Safety Considerations For Mouthpiece Ventilation - ResMed Astral Series Clinical Manual

Non-invasive ventilation (NIV)

Safety considerations for mouthpiece ventilation

The Disconnect Alarm allows detection of circuit disconnection (for example, when the mouthpiece has
fallen out of reach of the patient), and whether the patient is able to reliably trigger ventilation or not.
Regardless of whether the Disconnection Alarm is active or not, other mitigations may need to be put in
place to ensure that patient safety is not compromised, such as the Apnoea alarm, external monitoring,
an SpO alarm, or full-time supervision.
2
Alarm setting Selection
Disconnection Alarm On
Disconnection As appropriate
Tolerance (%)
Alarm Activation Time As appropriate
Apnoea Response Off
Low pressure alarms are sometimes used to imply circuit disconnection and are quick to activate. Should
this be an annoyance, for example when the patient is receiving a partial breath or missing a breath, or if
a false triggered breath occurs, it is at the discretion of the Clinician to turn OFF. Other mitigations may
need to be put in place to ensure that patient safety is not compromised. This may include external
monitoring, SpO alarm, or full-time supervision.
2
Mouthpiece Ventilation with Astral 100/150 mouthpiece circuit is not intended to support continuous
exhalation into the circuit. The non-user adjustable NV Mask/Rebreathing alarm will activate if the device
detects continuous exhalation into the circuit. For patients that may prefer continuous exhalation into the
circuit, a circuit with an expiratory valve or intentional leak should be considered.
102
Detail/ explanation
Enables Disconnection Alarm.
Sets a higher or lower tolerance to the degree of circuit disconnection
required to activate the Disconnection Alarm.
Refer to Setting and testing Disconnection Tolerance (see page 122).
The time it takes for the alarm to activate once the disconnection threshold
is satisfied. It can be adjusted from 5 seconds to 15 minutes for mouthpiece
interface, as appropriate for the patient's ventilator dependency.
Refer to Setting Activation Time (see page 124).
It may be appropriate to configure Apnoea Response to OFF if the
Disconnection Alarm is appropriately configured.