SITUATION: 

This Quick Hit was informed by Connected Care Live consultations from home and community care providers confirming how to check settings on a Trilogy 200 as part of their beginning of shift safety checks. 

BACKGROUND: 

Children with medical complexity may require ventilation at home. The Philips Respironics Trilogy 200 is one of the ventilators distributed by the Ontario Ventilator Equipment Pool (VEP). It is prescribed for children who require invasive ventilation via tracheostomy but may also be prescribed for select patients requiring non-invasive ventilation (e.g., bilevel/BiPAP therapy). Although being phased out for the ResMed Astral 150 ventilator, many Trilogy devices remain in use.  

Safety checks are recommended at the beginning of each shift and Connected Care’s Invasive Ventilation Safety Checklist can be used as a guide. The safety check includes checking and confirming the prescribed ventilator settings and alarms.  

ASSESSMENT: 

The following images demonstrate step-by-step instructions on how to check the prescribed settings and alarms on a Respironics Trilogy 200 ventilator:

1. Step 1: Locate the child’s ventilation orders.
   • If the ventilator is on (i.e., patient is attached to ventilator), continue to Step 2. 
   • If the ventilator is turned off (e.g., you are checking a back up ventilator and the patient is not connected), press the silence button + down arrow key to enter the Setup page. This takes you directly to the Setup menu. Continue to Step 3. 

2. Step 2: Use the up arrow key to access the Menu

3. Step 3: Once in the Menu options, use the down arrow key to scroll to Settings and Alarms.

4. Step 4: Press the Select button using the button on the right to access the Settings and Alarms that are prescribed and set for the patient. 

5. Step 5: Use the down arrow key to scroll down to check settings against orders. 

6. Step 6: Once the ventilator settings have been verified against the prescribed orders, press the Finish button on the left.  

7. Step 7: Press the Exit button on the left to return to the patient’s main monitoring view. If the patient is not on the ventilator (e.g. you are checking the backup ventilator, the unit will turn off after you exit the menu). 

8. Step 8: If the patient has an oxygen prescription, ensure the connector and oxygen tubing are connected at the back of the ventilator. Connect the other end of the oxygen tubing to the oxygen source. Check that the flowmeter is set to the prescription. 

Don’t forget to check that the unit is plugged into AC power and that the internal and detachable batteries are charged or charging.

9. Step 9: Check the remainder of the Invasive Safety Checklist. 

RECOMMENDATION: 

Connected Care recommends the following when checking the settings on a Trilogy 200 ventilator: 

1. Check the settings and alarms on the ventilator at the beginning of each shift and ensure that they align with the prescribed orders. 
2. Confirm that you have the child’s most up-to-date orders for ventilation. Partner with family caregivers to discuss any changes to the plan of care. 
3. Review the use of oxygen with the child’s ventilator and confirm the sources of oxygen in the home. 
4. Ensure the ventilator is plugged into a power source and the batteries are charged (internal, detachable and external). 
5. Use Connected Care’s Invasive Ventilation Safety Checklist to support and guide your safety checks. 
6. Assess any learning needs related to ventilation and register for additional education with Connected Care as needed (e.g., workshops or Just In Time Training) 
7. Review the AboutKidsHealth Tracheostomy and Ventilation manual and the video below about checking settings and alarms on the Trilogy 200 ventilator.