Evaluation of an enhanced pulse oximeter auditory display: a simulation study

Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies*

“…using a `shaded in´trace while leaving other waveforms as `line only´) [46,151]. The potential for enhanced displays or smart monitors [152],…”

Applying Human Factors Engineering to Address the Telemetry Alarm Problem in a Large Medical Center

“…We anticipated that auditory alarms could be redesigned to have a higher information encoding about events, which could reduce the cognitive burden of searching visually through a patient monitoring display, increase vigilance accuracy and reduce response times (Bruder et al, 2019). We were aware that encoding transitions between pulse oximetry values from low to critical ranges could be enhanced with tremolo and brightness changes in addition to varying pitch (Paterson et al, 2020).…”

Improving pulse oximetry auditory displays: Anesthesiologists' perceptions

“…They rated the enhanced sounds as significantly more dependable, reliable, and helpful, and less likely to contribute to patient harm. 3 We have not previously reported our subjects' free-form comments about their strategies for using the enhanced sounds or the sounds' potential effectiveness in practice. Of the 20 anesthesiologists, 19 (95%) stated that they preferred working with the enhanced sounds, and none suggested that the sounds were disruptive or deleterious.…”

“…In a previously published simulator study, we made the pulse oximeter sound more informative by adding acoustic enhancements to its variable-pitch tones to distinguish warning and critical oxygen saturation (SpO 2 ) ranges. 3 In a crossover study, 20 consenting Australian anesthesiologists identified clinical ranges more accurately, and detected when SpO 2 breached a specified target threshold faster and more accurately, with the enhanced sounds than with standard sounds comprising variable-pitch tones plus an alarm indicating the critical range. The benefits occurred despite ongoing timeshared tasks, background noise, and interruptions.…”

“…Together, these results indicate that enhanced sounds may allow anesthesiologists to safely monitor SpO 2 in peripheral awareness while carrying out other cognitively and visually demanding tasks. 3,7,8 In practice, users could adjust SpO 2 values at which auditory enhancements are introduced. Our laboratory has also implemented a pulse oximetry auditory display that provides an "all's well" chirp at spaced intervals and only emits variable-pitch tones when saturation is outside the target range, further alleviating potential annoyance.…”