Page 38 - GlobalCE 1st Special Issue

Lin, Zheng, Shen, Zheng, and Wu: Survey and Analysis of Current State of Ventilator Alarms in the Intensive Care Unit

MAteRIAls AnD MetHoD and analyzed common alarm contents, common alarm
Based on the literature review and our experience, intervention measures, and alarm causes. Since alarm
alarms can be categorized into meaningful alarms and limit settings are highly relevant with alarm occurrence,
meaningless alarms. Meaningful alarms are those alarms it is also important to record common alarm limit values
that require a clinician’s quick attendance due to changes accurately. Based on the key elements mentioned above,
in patient condition or those technical alarms originating we design the Statistics of Clinical Meaningful Alarms, as
from equipment malfunctions that require timely cor- shown in Table 1.
rection. Meaningless alarms are those that don’t reflect In this study, we selected the SLE5000 ventilator as an
the true changes of a patient’s condition, do not improve example, where this paper applies the designed survey
patient management, and may be caused by false alarm, table to the collection and observation of the SLE5000
improper alarm settings, or recoverable transient artifacts. ventilator alarms generated in daily use in the neonatal
In order to carry out an assessment of the common intensive care unit (NICU) over a period of 10 days.
ventilator alarms, we first consulted with clinicians to cat-
egorize the three main alarm interventions for ventilators in ResUlt
their routine practice: (1) clinician’s medical intervention, The Results of the Survey
(2) clinical engineering and nurse’s equipment correction;
This survey is based on 120 total questionnaires, with
and (3) alarm elimination by silencing. Clinician’s medi-
486 events of recorded alarm information from 112 valid
cal intervention means patients with clinically changed
questionnaires, and 12 kinds of common alarms generated.
conditions requiring timely intervention of medical staff;
The specific number of alarms shown in Figure 1. Among
clinical engineering and nurse’s equipment correction
them, the high-pressure alarm, low pressure alarm, and
means a technical problems with the ventilator occurred
cycle failure occur with higher frequency. The results of
requiring clinical engineering or nurse’s action such as
intervention are shown in Table 2.
immediate repair; while alarm elimination by silencing
According to the effectiveness of the alarm and the
means that both the patient and instrument were OK and
definition of meaningful alarms described earlier, we
the alarm did not recur after silencing. We also collected
classify 354 alarms events as meaningful alarms, and the

TABlE 1. Statistics of Clinical Meaningful Alarms
Ventilator Model: Patient Hospital Number: Date:
PEEP Amplitude Hz Frequency Tidal volume Minute ventilation
Set value H: H: H: H:
L: L: L: L:

Alarm content Intervention measures and their causes (multiple choice) The result of the intervention
Event hints:  Mute Endotracheal secretions are much, should suck  Alarm elimination by silencing
them out  Clinician’s medical intervention
 Abnormal machine and accessories The patient is  Clinical engineering and nurse’s equipment
restless correction
 There is water in the tube Replacement of the sensor
 Adjust the position of the endotracheal intubation
 pipeline discount, off other
…… …… ……

J Global Clinical Engineering Special Issue 1: 37-41; 2018 38