Literature DB >> 20966440

The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac surgery.

Felix Schmid1, Matthias S Goepfert, Daniela Kuhnt, Volker Eichhorn, Stefan Diedrichs, Hermann Reichenspurner, Alwin E Goetz, Daniel A Reuter.   

Abstract

BACKGROUND: Vital sign monitors and ventilator/anesthesia workstations are equipped with multiple alarms to improve patient safety. A high number of false alarms can lead to a "crying wolf" phenomenon with consecutively ignored critical situations. Systematic data on alarm patterns and density in the perioperative phase are missing. Our objective of this study was to characterize the patterns of alarming of a commercially available patient monitor and a ventilator/anesthesia workstation during elective cardiac surgery.
METHODS: We performed a prospective, observational study in 25 consecutive elective cardiac surgery patients. In all patients, identically fixed alarm settings were used. All incoming patient data and all alarms from the patient monitor and the anesthetic workstation were digitally recorded. Additionally, the anesthesia workplace was videotaped from 2 different angles to allow retrospective annotation and correlation of alarms with the clinical situation and assessment of the anesthesiologists' reaction to the alarms.
RESULTS: Of the 8975 alarms, 7556 were hemodynamic alarms and 1419 were ventilatory alarms. For each procedure, 359 ± 158 alarms were recorded, representing a mean density of alarms of 1.2/minute.
CONCLUSION: Approximately 80% of the total 8975 alarms had no therapeutic consequences. Implementation of procedure-specific settings and optimization in artifact and technical alarm detection could improve patient surveillance and safety.

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Year:  2010        PMID: 20966440     DOI: 10.1213/ANE.0b013e3181fcc504

Source DB:  PubMed          Journal:  Anesth Analg        ISSN: 0003-2999            Impact factor:   5.108


  15 in total

1.  Reduction of clinically irrelevant alarms in patient monitoring by adaptive time delays.

Authors:  Felix Schmid; Matthias S Goepfert; Frank Franz; David Laule; Beate Reiter; Alwin E Goetz; Daniel A Reuter
Journal:  J Clin Monit Comput       Date:  2015-11-30       Impact factor: 2.502

2.  Influence of non-invasive blood pressure measurement intervals on the occurrence of intra-operative hypotension.

Authors:  Grant H Kruger; Amy Shanks; Sachin Kheterpal; Tyler Tremper; Chi-Jung Chiang; Robert E Freundlich; James M Blum; Albert J Shih; Kevin K Tremper
Journal:  J Clin Monit Comput       Date:  2017-09-30       Impact factor: 2.502

3.  Anesthesia advanced circulatory life support.

Authors:  Vivek K Moitra; Andrea Gabrielli; Gerald A Maccioli; Michael F O'Connor
Journal:  Can J Anaesth       Date:  2012-04-21       Impact factor: 5.063

4.  Multi-Tiered Observation and Response Charts: Prevalence and Incidence of Triggers, Modifications and Calls, to Acutely Deteriorating Adult Patients.

Authors:  Arthas Flabouris; Savvy Nandal; Luke Vater; Katerina Flabouris; Alice O'Connell; Campbell Thompson
Journal:  PLoS One       Date:  2015-12-30       Impact factor: 3.240

5.  Correlating data from different sensors to increase the positive predictive value of alarms: an empiric assessment.

Authors:  Yuval Bitan; Michael F O'Connor
Journal:  F1000Res       Date:  2012-11-08

Review 6.  Patient monitoring alarms in the ICU and in the operating room.

Authors:  Felix Schmid; Matthias S Goepfert; Daniel A Reuter
Journal:  Crit Care       Date:  2013-03-19       Impact factor: 9.097

7.  Move the anesthesia workstation cautiously!

Authors:  Prakash K Dubey
Journal:  J Anaesthesiol Clin Pharmacol       Date:  2014-01

8.  Nurses' Perceptions and Practices Toward Clinical Alarms in a Transplant Cardiac Intensive Care Unit: Exploring Key Issues Leading to Alarm Fatigue.

Authors:  Azizeh Khaled Sowan; Albert Fajardo Tarriela; Tiffany Michelle Gomez; Charles Calhoun Reed; Kami Marie Rapp
Journal:  JMIR Hum Factors       Date:  2015-03-16

9.  Advanced Monitoring Is Associated with Fewer Alarm Events During Planned Moderate Procedure-Related Sedation: A 2-Part Pilot Trial.

Authors:  Richard L Applegate; John Lenart; Mathew Malkin; Minhthy N Meineke; Silvana Qoshlli; Monica Neumann; J Paul Jacobson; Alison Kruger; Jeffrey Ching; Mohammad Hassanian; Michael Um
Journal:  Anesth Analg       Date:  2016-04       Impact factor: 5.108

10.  Role of Large Clinical Datasets From Physiologic Monitors in Improving the Safety of Clinical Alarm Systems and Methodological Considerations: A Case From Philips Monitors.

Authors:  Azizeh Khaled Sowan; Charles Calhoun Reed; Nancy Staggers
Journal:  JMIR Hum Factors       Date:  2016-09-30
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