Newly Published
Perioperative Medicine  |   April 2018
Auditory Icon Alarms Are More Accurately and Quickly Identified than Current Standard Melodic Alarms in a Simulated Clinical Setting
Author Notes
  • From the Department of Anesthesiology (R.R.M., R.D.)
  • and the Department of Anesthesiology, Jackson Memorial Hospital (D.B.H.)
  • Miller School of Medicine, and Music Engineering Technology Program, Frost School of Music (C.L.B.)
  • University of Miami, Miami, Florida; and the Cognition Institute, Plymouth University, United Kingdom (J.R.E.).
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Submitted for publication May 19, 2017. Accepted for publication March 23, 2018.
    Submitted for publication May 19, 2017. Accepted for publication March 23, 2018.×
  • Research Support: Supported by the Association for the Advancement of Medical Instrumentation, Arlington, Virginia.
    Research Support: Supported by the Association for the Advancement of Medical Instrumentation, Arlington, Virginia.×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. McNeer: Division of Trauma and Critical Care, Department of Anesthesiology, University of Miami Miller School of Medicine, P.O. Box 016370 (M820), Miami, Florida 33101. mcneer@miami.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Critical Care
Perioperative Medicine   |   April 2018
Auditory Icon Alarms Are More Accurately and Quickly Identified than Current Standard Melodic Alarms in a Simulated Clinical Setting
Anesthesiology Newly Published on April 25, 2018. doi:10.1097/ALN.0000000000002234
Anesthesiology Newly Published on April 25, 2018. doi:10.1097/ALN.0000000000002234
Abstract

Background: Current standard audible medical alarms are difficult to learn and distinguish from one another. Auditory icons represent a new type of alarm that has been shown to be easier to learn and identify in laboratory settings by lay subjects. In this study, we test the hypothesis that icon alarms are easier to learn and identify than standard alarms by anesthesia providers in a simulated clinical setting.

Methods: Twenty anesthesia providers were assigned to standard or icon groups. Experiments were conducted in a simulated intensive care unit. After a brief group-specific alarm orientation, subjects identified patient-associated alarm sounds during the simulation and logged responses via a tablet computer. Each subject participated in the simulation twice and was exposed to 32 alarm annunciations. Primary outcome measures were response accuracy and response times. Secondary outcomes included assessments of perceived fatigue and task load.

Results: Overall accuracy rate in the standard alarm group was 43% (mean) and in the icon group was 88% (mean). Subjects in the icon group were 26.1 (odds ratio [98.75% CI, 8.4 to 81.5; P < 0.001]) times more likely to correctly identify an alarm. Response times in the icon group were shorter than in the standard alarm group (12 vs. 15 s, difference 3 s [98.75% CI ,1 to 5; P < 0.001]).

Conclusions: Under our simulated conditions, anesthesia providers more correctly and quickly identified icon alarms than standard alarms. Subjects were more likely to perceive higher fatigue and task load when using current standard alarms than icon alarms.