title: The effect of audible alarms on anaesthesiologists' response times to adverse events in a simulated anaesthesia environment: a randomised trial.
abstract: Alarms are ubiquitous in anaesthetic practice, but their net effect on anaesthesiologists' performance and patient safety is debated. In this study, 27 anaesthesiologists performed two simulation sessions in random order; one session was programmed to include an alarm condition, with a standard, frequent, clearly audible alarm sound. During these sessions, adverse events were simulated and anaesthesiologists' response times to these events were recorded. Perceived workload was assessed with the NASA Task Load Index. Response times to adverse events and perceived workload were similar in both groups. Pooled response times to atrial fibrillation and desaturation were fast, with a median (range [IQR]) of 8 (4-14 [1-41]) s and 9 (6-16 [1-44]) s, respectively. Pooled response times to an ST segment elevation on the ECG and an obstructed intravenous line were significantly slower, with median (IQR[range]) times of 34 (21-76[4-300]) s and 227 (95-399 [2-600]) s, respectively (p < 0.001). This study shows that in a simulated anaesthesia environment, response times to adverse events are similar in the absence or presence of an audible alarm, and that response times to various critical events differ.
authors.affiliation: Department of Anaesthesiology, Institute for Cardiovascular Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: F R
authors.initials: FR
authors.lastname: de Man
authors.forename: M
authors.initials: M
authors.lastname: Erwteman
authors.forename: D
authors.initials: D
authors.lastname: van Groeningen
authors.forename: P V
authors.initials: PV
authors.lastname: Ziedses des Plantes
authors.forename: C
authors.initials: C
authors.lastname: Boer
authors.forename: S A
authors.initials: SA
authors.lastname: Loer
authors.forename: R
authors.initials: R
authors.lastname: Krage
mesh_terms: D000776:Anesthesiology; D001307:Auditory Perception; D056902:Clinical Alarms; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D061214:Patient Safety; D016544:Patient Simulation; D011930:Reaction Time; D013997:Time Factors