Alarming tones: the unexplored phenomenon of auditory roughness

Abstract

Editor—The ultimate goal of alarm systems in perioperative and critical care environments is to maintain patient safety. Aims set out when designing alarm systems include that the alarm will be identifiable by the healthcare professional, result in an appropriate response, and not impede communication. 1 International Organization for Standardization. Medical electrical equipment—part 1-8: general requirements, tests and guidance for alarm systems in medical electrical equipment and medical electrical systems. IEC 60601-1-8 2006. Available from https://www.iso.org/obp/ui/#iso:std:iec:60601:-1-8:ed-2:v1:en60601:-1-8:ed-2:v1:en (accessed 27 April 2023). Google Scholar ,2 Loeb R.G. Incremental advances will improve medical device alarm sounds. Br J Anaesth. 2023; 130: 401-403 Google Scholar Despite these intentions, alarms remain problematic and a source of medical error. 3 de Man F.R. Greuters S. Boer C. et al. Intra-operative monitoring—many alarms with minor impact. Anaesthesia. 2013; 68: 804-810 Google Scholar One aspect of alarm tones not widely discussed in the literature is the qualitative nature of these sounds. Auditory roughness is a parameter of sound associated with alarm signals ranging from the human scream to foghorns and refers to the unpleasant flickering or buzzing auditory sensation characteristic of these sounds. The impact of auditory roughness is yet to be explored in a clinical setting. However, there are interesting non-clinical data that provide insight into the neurophysiological response to alarm tones. Investigating these responses in both clinicians and patients is a novel approach for the design of safer, relevant, and more effective alarm systems.