ALERT: How to Manage the Astral Ventilator Safety Reset Alarm
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
ALERT: How to Manage the Astral Ventilator Safety Reset Alarm
SITUATION:
This QuickHit is intended to inform home and community care providers (HCCPs) about a high priority built-in alarm on the ResMed Astral 150 ventilator that requires prompt assessment of the child and appropriate follow-up actions by HCCPs and/or family caregivers
BACKGROUND:
Children who require long-term invasive ventilation through a tracheostomy at home or non-invasive ventilation via mask may be using the ResMed Astral 150 ventilator. In Ontario, this ventilator is funded by the Assistive Devices Program (ADP) and provided through the Ontario Ventilator Equipment Pool (VEP) Program.
The child’s medical team is responsible for prescribing the ventilator settings and alarms. Certain alarms are built into the Astral ventilator for safety reasons and cannot be adjusted. One such alarm is the Safety Reset Alarm, which is an alarm that restarts the ventilator.
ASSESSMENT:
The Astral 150 ventilator includes a built-in, high-priority but rare alarm known as the Safety Reset Alarm. Like most ventilators, the Astral 150 continuously monitors its own performance while in use. If the device detects an internal fault, it will automatically shut down for approximately 20 to 30 seconds, though this reboot period may be longer. During this time, no ventilation is delivered. Once the device reboots and the restart is successful, the settings may revert to factory defaults instead of the child's prescribed settings. Regardless of the settings, the device should not be placed back on the child.
If the issue is resolved upon restarting, the ventilator will resume ventilation and activate an audiovisual alert to signal that the “Safety Reset is Complete.” However, if the issue persists, the ventilator will activate a continuous audiovisual alarm to notify the user that the problem remains unresolved. In either case, the child must be disconnected from the ventilator and switched to back up ventilation, if needed (see recommendations below).
RECOMMENDATION:
Connected Care recommends the following and to take action immediately if an Astral 150 ventilator signals the Safety Reset Alarm in home and community settings:
Immediately disconnect the child from the Astral 150 ventilator and place them on their back up ventilator.
If child only requires ventilation only when asleep, then can keep child awake until able to switch to backup ventilator.
If child requires ventilation when asleep and awake, then manually ventilate with a manual resuscitation bag until they can be placed back on the backup ventilator.
Do not reconnect the child to the ventilator that triggered the Safety Reset alarm.
Maintain constant observation and assess the child and ensure continuous oximeter monitoring is in place.
If the child does not have a backup ventilator prescribed, please refer to the child’s care plan/action plan. Seek immediate medical attention if necessary.
Inform the child’s family caregivers, their medical team and contact the VEP at 1-800-633-8977 to arrange for a replacement device to be shipped as soon as possible.
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