A) The ventilator should be set to deliver a lower fixed tidal volume.
B) The ventilator should be switched to a PRVC mode.
C) PEEP should be turned on; if it is already on, the respiratory rate should be lowered.
D) The provider should momentarily pause mechanical ventilation.
E) The provider should switch to manual ventilation while the anesthesia technician troubleshoots the ventilator.

Answer 1

The correct response when a mechanical ventilator reads a high inspiratory pressure and sounds an alarm is to switch to manual ventilation while the issue is being resolved. This action allows the patient to continue receiving ventilation while troubleshooting occurs to determine the cause of the alarm.

Step-by-step explanation:

When a mechanical ventilator reads high inspiratory pressure above the predetermined P-max, and an alarm sounds, it indicates that the pressure limit set on the ventilator has been exceeded. An appropriate response would typically involve assessing the situation to determine the cause of the high inspiratory pressure, such as a patient coughing, kink in the ventilator tubing, increased airway resistance, or decreased lung compliance. The ventilator settings may need to be adjusted to manage these issues. Several approaches can be considered:

• Check for and resolve any obstruction in the ventilator tubing.
• Assess for changes in the patient's condition that may have caused the increased pressure.
• Consider reducing the tidal volume if a volume-controlled mode is being used to minimize the risk of lung injury from high pressures.
• If PEEP is on and high inspiratory pressure persists, consulting with a respiratory therapist or a clinician to address the alarm is recommended.
• In case of ventilator malfunction, switching to manual ventilation while troubleshooting is a temporary solution.

Therefore, the correct answer to the question is E) The provider should switch to manual ventilation while the anesthesia technician troubleshoots the ventilator. This ensures patient safety by maintaining ventilation until the underlying issue is resolved.