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Clinical auditory alarms are often found in hospital wards and operating rooms. In these environments, regular daily tasks can result in having a multitude of concurrent sounds (from staff and patients, building systems, carts, cleaning devices, and importantly, patient monitoring devices) which easily amount to a prevalent cacophony. The negative impact of this soundscape on staff and patients’ health and well-being, as well as in their performance, demand for accordingly designed sound alarms. The recently updated IEC60601-1-8 standard, in guidance for medical equipment auditory alarms, proposed a set of pointers to distinctly convey medium or high levels of priority (urgency). However, conveying priority without compromising other features, such as ease of learnability and detectability, is an ongoing challenge. Electroencephalography, a non-invasive technique for measuring the brain response to a given stimulus, suggests that certain Event-Related Potentials (ERPs) components such as the Mismatch Negativity (MMN) and P3a may be the key to uncovering how sounds are processed at the pre-attentional level and how they may capture our attention. In this study, the brain dynamics in response to the priority pulses of the updated IEC60601-1-8 standard was studied via ERPs (MMN and P3a), for a soundscape characterised by the repetition of a sound (generic SpO2 “beep”), usually present in operating and recovery rooms. Additional behavioural experiments assessed the behavioural response to these priority pulses. Results showed that the Medium Priority pulse elicits a larger MMN and P3a peak amplitude when compared to the High Priority pulse. This suggests that, at least for the applied soundscape, the Medium Priority pulse is more easily detected and attended at the neural level. Behavioural data supports this indication, showing significantly shorter reaction times for the Medium Priority pulse. The results pose the possibility that priority pointers of the updated IEC60601-1-8 standard may not be successfully conveying their intended priority levels, which may not only be due to design properties but also to the soundscape in which these clinical alarms are deployed. This study highlights the need for intervention in both hospital soundscapes and auditory alarm design settings.

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Recently, several studies on pedestrian safety and particularly those addressing pedestrian crossing behaviour and decision-making, have been performed using virtual reality systems. The use of simulators to assess pedestrian behaviour is conditioned by the feeling of presence and immersion, for which the sound is a determining factor. This paper presents an implementation procedure in which tyre-road noise samples are auralized and presented as auditory stimuli in a virtual environment, for assessing pedestrian crossing decision-making. The auditory samples obtained through the Close Proximity (CPX) method and subsequently auralized to represent Controlled Pass-By (CPB) sounds reproduce the sounds of a vehicle approaching a crosswalk. The auralized sounds together with the presentation of visual stimuli composed an experiment which was carried out with 30 participants. Safety indicators, as the time-to-passage at the moment that participants decided to cross a virtual crosswalk and the minimum time-to-collision were registered and compared with data obtained in real-world road crossings. A comparison with real world data points to a close alignment between results obtained in virtual and real environments, indicating a good suitability of the approach for studying pedestrian crossing behaviour.