AUDITORY ALARMS DURING ANESTHESIA MONITORING WITH AN INTEGRATED MONITORING-SYSTEM

Alarms in the operating room remain a major source of annoyance and co nfusion. A previous study by Kestin et al. utilized a specific combina tion of distinct, separate monitors in SO pediatric patients. He repor ted a mean of 10 alarms per case with a mean frequency of one alarm ev ery 4.5 minutes. The alarms were classified as spurious (75%), change outside the alarm limits (22%), or patient risk (3%). We performed a s imilar study with 50 adult patients under general anesthesia with defa ult alarm settings on an integrated monitor, (Cardiocap(TM), Datex, He lsinki). In our study, the number of alarms averaged 3 per case with a mean frequency of one every 34 minutes. Spurious alarms (those caused by electrocautery, accidental patient movement, or other non-physiolo gical reasons) represented only 24% of all alarms. Those alarms soundi ng that were outside the limits occurred at a rate of 53%, and those t hat were considered patient risks occurred at a rate of 23%. Of the al arms, 67% occurred during the beginning and end of anesthesia. The end -tidal carbon dioxide accounted for 42% of the alarms, mostly during i ntubation and extubation. Suggestions are made for further improvement in alarm systems.