WARNING: The information in this section is meant as a general guide for parents and caregivers with certain problems related to invasive ventilation, non-invasive ventilation and manual ventilation. It is not intended to replace the recommendations of your child’s healthcare team.

Discuss your child’s unique needs with the healthcare team, including WHO and WHEN to contact when problems arise.

Fever with or without general malaise: ≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit

General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy)

One or more of these symptoms of breathing difficulties: shortness of breath, trouble breathing or noisy breathing, breathing more quickly; chest pain; coughing more than usual or has a weaker cough; faster heart rate than usual; chest retractions and/or nasal flaring; decreased oxygen saturation compared to their normal values; purple or gray lips, tongue or fingertips (cyanosis); clammy skin\cold extremities; changes to behavior either fatigue or irritability; more comfortable breathing when sitting up; extends their neck and head backwards to take in a breath

One or more of these symptoms: decreased urination, increased thirst, dry lips and mouth, faster heart rate than usual, weight loss

Child agitated, crying, uncomfortable and/or having difficulty falling asleep

Bloated belly or abdominal distension during invasive or non-invasive ventilation

Difficulty to speak or swallow during non-invasive ventilation

Vomiting during manual ventilation

Distention of the abdomen during manual ventilation

Problems related to the mask

Irritation (redness, sores) of facial skin and/or eyes redness, in the child who uses a mask

Dryness of the nose, in the child who uses a mask

Nose or sinus congestion, in the child who uses a mask

Red, dry or irritated eyes, in the child who uses a mask

Mouth dryness, in the child who uses a facial mask

Problems related to invasive ventilation and non-invasive ventilation

Ventilatory assistance device alarms

Ventilatory assistance device does not turn on (no lights or alarms)

Disconnected parts in the ventilation circuit

Broken equipment: interface or any components of the ventilation circuit (eg, tubing, tracheostomy adapter)

Insufficient air flow from the ventilatory assistance device

Warmer air than usual in the ventilation circuit

Dropped ventilatory assistance device (device falls to the ground)

Irregular display on the ventilatory assistance device

No water in the water chamber of the ventilatory assistance device

Presence of condensation in the ventilation circuit

Presence of condensation in the mask and/or your child has droplets of water on the face during non-invasive ventilation

Accumulation of water in the tubing of the ventilation circuit

Leakage of water from the water chamber of the ventilatory assistance device

Sensation that the ventilatory assistance device pushes the air more forcefully or is noisier than usual

Problems related to manual ventilation

Absence of movement of the chest during manual ventilation

Unable to compress the ventilatory bag during manual ventilation

No resistance during compression of the ventilatory bag during manual ventilation

 

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.

When to consult your healthcare team

General state of health

When your child has any of the following symptoms:

  • Fever (≥ 38⁰C rectal or ≥ 5⁰C oral or ≥ 37.5⁰C armpit).
  • General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy).
  • Signs and/or symptoms of breathing difficulties:
    • Short of breath, trouble breathing or noisy breathing,
    • Breathes more quickly,
    • Chest pain,
    • Coughs more than usual or weaker cough,
    • Heart rate faster than usual,
    • Chest retraction and/or nasal flaring,
    • Oxygen saturation monitor indicates that your child has a decreased oxygen saturation compared to their normal values,
    • Purple or gray lips, tongue or fingertips (cyanosis),
    • Clammy skin\cold extremities,
    • Changes to behavior either fatigue or irritability,
    • More comfortable breathing when sitting up,
    • Extends their neck and head backwards to take in a breath.
  • Signs and/or symptoms of dehydration:
    • Decreased urination
    • Increased thirst
    • Dry lips and mouth
    • Faster heart rate than usual
    • Weight loss
  • Difficulty adapting to the ventilator assistance and to coordinate breathing with the device.
  • Agitated, crying or uncomfortable with the ventilatory assistance and/or has difficulty falling asleep.
  • Abdomen remains distended.
  • Vomits during manual ventilation.
  • Difficulty speaking or swallowing during non-invasive ventilation.
  • Other problems during or after ventilatory assistance.

Mask

  • Your child remains uncomfortable while wearing the mask.
  • The skin of the face, nose or the eyes is red or irritated.
  • Your child’s nose and/or mouth remain dry.
  • Your child’s nose and sinuses remain congested.
  • Your child’s eyes remain irritated or red.

Ventilation circuit

  • Interface or a part of the ventilation circuit is broken (eg, tubing, tracheostomy adapter).
  • Water condensation persists in the circuit and/or mask and/or water continues to accumulate in the tubing of the circuit.
  • The air in the circuit remains more warm than usual.

Ventilatory assistance device and humidifier

  • Any alarm persists.
  • The device does not operate.
  • The flow of air from the device remains insufficient.
  • The screen on the device continues to be irregular.
  • The water chamber is damaged or broken.
  • The device continues to push air more forcefully than usual.
  • The device operates with more noise than usual.

Ventilatory bag

  • The ventilatory bag does not function, despite your attempts to resolve the problem.

Your child’s healthcare team will take the opportunity during your child’s follow-up appointments to review your child’s care and equipment. Adjustments will be made as required.

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.