Assessing validity of infant monitor alarms with event recording.
We evaluated the performance of an event recorder system in a large, consecutive series of referred monitored patients to determine the relative incidence of true apnea and true bradycardia, false alarms, and alarms for movement or a loose lead. In addition, we developed an event classification system based on the reason for the event being recorded. The recorder stored transthoracic impedance and electrocardiogram signals on a floppy disk before, during, and after each monitor alarm. These events on 302 disks from 83 patients were analyzed and classified as true, false, or movement-loose lead. Of 14,131 events, only 8% were caused by apnea or bradycardia (true events). Of true events, 70% were triggered by apnea and 30% by bradycardia. These true events occurred in 48% of the patients. False alarms constituted 23%, and movement-loose lead 69%, of all events. Even when movement-loose lead events were excluded, nearly three of four events were found to be false. Event recording proved helpful clinically, allowing discontinuation of the monitor in 49% of patients, modification of monitor alarm settings, or reassurance and counseling for parents.
Weese-Mayer
D E
DE
Department of Pediatrics, Northwestern University Medical School, Children's Memorial Hospital, Chicago, Illinois.
Brouillette
R T
RT
Morrow
A S
AS
Conway
L P
LP
Klemka-Walden
L M
LM
Hunt
C E
CE
D001049:Apnea / Q000503:physiopathology*; D001919:Bradycardia / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D007224:Infant Care; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011446:Prospective Studies