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Jose Morillo
ALARM FATIGUE. AN ENEMY EASY TO FIGHT
July 23, 2011 11:10
Never until now, nurses and medical personal was as expose to alarms detectors as now. Multiparameter monitors make possible measure almost any bilogocal parameter and asign, even automatically, alarms parameters for each one.
Two big problems are still present with alarms: 1.- Misadjusted alarms parameters that make it activate all time. 2.- Electrode, Transducers misconnections.
Both problems have solution. A correct alarm adjustment must consider the normal fluctuation of any parameter, human body is not a swiss clock. We must adjust alarms to levels that indicate a warning condition. It will mean a wider window of adjustment and a significative reduction of flase alarms (those alarms that haven't a clinical importance.
AN intelligent algoritm design can make monitors evaluate the alarm condition in a scale. Rarely the human parameters are independ one each other. Often a HR is follow or anteceded by an Arterial pressure variation, SpO2 or temperature variation. An "intelligent" monitor can evaluate, for example, HR from ECG and SpO2 at the same time two difference between an emergency condition and a loose transducer or electrode. it can consideer HR variation vs. Artery Pressure and/or SpO2 to determine a danger trend and launch a real alarm.
An intelligent ECG monitor can use as few as just 2 electrodes. Basically a ICU monitor is following Heart Rate, waveshape has no alarm itself. All alarm condition mean a frequency variation, soo 2 electrode are enough to check it. Always in case of doubt an ECG is maded with a full 12 electrodes ECG.
SpO2 and NIBP can be acopled. SUre a significative wave amplitude variation on SpO2 can mean an Arterial pressure variation. Monitor can launh a NIBP measurement to confirm BEFORE launch an alarm.
Parameter inter relations have no limits. A doctors and Biomedical team can make a new generation of Intelligents monitors.
Go ahead!
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