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Hypoxic Brain Injuries

Ventilators and Hypoxic Brain Injuries

Ventilators are used to provide vital oxygen to patients who may not be able to breathe on their own. When used properly, they provide life-saving oxygen to the brain and body. When used improperly, they can actually deprive the body of the oxygen it needs and cause brain injury or death within minutes. Each year, ventilator patients are left permanently brain damaged as a result of malfunctioning equipment or negligent medical staff.


Aside from death, the most tragic injury that ventilator patients can face is a hypoxic brain injury. When the brain is deprived of oxygen, even for just a few minutes, it begins to shut down. After about 5 minutes, irreversible tissue damage begins to occur. Victims of ventilator failure may be left completely brain dead or may suffer permanent disabilities including reduced motor function, psychological/neurological abnormalities, tremors and seizures.


In 2002, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) issued a Sentinel Event Alert reporting 23 instances related to ventilator malfunction. 19 of these events resulted in deaths, 4 resulted in comas. To identify the cause of these events, the Joint Commission performed a root analysis study. They identified the following contributing factors:

  • Staffing Issues– Staffing issues contributed to the majority of the sentinel events. Inadequate orientation and training and insufficient staffing levels were the most common factors cited.
  • Communication Breakdown– Communication breakdown was the second most common factor contributing to ventilator injury and/or death. This occurred most often among respiratory therapists and nurses during the night shift.
  • Incomplete Patient Assessment– Incomplete patient assessment occurred in small rooms like ERs or areas containing MRI or CT machines. Additionally, placing patients in the prone position hindered proper assessment.
  • Equipment Issues– Equipment issues included alarms that were turned off or set incorrectly, absence of alarms, inaudible alarms, and restraint failure which led to unplanned extubation.
  • Caregiver Distraction– Caregiver distraction was another factor that was found to contribute to ventilator injury and/or death. Distractions included loud noise and false alarms.


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