Intra‐operative monitoring – many alarms with minor impact. (7th June 2013)

• Record Type: Journal Article
• Authors: de Man, F. R.; Greuters, S.; Boer, C.; Veerman, D. P.; Loer, S. A.
• Is Part Of: Anaesthesia. Volume 68:Number 8(2013:Aug.)
• Page Start: 804
• Page End: 810
• Publication Date: 2013-06-07
• Subjects: Anesthesia -- Periodicals; 617.96
• DOI: 10.1111/anae.12289
• Languages: English
• ISSNs: 0003-2409

Abstract

Summary: Alarms are key components of peri‐operative monitoring devices, but a high false‐alarm rate may lead to desensitisation and neglect. The objective of this study was to quantify the number of alarms and assess the value of these alarms during moderate‐risk surgery. For this purpose, we analysed documentation of anaesthesia workstations during 38 surgical procedures. Alarms were classified on technical validity and clinical relevance. The median (IQR [range]) alarm density per procedure was 20.8 (14.5–34.2 [3.7–85.6]) alarms.h −1 (1 alarm every 2.9 min) and increased during induction and emergence of anaesthesia, with up to one alarm per 0.99 min during these periods (p < 0.001). Sixty‐four per cent of all alarms were clinically irrelevant, whereas 5% of all alarms required immediate intervention. The positive predictive value of an alarm during induction and emergence was 20% (95% CI 16–24%) and 11% (95% CI 8–14%), respectively. This study shows that peri‐operative alarms are frequently irrelevant, with a low predictive value for an emerging event requiring clinical intervention. Abstract : This article is accompanied by an Editorial by Edworthy, pp 791–794 of this issue.