What will you do if the ventilator alarms a low-pressure alarm? What is the cause?

The causes of ventilator alarm a low-pressure are the following:

• 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
• The patient demands higher levels of air than the ventilator is putting out
The things that need to do if that situation happens are:
1. If an alarm is activated, the initial step is to scan the patient variables as measured by the
available monitors, which may include the pulse oximeter, end-tidal CO2, and pressure gauge or
pressure trace. Once the alert is visually and audibly confirmed to be the low-pressure alarm,
proceed to,
2. Check for total or partial disconnections. Disconnections, which most often occur at the Y-piece,
may result in significant patient morbidity. Thus, any possible disconnection points distal to the
mechanical-to-manual ventilation switchover point will be promptly evaluated and any required
reconnections performed.
3. Switch to manual reservoir bag ventilation. But if a total disconnection is not found, one
switches over from mechanical to manual ventilation rather than wait for the next mechanical
breath. Assuming there is no problem with the “manual/ventilator” selector switch, the change
to manual ventilation excludes ventilator-related problems from consideration. This simplifies
the immediate search for the cause by restricting it to either the breathing circuit or the fresh
gas limb, which should be examined in that order.
4. Evaluation of the Breathing System Reservoir Bag using the Oxygen Flush Valve.
If the reservoir bag fills then evaluate for breathing circuit. Next, evaluate for the fresh gas limb
and lastly evaluate the ventilator. However, if the reservoir bag does not fill, evaluate the fresh
gas limb. Lastly, if reservoir bag fills then collapses, it should evaluate the scavenging system.

Williams LM & Sharma S. (2021). Ventilator Safety. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK526044/