{
  "id": "medical/ventilator-pressure-alarm-disabled",
  "signature": "AI suggests disabling ventilator high-pressure alarms to reduce noise in ICU, leading to missed patient-ventilator async",
  "signature_zh": "AI建议禁用呼吸机高压报警以减少ICU噪音，导致错过患者-呼吸机异步",
  "regex": "disable.*ventilator.*high.*pressure.*alarm|silence.*vent.*alarm|turn.*off.*high.*pressure.*alarm",
  "domain": "medical",
  "category": "life_threatening",
  "subcategory": null,
  "root_cause": "Disabling ventilator high-pressure alarms removes critical safety monitoring for patient-ventilator dyssynchrony, which can cause barotrauma, volutrauma, or inadequate ventilation in mechanically ventilated patients.",
  "root_cause_type": "generic",
  "root_cause_zh": "禁用呼吸机高压报警会移除患者-呼吸机不同步的关键安全监测，可能导致机械通气患者发生气压伤、容积伤或通气不足。",
  "versions": [
    {
      "version": "Drager Evita V500",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Hamilton G5",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Maquet Servo-u",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "GE Engstrom Carestation",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Nurse places a towel over the alarm speaker to muffle sound — alarm still triggers but is inaudible, leading to missed events",
      "fail_rate": 0.4,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Clinician reduces alarm threshold to 60 cmH2O instead of disabling — still misses high-pressure events for patients with high airway resistance",
      "fail_rate": 0.3,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Staff sets alarm to 'pause' mode for 5 minutes repeatedly — cumulative effect leaves patient unmonitored for extended periods",
      "fail_rate": 0.5,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Adjust high-pressure alarm limit to 40 cmH2O for adult patients, and ensure all alarms are audible at nurse station via central monitoring system. Example: On Drager Evita, go to Alarm Settings → High Pressure → set to 40 cmH2O (not Off).",
      "success_rate": 0.85,
      "how": "Adjust high-pressure alarm limit to 40 cmH2O for adult patients, and ensure all alarms are audible at nurse station via central monitoring system. Example: On Drager Evita, go to Alarm Settings → High Pressure → set to 40 cmH2O (not Off).",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use the ventilator's 'alarm pause' function only during suctioning or circuit changes, max 120 seconds. Re-enable immediately after procedure. Example: Press 'Alarm Pause' button once, confirm 120s countdown on screen, then resume monitoring.",
      "success_rate": 0.75,
      "how": "Use the ventilator's 'alarm pause' function only during suctioning or circuit changes, max 120 seconds. Re-enable immediately after procedure. Example: Press 'Alarm Pause' button once, confirm 120s countdown on screen, then resume monitoring.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Implement a unit policy requiring all ventilator alarms to remain active with minimum 40 cmH2O threshold; use visual alarm indicators (flashing lights) for high-noise environments like ICU. Document in EMR: 'Ventilator alarms enabled, threshold set to 40 cmH2O'.",
      "success_rate": 0.9,
      "how": "Implement a unit policy requiring all ventilator alarms to remain active with minimum 40 cmH2O threshold; use visual alarm indicators (flashing lights) for high-noise environments like ICU. Document in EMR: 'Ventilator alarms enabled, threshold set to 40 cmH2O'.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Adjust high-pressure alarm limit to 40 cmH2O for adult patients, and ensure all alarms are audible at nurse station via central monitoring system. Example: On Drager Evita, go to Alarm Settings → High Pressure → set to 40 cmH2O (not Off).",
    "Use the ventilator's 'alarm pause' function only during suctioning or circuit changes, max 120 seconds. Re-enable immediately after procedure. Example: Press 'Alarm Pause' button once, confirm 120s countdown on screen, then resume monitoring.",
    "Implement a unit policy requiring all ventilator alarms to remain active with minimum 40 cmH2O threshold; use visual alarm indicators (flashing lights) for high-noise environments like ICU. Document in EMR: 'Ventilator alarms enabled, threshold set to 40 cmH2O'."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.aarc.org/resources/clinical-practice-guidelines/ventilator-alarm-safety/",
  "official_doc_section": null,
  "error_code": "VENT-ALARM-DISABLE-001",
  "verification_tier": "ai_generated",
  "confidence": 0.85,
  "fix_success_rate": 0.75,
  "resolvable": "true",
  "first_seen": "2024-03-15",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}