Abstract
To characterize the sound alarms of the Intra-Aortic Balloon Pump (IABP) during aortic counterpulsation therapy; to measure the stimulus-response time of the team to these; and to discuss the implications of increasing this time for patient safety from the alarm fatigue perspective. This is an observational and descriptive study with quantitative and qualitative approach, case study type, carried out in a Cardiac Surgical Intensive Care Unit. The most audible IABP alarm was the one of high priority increased-reduced diastolic blood pressure. The stimulus-response time was 33.9 seconds on average. Managing the alarms of these equipment is essential to minimize the occurrence of the alarm fatigue phenomenon and to offer a safer assistance to patients who rely on this technology.
Highlights
The Intra-Aortic Balloon Pump (IABP) was clinically introduced in the 1960s as a cardiogenic shock therapy after Myocardial Infarction (MI)
Another fact that can contribute to the understanding of the data found considering the response time of nurses to alarms of the intra-aortic balloon pump is that the studied unit has a personnel sizing (3.8 patient/nurse ratio) very close to the patient/nurse ratio determined by the Ordinance 123 of the Ministry of Health, from February 28, 2005, for meeting high complexity services of Postoperative Cardiac Surgery, which establishes 1 nurse/3 beds[11]
Considering alarms of monitored variable by the IABP console, the fact that alarms related to decreased high diastolic blood pressure (HDBP) were the variable that most caused alarm signals caught our attention, since it is a high priority alarm that tries to alert the professional for myocardial oxygenation issues in patients who need immediate intervention
Summary
The Intra-Aortic Balloon Pump (IABP) was clinically introduced in the 1960s as a cardiogenic shock therapy after Myocardial Infarction (MI). Another group of patients who benefit from the IABP therapy is the one with drug therapy-resistant unstable angina[1]. The machine console used for cycling of the intraaortic balloon pump is equipped with a system of clinical alarms; the asynchronism alarm is an example. When it sets off, it alerts the professional about a possible lack of synchronism, putting the patient’s life at risk. The lack of synchronism may result in a decrease in myocardial perfusion and, in the increased probability of fatal arrhythmias, such as: ventricular fibrillation, ventricular tachycardia and acute coronary syndrome[2]
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