We tested whether enhanced sonifications would improve participants' ability to judge the oxygen saturation levels (SpO 2) of simulated neonates in the first 10 min after birth. Background: During the resuscitation of a newborn infant, clinicians must keep the neonate's SpO 2 levels within the target range, however the boundaries for the target range change each minute during the first 10 min after birth. Resuscitation places significant demand on the clinician's visual attention, and the pulse oximeter's sonification could provide eyes-free monitoring. However, clinicians have difficulty judging SpO 2 levels using the current sonification. Method: In two experiments, nonclinicians' ability to detect SpO 2 range and direction-while performing continuous arithmetic problems-was tested with enhanced versus conventional sonifications. In Experiment 1, tremolo signaled when SpO 2 had deviated below or above the target range. In Experiment 2, tremolo plus brightness signaled when SpO 2 was above target range, and tremolo alone when SpO 2 was below target range. Results: The tremolo sonification improved range identification accuracy over the conventional display (81% vs. 63%, p < .001). The tremolo plus brightness sonification further improved range identification accuracy over the conventional display (92% vs. 62%, p <.001). In both experiments, there was no difference across conditions in arithmetic task accuracy (p >.05). Conclusion: Using the enhanced sonifications, participants identified SpO 2 range more accurately despite a continuous distractor task. Application: An enhanced pulse oximetry sonification could help clinicians multitask more effectively during neonatal resuscitations.
Manufacturers could improve the pulse tones emitted by pulse oximeters to support more accurate identification of a patient's peripheral oxygen saturation (SpO2) range. In this article, we outline the strengths and limitations of the variable-pitch tone that represents SpO2 of each detected pulse, and we argue that enhancements to the tone to demarcate clinically relevant ranges are feasible and desirable. The variable-pitch tone is an appreciated and trusted feature of the pulse oximeter's user interface. However, studies show that it supports relative judgments of SpO2 trends over time and is less effective at supporting absolute judgments about the SpO2 number or conveying when SpO2 moves into clinically important ranges. We outline recent studies that tested whether acoustic enhancements to the current tone could convey clinically important ranges more directly, without necessarily using auditory alarms. The studies cover the use of enhanced variable-pitch pulse oximeter tones for neonatal and adult use. Compared with current tones, the characteristics of the enhanced tones represent improvements that are both clinically relevant and statistically significant. We outline the benefits of enhanced tones, as well as discuss constraints of which developers of enhanced tones should be aware if enhancements are to be successful.
Background Many physiological aspects of the neonatal transition after birth are unobservable because relevant sensors do not yet exist, compromising clinicians’ understanding of a neonate’s physiological status. Given that a neonate’s true physiological state is currently unavailable, we explored the feasibility of using clinicians’ degree of concordance as an approximation of the true physiological state. Methods Two phases of structured interviews were conducted. In Phase 1 ( N = 8) and Phase 2 ( N = 12), we presented neonatal experts with eight graphical trajectories of real newborns’ heart rate and oxygen saturation values in the first 10–15 min after birth. We elicited the participants’ interpretations of potential underlying physiological conditions that could explain the vital sign patterns. Results The global differential diagnosis data for each phase produced the same pattern of results: (1) four trajectories produced a substantial degree of concordance among clinicians (61–80%) and (2) four trajectories produced a strong degree of concordance among clinicians (81–100%). Conclusions It is possible to achieve a strong degree of concordance among neonatal experts’ interpretations of newborn trajectories. Thus, using the degree of concordance as an approximation of the neonate’s true physiological state in resuscitation after birth may be a promising direction to explore for cognitive aid design. Impact Differential diagnoses with a good degree of concordance among expert neonatal clinicians could potentially substitute in part for the direct measurement of key physiological and anatomical variables of the neonatal transition, which is currently unavailable. The concordance of clinicians’ judgements or inferences with regards to the true physiological state of the newborn during resuscitation after birth has never been explored. The findings provide a crucial first step toward using consensus of neonatal experts’ judgements in the design of a cognitive aid to support clinicians’ management of the newborns who require resuscitation after birth.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.