Optimization of Alarms: A Study on Alarm Limits, Alarm Sounds, and False Alarms, Intended to Reduce Annoyance

Alarms in the operating room remain a major source of annoyance and confusion. Nearly all alarms result from a transgression of certain alarm limits. We surveyed manufacturers at a major meeting of anesthesiologists for their default alarm limits. We also conducted a mail survey of anesthesiologists in the United States, Finland, and the Netherlands, to learn their chosen alarm limits, reasons for turning off the alarms, and estimates of the number of false alarms. The surveys of medical monitoring manufacturers demonstrated a wide variety of default alarm settings. Anesthesiologists' chosen alarm limits tended to parallel the manufacturers' defaults. Fewer than 30% of anesthesiologists stated that they did not turn off the alarms. The leading reason for turning off alarms was the large number of false alarms. Estimates of the number of false alarms varied from 30% to 76%. The desired role of alarms in anesthetic practice and some suggestions for the general improvement of alarms are discussed.

[1]  Matthew B. Weinger,et al.  Ergonomic and Human Factors Affecting Anesthetic Vigilance and Monitoring Performance in the Operating Room Environment , 1990, Anesthesiology.

[2]  Margaret J. Robertson,et al.  Design and Analysis of Experiments , 2006, Handbook of statistics.

[3]  C. Brian Burke.  Alarms that Speak , 1986 .

[4]  R. Patterson.  Auditory warning sounds in the work environment. , 1990, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[5]  S I Samuels,et al.  An alarming problem. , 1986, Anesthesiology.

[6]  A. J. Barr,et al.  SAS user's guide , 1979 .

[7]  R. R. Patterson,et al.  Guidelines for auditory warning systems on civil aircraft , 1982 .

[8]  J. McIntyre,et al.  Ergonomics: Anaesthetists’ use of auditory alarms in the operating room , 1985, International journal of clinical monitoring and computing.

[9]  S. Esterby.  American Society for Testing and Materials , 2006 .

[10]  M. Weinger.  Proposed new alarm standards may make a bad situation worse. , 1991, Anesthesiology.

[11]  F. Block.  Evaluation of users' abilities to recognize musical alarm tones , 1992, Journal of clinical monitoring.

[12]  D. W. Edsall,et al.  A481 ANALYSIS AND FREQUENCY OF ARTIFACTS GENERATED BY ANESTHESIA INFORMATION MANAGEMENT SYSTEMS , 1990 .

[13]  J Edworthy,et al.  Improving Auditory Warning Design: Relationship between Warning Sound Parameters and Perceived Urgency , 1991, Human factors.

[14]  Kerr Jh,et al.  Symposium on anaesthetic equipment. Warning devices. , 1985 .

[15]  S I Schmidt,et al.  Alarms: help or hindrance? , 1986, Anesthesiology.

[16]  J H Kerr.  Symposium on anaesthetic equipment. Warning devices. , 1985, British journal of anaesthesia.

[17]  G. Casella,et al.  Statistical Inference , 2003, Encyclopedia of Social Network Analysis and Mining.