Troubleshooting Guide
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SLE6000
SLE6000 Troubleshooting Alarms and Messages
This document covers possible actions that can be taken to resolve alarms generated on the SLE6000. Please note that there are 3 levels of priority assigned to alarms so that in certain situations this hierarchy may mean that if one alarm is resolved a second lower priority alarm may appear. Alarm Category
High Priority
Medium Priority
Low Priority
Flash and Tones
Flow Sensor Alarms (Red and Yellow Alarms)
There are a number of flow sensor alarms and messages which will need action to resolve: Faulty Flow Sensor – this message advises that you should replace the flow sensor and then recalibrate the flow sensor. Flow sensor not connected – this can be caused by the following •
Flow sensor is not connected to the flow sensor cable
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Flow sensor cable is not connected to the ventilator
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Flow sensor cable has a break and requires replacement.
Unable to calibrate – flow sensor or cable fault Flow sensor defective – change flow sensor
Connecting a flow sensor or replacing the flow sensor cable should resolve this alarm message Calibrate flow sensor – the user needs to calibrate the flow sensor. This message appears whenever the flow sensor cable is disconnected from the ventilator or the flow sensor is disconnected from the flow sensor cable. Select utilities and follow on screen instructions Flow sensor is contaminated – replace flow sensor or disconnect and rinse (as per user instructions). Special note ensure that the flow sensor is not in place when administering Surfactant Flow sensor reversed – this message is likely to clear after a few seconds and is due to transitory reverse flow of gas across the flow sensor. The connections of the flow sensor do not allow for it to be connected in a reverse position. Flow sensor clipping – This is generated if the flow across the flow sensor is too high. To resolve this reduce pressure / volume. N.B The flow sensor is designed for flows up to 30LPM only. This alarm is typically generated when Higher volumes are selected when ventilating larger volume lungs and in also in HFOV. Continue without flow sensor – if the flow sensor is connected In NIV modes there will be a message in the information bar ‘Continue without flow’ It can also occur if a flow sensor or cable is disconnected in invasive ventilation.
Pressure alarms (Red alarms)
The SLE6000 has a number of pre-set alarms for high and low pressure (see manual for pre-set values) If these values are exceeded (above or below) the cause will be insufficient or too much pressure in the circuit and the user should check ventilation settings. Low pressure alarms can be caused by a variety of reasons.
© SLE 2020 | Subject to Change | G0210/0UK/001 05/20
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Leak in circuit (Leaking Fresh Gas alarm); user should check the following
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Check temp probes inputs
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Circuit connections
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Water bag connection
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Correctly seated exhalation block
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Disconnected pressure line.
High Pressure Alarms
Check exhalation filter is not blocked or saturated with water (this can also cause excessive PEEP and cause alarms) •
Occlusions in circuit
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Spontaneous breathing by infant
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Occluded/blocked proximal pressure line.
Tidal Volume and Minute Volume alarms (Red Alarms)
The two most commonly seen alarms are low volume – and minute volume Low Volume usually seen in Volume Targeting Mode (VTV) if the max PIP has been reached but the target volume has not been achieved Low or high Minute Volume usually due to a fast change in Tidal volumes due to exiting VTV mode, changing pressure settings after suction or administering surfactant. Check the following as other possible causes: •
Has there been an Increase in leak % (leak around the ET tube); Leak should not be more than 50% in VTV
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Has the Resistance or Compliance changed – check ventilator settings
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Check bilateral air entry and listen for secretions.
Oxygen (Red Alarms)
Difference in Set and measured FiO2 more than 2% (NOTE This is not a visual alarm but a user observation) The likely cause is FiO2 drift (O2 measuring less than the set) so the user should try a 1 point calibration. If no improvement then this is an indication that the O2 sensor may be nearing the end of its operational life Low Oxygen alarm is generated when the delivered oxygen is more than 5% below the set level.
High Oxygen alarm is when the delivered oxygen is higher than the set level by 5%. This may be due to a blender failure. It could also be that a ‘dummy’ O2 cell has been left in place. Note these alarms can also be generated if the pressure from an Air compressor or through wall O2 supply is outside of acceptable limits (2.8-6.0 Bar).
Battery (Yellow Alarm or Red Alarm if <10 mins Power Remaining)
Battery low - The % charge on the battery is indicated on the upper right hand corner of the screen. In order to charge the battery connect to a mains supply and always plug in ventilator when not in use to maintain charge. It will take 8 hours for the battery to reach 80% capacity. Full charge is reached after 18 hours.
Mains power fail alarm (Blue Alarms)
Plug into mains and or switch on. When mains power fails the unit automatically switches to battery power. A fully charged battery will provide >3 hours continuous operation in all modes of ventilation.
High Patient Leak (Red alarm)
This is the leak around the end of the uncuffed ET tube. It is measured and displayed in the right hand monitoring column. A high patient leak will affect delivery of the required Tidal Volume in V T V mode. A high Patient leak can also be clearly seen on the waveforms on the screen. This is different to ‘Leaking Fresh Gas’ which is circuit related. The alarm threshold default for High Patient leak is set at 35% in the Alarm Menu. It can be changed to
reflect operational considerations.
Apnoea (Red Alarm)
This alarm is primarily seen if no breath is detected or generated by the patient the ventilator sees no patient effort. This alarm may be evidence of Apnoea of prematurity which requires medical intervention.
Breath not Detected (Red Alarm)
The ventilator has to see a complete inspiration and expiration to register a breath. This could be due to the following: High patient leak ET tube displacement Blocked or partially blocked ET tube Incorrect Flow sensitivity set in Flow sensor mode or Pressure sensitivity in Pressure ventilation / NIV modes.
Leaking Fresh Gas (Red Alarm)
This indicates a leak in the patient circuit from a loose connection or an open port on the circuit (for example a temp probe or a poor connection). NOTE This is different to the ‘High Patient Leak’ alarm. Check type of circuit connected. If 15mm circuit is used when 10mm is selected on ventilator
Incorrect diameter of Patient circuit. Although 15mm may be selected note some circuits from other 3rd party manufacturers have differing internal dimensions than SLE 15mm circuits.
Blocked Fresh Gas (Red Alarm)
An indication that the fresh gas limb of the patient circuit is blocked. Check that the correct patient circuit is being used. Look for any signs of occlusion or blockage in the fresh gas limb side of the circuit. This may also be due to 15mm circuit on ventilator selected and 10mm circuit is in use.
Continuing Positive Pressure (Red Alarm)
This alarm message is generated in two modes of ventilation: CPAP If the pressure remains >5mbar above set CPAP for more than 4 seconds. Check proximal airway line, check that the expiratory filter is not blocked. In HFO if the MAP is >15mbar above captured MAP. Actions include check that the filter is not blocked, remove any restriction or change the Expiratory filter.
SpO2 FASTSAT
In SpO2 monitoring. What is FastSat?
FastSat – This mode is taken from Masimo module which enables a rapid response to, and display of, fast changes in SpO2. Priority is given to the most recent data measured. Caution - FastSat is not recommended for routine monitoring as it may result in an increase in the frequency of alarms caused by rapid, transitory SpO2 changes.
OxyGenie and SpO2 alarms (Yellow Alarms)
The OxyGenie system will only operate if a good signal SpO2 and pulse is received from the SpO2 module.
In SpO2 only mode the alarm setting are defaulted for High and Low SpO2 and High and Low pulse rate which can be amended and user defined. When OxyGenie is enabled they are automatically reset set +1 and -1 from target range selected, which can be user changed. If a poor signal or technical fault detected with the module or sensor then OxyGenie will default back to ‘Fallback’ Mode.
HFO Alarms - PAW Alarm in HFO Alarm Thresholds Invasive HFO (Red Alarms) A. Zero pressure line B. Waveform Alarm Thresholds 1. Low press (Low Paw alarm control) Autoset and user adjustable 2. High Pressure (High Paw alarm control) Autoset and user adjustable 3. High pressure threshold exceeded (+5 mbar above PIP) Autoset 4. High pressure threshold exceeded (+20 mbar above PIP) Autoset 5. Unexpected drop in mean P. (+5 mbar below mean P.) Autoset 6. Unexpected rise in mean P. (+5 mbar above mean P.) Autoset 7. Continuing positive pressure (+10 mbar above mean P for more than 4 seconds) Autoset 8. Sub ambient (Mean pressure to -2 mbar below zero pressure) Autoset. Alarm Thresholds Non Invasive HFO (Red alarms)
1. Unexpected rise in delta P. (+5 mbar above delta P) Autoset 2. Unexpected drop in delta P. (-5 mbar below delta P) Autoset
Please note, this document is designed to act as a guide for troubleshooting alarms and messages. It is not intended to replace formal training or the User Manual. All operators of the SLE6000 must be trained and competent in the use of the SLE6000. All data correct at time of publication. Specifications relevant to software version V 2.0.90 onwards, however some software versions may differ.