To Beep or Not to Beep? Evaluating Modalities for Multimodal ICU Alarms

Abstract

Technology plays a prominent role in intensive care units (ICU), with a variety of sensors monitoring both patients and devices. A serious problem exists, however, that can reduce the sensors’ effectiveness. When important values exceed or fall below a certain threshold or sensors lose their signal, up to 350 alarms per patient a day are issued. These frequent alarms are audible in several locations on the ICU, resulting in a massive cognitive load for ICU nurses, as they must evaluate and acknowledge each alarm. “Alarm fatigue” sets in, a desensitization and delayed response time for alarms that can have severe consequences for patients and nurses. To counteract the acoustic load on ICUs, we designed and evaluated personal multimodal alarms for a wearable alarm system (WAS). The result was a lower response time and higher ratings on suitability and feasibility, as well as a lower annoyance level, compared to acoustic alarms. We find that multimodal alarms are a promising new approach to alert ICU nurses, reduce cognitive load, and avoid alarm fatigue.

Improvements in Accurate Detection of Cardiac Abnormalities and Prognostic Health Diagnosis Using Artificial Intelligence in Medical Systems

“…The design of medical systems towards more accuracy and resiliency is quite challenging, and to mitigate, in the recent past decade, developed and used few techniques like data fusion techniques [1], [3], [12], [16], [21], Artificial Intelligence (AI) based techniques [17]- [23] and correlation techniques [7]- [9], [23], [24]. However, all these techniques will have its limitations and lack in mitigating the challenges, like accurate identification and separation of the apt signal data for data analytics to extract the artifacts, identification of inaccurate signal data, and finding the root cause of the faults like systemic or random failures towards determining the health of the medical systems.…”

“…However, all these techniques will have its limitations and lack in mitigating the challenges, like accurate identification and separation of the apt signal data for data analytics to extract the artifacts, identification of inaccurate signal data, and finding the root cause of the faults like systemic or random failures towards determining the health of the medical systems. In-depth studies [5], [10]- [12], [16], [24] show that potential faults in sensors or related system design factors may cause the biosignal embedded with external environmental faults.…”

“…The associate editor coordinating the review of this manuscript and approving it for publication was Roberto Pietrantuono . system architectures, i.e., one sensor measures one or more vital health parameters and generates an alarm as per safety severity level if any disturbance occurs, and halts system functional operation if the severity level is high [11], [12]. This type of non-invasive medical monitoring devices is often subject to an insignificant number of failures with potentially catastrophic impacts on patients.…”

Sleeping Soundlessly in the Intensive Care Unit

“…Furthermore, the addition of a secondary sensory stream may decrease the informational burden on a single sensory stream by allowing a salient alarm to be delivered at a lower intensity. A second group found a personal and wearable visual-tactile alarm to lower response time, improve ratings on suitability and feasibility, and lower annoyance level when compared to acoustic alarms [58]. Tactile stimuli have an advantage over visual stimuli, specifically in healthcare environments where visual attention may be necessary such as the operating room or other procedures.…”

Augmenting Critical Care Patient Monitoring Using Wearable Technology: Review of Usability and Human Factors (Preprint)

“…Cobus and Heuten's [26] head-mounted displays displaying a high-priority alarm. All light-emitting diodes (LEDs) were activated simultaneously for the alarms.…”