Anesthesia alarms in context: An observational study

This paper surveys current work on the design of alarms for anesthesia envi ronments and notes some of the problems arising from the need to interpret alarms in context. Anesthetists' responses to audible alarms in the operati ng room were observed across four types of surgical procedure (laparoscopic , arthroscopic, cardiac, and intracranial) and across three phases of a pro cedure (induction, maintenance, and emergence). Alarms were classified as ( a) requiring a corrective response, (b) being the intended result of a deci sion, (c) being ignored as a nuisance alarm, or (d) functioning as a remind er. Results revealed strong effects of the type of procedure and phase of p rocedure on the number and rate of audible alarms. Some alarms were relativ ely confined to specific phases; others were seen across phases, and respon ses differed according to phase. These results were interpreted in light of their significance for the development of effective alarm systems. Actual or potential applications of this research include the design of alarm syst ems that are more informative and more sensitive to operative context than are current systems.