title: Novel Pulse Oximetry Sonifications for Neonatal Oxygen Saturation Monitoring: A Laboratory Study.
abstract: OBJECTIVE
  We aimed to test whether the use of novel pulse oximetry sounds (sonifications) better informs listeners when a neonate's oxygen saturation (SpO2) deviates from the recommended range.
  
  
  BACKGROUND
  Variable-pitch pulse oximeters do not accurately inform clinicians via sound alone when SpO2 is outside the target range of 90% to 95% for neonates on supplemental oxygen. Risk of blindness, organ damage, and death increase if SpO2 remains outside the target range. A more informative sonification may improve clinicians' ability to maintain the target range.
  
  
  METHODS
  In two desktop experiments, nonclinicians' ability to detect SpO2 range and direction of change was tested with novel versus conventional sonifications of simulated patient data. In Experiment 1, a "shoulder" sonification used larger pitch differences between adjacent saturation percentages for SpO2 values outside the target range. In Experiment 2, a "beacon" sonification used equal-appearing pitch differences, but when SpO2 was outside the target range, a fixed-pitch reference tone from the center of the target SpO2 range preceded every fourth pulse tone.
  
  
  RESULTS
  The beacon sonification improved range identification accuracy over the control display (85% vs. 60%; p < .001), but the shoulder sonification did not (55% vs. 52%).
  
  
  CONCLUSIONS
  The beacon provided a distinct auditory alert and reference that significantly improved nonclinical participants' ability to identify SpO2 range.
  
  
  CONCLUSIONS
  Adding a beacon to the variable-pitch pulse oximeter sound may help clinicians identify when, and by how much, a neonate's SpO2 deviates from the target range, particularly during patient transport situations when auditory information becomes essential.
authors.affiliation: The University of Queensland, St. Lucia, AustraliaUniversity of Arizona, TucsonMater Mothers' Hospital, Brisbane, AustraliaThe University of Queensland, St. Lucia, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Hinckfuss
authors.affiliation: The University of Queensland, St. Lucia, Australia uqpsande@uq.edu.au.
authors.forename: Penelope
authors.initials: P
authors.lastname: Sanderson
authors.affiliation: University of Arizona, Tucson.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Loeb
authors.affiliation: Mater Mothers' Hospital, Brisbane, Australia.
authors.forename: Helen G
authors.initials: HG
authors.lastname: Liley
authors.affiliation: The University of Queensland, St. Lucia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D001307:Auditory Perception / Q000502:physiology*; D056902:Clinical Alarms; D006801:Humans; D015931:Intensive Care, Neonatal / Q000379:methods*; D008962:Models, Theoretical; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry / Q000379:methods*; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: auditory displays; critical care; medical devices and technologies; pediatrics and neonatology; sonification