Should we be alarmed by our alarms?

Abstract

The number of alarms in the anaesthesia environment has gone from none to many dozens during the past 50 years. Until recently, each equipment manufacturer designed their own alarm set, resulting overall in a chaotic acoustic environment. Anaesthesiologists tend to have an uneasy relationship with monitoring alarms. On one hand they warn of mishaps, but on the other the many unnecessary alarms can be irritating and actually impede clinical care. There is evidence that these factors prevent alarms from realizing their full potential to enhance patient safety. This review explores current developments in clinical alarm design and technology. A considerable body of research currently exists on the design of nonverbal auditory alarms, their relationship with human behaviour, and implications for medical alarms. Technology to reduce the unacceptably high rate of false-positive alarms is being introduced. Much work has been done to standardize alarm conditions and alarm sounds. Although this is a work in progress, the introduction of these standards should make clinical alarms more useful and less grating. The disadvantages of current clinical alarms have been identified and are in the process of being addressed.