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Electronic monitoring equipment appears to have advanced measurably the safety of anesthesia care by extending the human senses of the anesthetist beyond his native sight, touch, smell, and hearing. Yet electronic vigilance of an anesthetized patient is effective only when information receives the attention of the anesthetist for analysis and action. Auditory signaling has been used commonly to alert the anesthetist to unusual measurements made by a monitoring device. While there is general acceptance that auditory signaling or auditory alarms may be suboptimal in the operating room, there may not be sufficient quantification of the acceptability of alarms for rational selection of remedies.
Five hundred anesthesiologists in active practice in the United States of America were selected at random from the directory of the American Society of Anesthesiologists. A letter and a questionnaire were mailed to each anesthesiologist with a stamped envelope to facilitate a reply. The number of responses and the frequency of comments indicates a high degree of interest in the issue of operating room alarms. Alarms appear to be viewed as a contributor to stress in the operating room. Anesthesiologists want their alarms to be clearly different than alarms on other equipment in the operating suite. There appears to be good support for distinctive alarm sounds, graded alarms, and intermittent alarms, although there are differences in opinion on the optimal type of alarm between voice, central displays, or distinctive tones.
operating room alarms, anesthesia monitor alarms, audible alarms, alarm standards, audible warning signals, auditory loading
Corporate medical director, Becton Dickinson, Rutherford, NY
Assistant professor of Psychology, Rensselaer Polytechnic Institute, Troy, NY