Skip to main content
SpringerLink
Log in

Patient Monitoring Alarms in the ICU and in the Operating Room

  • Chapter
Annual Update in Intensive Care and Emergency Medicine 2013

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

Historically, the word ‘alarm’ originates from the Latin, ‘ad arma’, or the French, ‘à l’arme’, which can be translated into ‘to your weapons’. Hence, the word indicates a call for immediate action, for attack or for defense. Alarms have existed ever since humans have lived in groups. Some of the first documented alarms are watchmen on towers in the Middle Ages, who warned of fires or enemies by ringing bells. Warning fires provided a visual alert to enemy attacks, visible across long ranges and enabling an early reaction of armed forces. Today, comparable systems are available that send warning-SMSs (Short Message Service) of nearing tsunamis to mobile phones [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tsunami Alarm System. Available at: http://www.tsunami-alarm-system.com/en/index.html. Accessed Oct 2012

    Google Scholar 

  2. Billings CE, Raynard WD (1984) Human factors in aircraft incidents: results of a 7-years study. Aviat Space Environ Med 55:960–965

    PubMed  CAS  Google Scholar 

  3. Kowalski-Trakofler KM, Vaught C, Mallett LG et al (2004) Safety and health training for an evolving workforce: an overview from the mining industry. Information Circular 9474:1–15

    Google Scholar 

  4. International Organization for Standardization (2010) IEC-ISO 60601-1-11. Available at http://www.iso.org/iso/home/store/catalogue_tc/catalogue_detail.htm?csnumber=45605. Accessed August 2012

    Google Scholar 

  5. International Organization for Standardization (2010) IEC 80001-1:2010. Available at http://www.iso.org/iso/home/store/catalogue_tc/catalogue_detail.htm?csnumber=44863. Accessed August 2012

    Google Scholar 

  6. Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW (1989) Role of monitoring devices in prevention of anesthetic mishaps: A closed claims analysis. Anesthesiology 71:541–546

    Article  PubMed  CAS  Google Scholar 

  7. Cooper JB, Newbower RS, Kitz RJ (1984) An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology 60:34–42

    Article  PubMed  CAS  Google Scholar 

  8. Flight Safety Foundation (2003) Flight Safety Digest – The Human Factors Implications for Flight Safety of Recent Developments in the Airline Industry. Available at: http://flightsafety.org/fsd/fsd_mar-apr03.pdf Accessed Oct 2012

    Google Scholar 

  9. Imhoff M, Kuhls S (2006) Alarm algorithms in critical care monitoring. Anesth Analg 102:1525–1537

    Article  PubMed  Google Scholar 

  10. Loeb RG (1993) A measure of intraoperative attention to monitor displays. Anesth Analg 76:337–341

    PubMed  CAS  Google Scholar 

  11. Morris RW, Montano SR (1996) Response times to visual and auditory alarms during anaesthesia. Anaesth Intensive Care 24:682–684

    PubMed  CAS  Google Scholar 

  12. Imhoff M, Kuhl S, Gather U, Fried R (2009) Smart alarms from medical devices in the OR and ICU. Best Pract Res Clin Anaesthesiol 23:39–50

    Article  PubMed  Google Scholar 

  13. Block FE, Rouse JD, Hakala M, Thomson CL (2000) A proposed new set of alarm sounds which satisfy standards and rationale to encode source information. J Clin Monit 16:541–546

    Article  Google Scholar 

  14. Chambrin MC, Raveaux P, Calvelo-Aros D, Jaborska A, Chopin C, Boniface B (1999) Multicentric study of monitoring alarms in the adult intensive care unit (ICU): A descriptive analysis. Intensive Care Med 25:1360–1366

    Article  PubMed  CAS  Google Scholar 

  15. Lawless ST (1994) Crying Wolf: False alarms in a pediatric intensive care unit. Crit Care Med 22:981–985

    Article  PubMed  CAS  Google Scholar 

  16. Tsien CL, Fackler JC (1997) Poor prognosis for existing monitors in the intensive care unit. Crit Care Med 25:614–619

    Article  PubMed  CAS  Google Scholar 

  17. O’Carroll TM (1986) Survey of alarms in an intensive care unit. Anaesthesia 41:742–744

    Article  PubMed  Google Scholar 

  18. Siebig S, Kuhls S, Imhoff M et al (2010) Collection of annotated data in a clinical validation study for alarm algorithms in intensive care – A methodologic framework. J Crit Care 25:128–135

    Article  PubMed  Google Scholar 

  19. Schmid F, Goepfert MS, Kuhnt D et al (2011) The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac surgery. Anesth Analg 112:78–83

    Article  PubMed  Google Scholar 

  20. Seagull FJ, Sanderson PM (2001) Anesthesia alarms in context: An observational Study. Hum Factors 43:66–78

    Article  PubMed  CAS  Google Scholar 

  21. Kestin IG, Miller BR, Lockhart CH (1988) Auditory alarms during anesthesia monitoring. Anesthesiology 69:106–109

    Article  PubMed  CAS  Google Scholar 

  22. Takla G, Petre JH, Doyle JD, Horibe M, Gopakumaran B (2006) The problem of artefacts in patient monitor data during surgery: A clinical and methodological review. Anesth Analg 103:1196–1204

    Article  PubMed  Google Scholar 

  23. Aesop (1985)  The Shepherd Boy and the Wolf. In: Aesops Fables. Watermill Classic Edition. NJ Watermill Press, Mahwah, pp 116–117

    Google Scholar 

  24. Breznitz S (1984) Cry wolf: The Psychology of False Alarms. Psychology Press, New York

    Google Scholar 

  25. Barkeley AW, Cooper J, George WF et al (1946) Congressional investigation of the pearl harbor attack. US Government, Washington, pp 141–143

    Google Scholar 

  26. Westenskow DR, Orr J, Simon FH, Bender HJ, Frankenberger H (1992) Intelligent alarms reduce anaesthesiologist’s response time to critical faults. Anesthesiology 77:1074–1079

    Article  PubMed  CAS  Google Scholar 

  27. Bliss JP, Dunn MC (2000) Behavioural implications of alarm mistrust as a function of task workload. Ergonomics 43:1283–1300

    Article  PubMed  CAS  Google Scholar 

  28. Block FE, Nuutinen L, Ballast B (1999) Optimization of alarms: A study on alarm limits, alarm sounds and false alarms intended to reduce annoyance. J Clin Monit 15:75–83

    Article  Google Scholar 

  29. Kam PCA, Kam AC, Thompson JF (1994) Noise pollution in the anaesthetic and intensive care environment. Anaesthesia 49:982–986

    Article  PubMed  CAS  Google Scholar 

  30. Hagerman I, Rasmanis G, Blomkvist V, Ulrich R, Eriksen CA, Theorell T (2005) Influence of intensive coronary care acoustics on the quality of care and physiological state of patients. Int J Cardiol 98:267–270

    Article  PubMed  Google Scholar 

  31. Topf M, Dillon E (1988) Noise induced stress as a predictor of burnout in critical care nurses. Heart Lung 17:567–573

    PubMed  CAS  Google Scholar 

  32. Aaron JN, Carlisle CC, Carskadon MA, Meyer TJ, Hill NS, Millman RP (1996) Environmental noise as a cause of sleep disruption in an intermediate respiratory care unit. Sleep 19:707–710

    PubMed  CAS  Google Scholar 

  33. Hansell HN (1984) The behavioural effects of the noise on men: The patient with “intensive care psychosis”. Heart Lung 13:59–65

    PubMed  CAS  Google Scholar 

  34. Smith R, Johnson L, Rothfeld D, Zir L, Tharp B (1972) Sleep and cardiac arrythmias. Arch Intern Med 130:751–753

    Article  PubMed  CAS  Google Scholar 

  35. Minckley BB (1968) A study of noise and its relationship to patient discomfort in the recovery room. Nurs Res 17:247–250

    PubMed  CAS  Google Scholar 

  36. Van Rompaey B, Elseviers MM, Van Drom W, Fromont V, Jorens PG (2012) The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients. Crit Care 16:R73

    Article  PubMed  Google Scholar 

  37. Aboukhalil A, Nielsen L, Saeed M, Mark RG, Clifford GD (2008) Reducing false alarm rates for critical arrhythmias using the arterial blood pressure waveform. J Biomed Inf 41:442–451

    Article  Google Scholar 

  38. Görges M, Markewitz BA, Westenskow DR (2009) Improving alarm performance in the medical intensive care unit using delays and clinical context. Anesth Analg 108:1546–1552

    Article  PubMed  Google Scholar 

  39. Kennedy RR (1995) A modified trigg’s tracking variable as an “advisory” alarm during anesthesia. Int J Clin Monit Comput 12:197–204

    Article  PubMed  CAS  Google Scholar 

  40. Mäkivirta A, Koski E, Kari A, Sukuvaara T (1991) The median filter as a processor for a patient monitor limit alarm system in intensive care. Comput Methods Programs Biomed 34:139–144

    Article  PubMed  Google Scholar 

  41. Shortliffe EH, Davis R, Axline SG et al (1975) Computer-based consultations in clinical therapeutics: Explanation and rule acquisition capabilities of the MYCIN-System. Comput Biomed Res 8:303–320

    Article  PubMed  CAS  Google Scholar 

  42. Sukuvaara T, Koki EM, Mäkivirta A, Kari A (1993) A knowledge-based system for monitoring cardiac operated patients – technical construction and evaluation. Int J Clin Monit Comput 10:117–126

    Article  PubMed  CAS  Google Scholar 

  43. Baxt WG, Skora J (1996) Prospective validation of artificial neural network trained to identify acute myocardial infarction. Lancet 347:12–15

    Article  PubMed  CAS  Google Scholar 

  44. Orr JA, Westenskow DR (1994) A breathing circuit alarm system based on neural networks. J Clin Monit 10:101–109

    Article  PubMed  CAS  Google Scholar 

  45. Zadeh LA (1965) Fuzzy sets. Inform Control 8:338–353

    Article  Google Scholar 

  46. Goldman JM, Cordova MJ (1994) Advanced clinical monitoring: Considerations for real-time hemodynamic diagnostics. Proc Annu Symp Comput Appl Med Care :752–756

    Google Scholar 

  47. Laursen P (1994) Event detection on patient monitoring data using causal probabilistic networks. Method Inform Med 33:111–115

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Hamburg Eppendorf University Hospital, Martinistr. 52, 20246, Hamburg, Germany

    F. Schmid, M. S. Goepfert & D. A. Reuter

Authors
  1. F. Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. S. Goepfert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. A. Reuter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Schmid .

Editor information

Editors and Affiliations

  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg and BioMed Central Ltd.

About this chapter

Cite this chapter

Schmid, F., Goepfert, M.S., Reuter, D.A. (2013). Patient Monitoring Alarms in the ICU and in the Operating Room. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2013. Annual Update in Intensive Care and Emergency Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35109-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35109-9_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35108-2

  • Online ISBN: 978-3-642-35109-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation