Guidelines for selective activation of alarms for blood pressure monitoring: effect on noise pollution in ICU

Objective: To evaluate a selective activation of sounding alarms on non-inv asive blood pressure (BP) monitoring according to the patient haemodynamic status. Study design: Prospective study. Methods: Activation of alarms on BP was regulated with a protocol. Sounding alarms were either inactivated when patient's haemodynamic status was stab le (group 1), or activated when it was unstable (group 2). The frequency of BP measurement was one every 15 min. For all mean BP value recorded, the f ollowing criteria were analyzed : 1) normality of the value compared to ran ges 65 -115 mmHg in group 1 or compared to alarm thresholds in group 2; 2) consequences on the care and therapeutic; 3) delay when an abnormal value w as detected and managed after more than 15 min. Results: 1,674 hours of monitoring from 42 patients, allowed the analysis o f 6,695 measurements of mean BP, 3,092 in group 1 and 3,603 in group 2. In group 1, 2,822 measurements were considered as normal and 3,094 measures in group 2. Eight measurements had consequences on therapeutic in group 1, wi th only one with delay in care giving. 287 measurements had consequences on therapeutic in group 2, 8 with delay in care giving. Six per cent of abnor mal measurements in group 2 were managed with delay. This protocol reduced by 52% the production of sounding alarms on BP, without noxious effects for the patients. Conclusion: Selective activation of sounding alarms on BP, a ccording to the patient haemodynamic status, reduced noise pollution and co uld be one solution to improve monitoring efficiency in intensive care unit . (C) 2001 Editions scientifiques et medicales Elsevier SAS .