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A Response Algorithm for The Low-Pressure Alarm Condition

Received from the Department of Anesthesiology, University of Connecticut School of Medicine, Farmington, Connecticut.

A response algorithm consists of a logical sequence of maneuvers to be performed in response to a specific condition. With the advent of alarm-equipped monitors that alert anesthesiologists to the presence of potentially hazardous clinical conditions, a need has arisen to develop the corresponding alarm-oriented responses expected from anesthesiologists; this problem, however, has not been satisfactorily addressed in the literature. An algorithm is proposed that guides the anesthesiologist through the three limbs of the ventilation system — gas supply system, breathing circuit, and mechanical ventilator — in response to a low-pressure alarm condition during automatic mechanical ventilation, The three-limbed algorithm rapidly and efficiently localizes the likely cause of the low-pressure condition without compromising patient safety; in the event that the search for a cause is fruitless, a default mode of ventilation is employed. A discussion is provided of common causes (e.g., disconnections), alarm-defeating circumstances (false negatives), and potential algorithm-defeating situations (multiple faults).

Key Words: COMPLICATIONS—low-pressure conditions • EQUIPMENT, CIRCUITS—low-pressures • MONITORING—low-pressure conditions

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