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Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 3:37 pm
by Pulmonette
I mean the episodes occur once per minute, so there are like dozens of these things.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 3:42 pm
by -SWS
Ah... perhaps Madalot can check episode frequency and report back....
I have a hypothesis to add---an offshoot of the faulty-valve hypothesis. These pulsations are occurring only during exhalation. I see the Trilogy should be fit with either an active-exhalation port block or a passive-exhalation port block. Madalot needs a passive-exhalation port block. I wonder if this loaner machine has the wrong port block? Alternately, I wonder if the exhalation port block needs to be reseated?
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 3:48 pm
by Madalot
I will try to answer all your questions, but I'm doing this from my car on my phone.
If I'm lucky, I'll get my trilogy back mid-october. But I have no hopes that I'll get it that soon.
Other than checking to the best of my ability, I have not checked the mask. If that is likely the culprit, I can get a new one out tonight and see if that makes any difference.
This is not a heated hose. I have two hoses that I rotate weekly. I use a hose cover. I have not seen any problems with either hose, but can double check to make sure nothing is wrong. I can also get a new hose out if you think that might be helpful.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 4:22 pm
by -SWS
-SWS wrote:I see the Trilogy should be fit with either an active-exhalation port block or a passive-exhalation port block.
Pulmonette, do you know if these exhalation port blocks are fitted ONLY when servicing the Trilogy:
Active Exhalation Porting Block with PAP (RI p/n 1054670)
Passive Exhalation Porting Block (RI p/n 1040372)
If they are not fitted during normal operation, then we can cancel the porting-block hypothesis...
Edit: I see there's also a Universal Porting Block (RI p/n 104370)... If the porting blocks are only fitted by a tech for servicing, then no-go on this hypothesis. If the exhalation porting blocks are also fitted during normal operation, then a faulty/unseated/incorrect exhalation block might explain Madalot's pulsations during exhale: there's a partial or intermittent breach through the port during exhalation rather than a block.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 5:01 pm
by -SWS
As it turns out the exhalation porting block is used during normal operation:
http://trilogy100.respironics.com/clinical/faq.aspx#2
These unwanted pulsations are limited to the exhalation phase. They also manifest on the leak graph. I'm definitely favoring the hypothesis that Madalot's Exhalation Porting Block is faulty, poorly seated, or of the incorrect type. It doesn't always block during exhalation.
Madalot, if the Exhalation Porting Block is the problem, then your DME should be able to rectify it without sending the loaner Trilogy in for service....
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 5:16 pm
by Madalot
-SWS wrote:Madalot, if the Exhalation Porting Block is the problem, then your DME should be able to rectify it without sending the loaner Trilogy in for service....
Could be coincidence, but this was not happening on regular AVAPS. Happened either the first or second night on AVAPS-AE. If port is faulty, shouldn't it be happening in regular AVAPS as well? If so, should I sleep on regular AVAPS a night and see? Only difference between AVAPS & AVAPS-AE settings is EPAP at 9 vs Max EPAP at 10 and Flow Trigger vs Auto Trak.
And if something IS wrong with the Trilogy requiring service the DME can't provide in the field, they don't have another one. This is THE backup unit they have.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 5:34 pm
by -SWS
Madalot, see if you can replicate the pulsing by giving the machine different exhalation patterns. Here are a couple patterns to try:
1) forceful exhalation immediately after inhalation
2) inhalation, then hold breath, then forceful exhalation
If you can replicate the unwanted pulsing with a certain pattern, then try that same test pattern in ordinary AVAPS mode...
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 5:50 pm
by Madalot
No problem. I'll "go back" early enough to try what you suggest.
Interestingly, last night, during one of these pulsing episodes, I tried forceful exhaling to see if the pulses would stop. First time they did. Next exhale they didn't stop no matter how hard I exhaled.
I'll post later after I try duplicating the pulses.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 5:52 pm
by Pulmonette
-SWS wrote:If the exhalation porting blocks are also fitted during normal operation, then a faulty/unseated/incorrect exhalation block might explain Madalot's pulsations during exhale: there's a partial or intermittent breach through the port during exhalation rather than a block.
Porting Blocks: Check O-Rings around the porting blocks for cracks, wear, or incorrect fit. Lubricate or replace the porting block as necessary.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 6:15 pm
by Madalot
Please forgive my ignorance. But where on the trilogy should we look for this?
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 6:42 pm
by mollete
http://www.healthcare.philips.com/pwc_h ... 084580.pdf
Page 24 and 25.
However, it would seem that there should have been a bunch of E291 codes if the block was displaced, leaking, etc.
TS, given the intensity of events, it sure seems that's where the problem is.
TS2, this is rapidly turning into a having them fix it issue.
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 6:51 pm
by mollete
History of this machine since 1/6/2012:
Code: Select all
COUNT ERRCODE Log 17 (Encrypted Significant Event Text)
1 E-053 ERR_HIGH_VTE_ALARM HIGH_ALARM
1 E-054 ERR_LOW_VTE_ALARM HIGH_ALARM
41 E-072 ERR_MMC_SD_CARD_INSERTED BEEP_ONLY
10 E-074 ERR_MMC_SD_CARD_REMOVED BEEP_ONLY
102 E-110 ERR_LOW_PIP_ALARM HIGH_ALARM
1 E-111 ERR_HIGH_RATE_ALARM HIGH_ALARM
1 E-114 ERR_LOW_MIN_VENT_ALARM HIGH_ALARM
3 E-118 ERR_LOW_CIRCUIT_LEAK_ALARM HIGH_ALARM
11 E-120 ERR_APNEA_ALARM HIGH_ALARM
8 E-121 ERR_PATIENT_DISCONNECT_ALARM HIGH_ALARM
18 E-165 ERR_LOW_PEP_ALARM HIGH_ALARM
67 E-166 ERR_UI_RESET_KEY_PRESS KEYPRESS
17 E-167 ERR_UI_HIDE_KEY_PRESS KEYPRESS
73 E-168 ERR_UI_AUDIO_PAUSE_KEY_PRESS KEYPRESS
9 E-169 ERR_HIGH_PIP_STAGE1_ALARM BEEP_ONLY
1 E-170 ERR_HIGH_PIP_STAGE2_ALARM MED_ALARM
1 E-171 ERR_HIGH_PIP_STAGE3_ALARM HIGH_ALARM
22 E-173 ERR_START_ON_BATTERY INFO_ALARM
145 E-179 ERR_PWR_REDUCTION_AC_DISCONNECTED MED_ALARM
1 E-180 ERR_PWR_REDUCTION_LEAD_ACID_DISCONNECTED INFO_ALARM
1 E-181 ERR_PWR_REDUCTION_DET_LI_ION_DISCONNECTED INFO_ALARM
2 E-250 ERR_LEAD_ACID_BATT_CONNECTED BEEP_ONLY
34 E-251 ERR_DET_LI_ION_CONNECTED BEEP_ONLY
31 E-252 ERR_INT_LI_ION_CONNECTED BEEP_ONLY
31 E-264 ERR_MENU_BYPASS_ACTIVATED KEYPRESS
1 E-283 ERR_SW_UPGRADE_PERFORMED KEYPRESS
127 E-284 ERR_PWR_UPGRADE_AC_IN_USE BEEP_ONLY
4 E-286 ERR_PWR_UPGRADE_DET_LI_ION_IN_USE BEEP_ONLY
3 E-291 ERR_CIRCUIT_CHECK HIGH_ALARM
94 E-293 ERR_POWER_OFF_KEY KEYPRESS
89 E-294 ERR_POWER_OFF_YES_KEY KEYPRESS
89 E-324 ERR_POWER_ON KEYPRESS
COUNT ERRCODE Log 18 (Encrypted Engineering Debug Text)
1 E-018 ERR_DSP_DC_DC_CONTROL LOG_ONLY
31 E-034 ERR_DSP_EXT_POWER_UP_SYSTEM_INIT LOG_ONLY
1 E-035 ERR_DSP_SOFTWARE_RESET_SYSTEM_INIT LOG_ONLY
32 E-055 ERR_VOLUME_LEAK LOG_ONLY
9 E-057 ERR_THREAD_STACK_RESERVE LOG_ONLY
19 E-096 ERR_CALIBRATION_CONTROL LOG_ONLY
41 E-117 ERR_MMC_SD_DRIVER_ERROR LOG_ONLY
1 E-124 ERR_REBOOT_ACTIVATED REBOOT
15 E-140 ERR_NVDATA_READBACK_ATTEMPT LOG_ONLY
426 E-148 ERR_DEBUG LOG_ONLY
1 E-151 ERR_SW_UPGRADE_STARTED LOG_ONLY
32 E-152 ERR_POWER_UP_SYSTEM_INITIALIZATION LOG_ONLY
1 E-170 ERR_HIGH_PIP_STAGE2_ALARM MED_ALARM
1 E-171 ERR_HIGH_PIP_STAGE3_ALARM HIGH_ALARM
2 E-248 ERR_INFORMATION LOG_ONLY
145 E-249 ERR_AC_CONNECTED LOG_ONLY
1 E-259 ERR_SHIPMODE_SUCCESSFUL LOG_ONLY
3 E-291 ERR_CIRCUIT_CHECK HIGH_ALARM
32 E-297 ERR_SLEEP_EVENT LOG_ONLY
3 E-298 ERR_WAKEUP_EVENT LOG_ONLY
2 E-310 ERR_CAL_DATA_WRITE LOG_ONLY
1 E-329 ERR_RTOS_HEAP_FRAGMENT_RESERVE LOG_ONLY
1 E-336 ERR_INT_LI_ION_EXITED_SHIP_MODE LOG_ONLY
131 E-341 ERR_FAN_CONTROL LOG_ONLY
19 E-365 ERR_MMC_SD_DRIVER_DEBUG_MESSAGE LOG_ONLY
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 7:15 pm
by Madalot
This loaner machine has had all those errors in just under 2 years? Would the patient or user been aware of them? Is there any point in doing more testing to see if there's something else going on or should I not worry about it at this point and just wait for my trilogy to come back?
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 7:21 pm
by mollete
Porting block adapter connections and caps:
Re: Trilogy AVAPS-AE - Ongoing
Posted: Mon Sep 02, 2013 7:23 pm
by -SWS
mollete wrote:http://www.healthcare.philips.com/pwc_h ... 084580.pdf
Page 24 and 25.
However, it would seem that there should have been a bunch of E291 codes if the block was displaced, leaking, etc.
TS, given the intensity of events, it sure seems that's where the problem is.
TS2, this is rapidly turning into a having them fix it issue.
I suspect the problem's intermittency relative to diagnostic code's infrequency of execution explain the lack of error-log entries: every time the intermittent problem crops it's head, that particular leg of diagnostic code is probably NOT running.
Glad to see you, Mollete.