When the high pressure alarm on a mechanical ventilator sounds, what action is indicated?

• A. Discontinue ventilation and bag the patient manually
• B. Suction the airway
• C. Increase the ventilator rate
• D. Administer an IV fluid bolus

Answer: (B)

When the high pressure alarm sounds, the problem is usually increased airway resistance or a blockage in the airway or ventilator circuit, most commonly from secretions or a mucus plug in the endotracheal tube. The action that best resolves this is suctioning the airway to remove the obstruction, restore patency, and allow the ventilator to deliver breaths with normal pressures. After suctioning, recheck the tube and circuit for kinks or condensation, assess for improving ventilation, and consider further evaluation if the alarm recurs. Increasing the ventilator rate, giving an IV fluid bolus, or discontinuing ventilation and bagging manually don’t address the underlying airway obstruction and aren’t the first step in this scenario.