Skip to main content
SpringerLink
Log in

A Review of Design Guidelines for Clinical Auditory Alarms

  • Conference paper
  • First Online:
Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors (HEPS 2019)

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 1012))

Included in the following conference series:

Abstract

The global medical safety standard IEC 60601-1-8 includes general requirements for the design of auditory alarms for medical equipment. This document was last amended in 2012 and is currently being updated to be released in the end of 2019. The update includes major changes in the auditory warning signals design guidelines. One of the most important is the fact that it will allow stakeholders to design different versions of the same sound. It is thus relevant to systematize the thorough and robust body of knowledge developed in recent years regarding the design of clinical auditory alarms. This paper identifies the reported problems with clinical auditory alarms; revisits early and current audio design guidelines; and systematizes recommendations or good-practices on healthcare noise, considering spectral, temporal and spatial characteristics of auditory alarms. All content is based on standards and/or experimental studies on detection, learning, subjective perception, or spatial localization. Its aim is to provide a practical tool for designers to design better clinical auditory alarms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Notes

  1. 1.

    A brief continuous sound having a specific spectral content.

  2. 2.

    Nonprofit organization that establishes best practices to improve patient care using applied scientific research in healthcare.

  3. 3.

    A recurrent group of sound pulses with short but distinct interruptions [3].

References

  1. Edworthy, J., Meredith, C., Hellier, E., Rose, D.: Learning medical alarms whilst performing other tasks. Ergonomics 56(9), 1400–1417 (2013)

    Article  Google Scholar 

  2. Wee, A.N., Sanderson, P.M.: Are melodic medical equipment alarms easily learned? Anesth. Analg. 106(2), 501–508 (2008)

    Article  Google Scholar 

  3. AAMI: ANSI/AAMI/ IEC 60601-1-8:2006 & A1:2012 Medical Electrical Equipment–Part 1–8: General requirements for basic safety and essential performance–Collateral Standard: General requirements, tests and guidance for alarm systems in medical electrical equip (2013)

    Google Scholar 

  4. Edworthy, J., Reid, S., McDougall, S., Edworthy, J., Hall, S., Bennett, D., Khan, J., Pye, E.: The recognizability and localizability of auditory alarms: setting global medical device standards. Hum. Factors 59(7), 1108–1127 (2017)

    Article  Google Scholar 

  5. McNeer, R.R., Horn, D.B., Bennett, C.L., Edworthy, J.R., Dudaryk, R.: Auditory icon alarms are more accurately and quickly identified than current standard melodic alarms in a simulated clinical setting. Anesthesiology 1–9 (2018)

    Google Scholar 

  6. Edworthy, J.R., McNeer, R.R., Bennett, C.L., Dudaryk, R., McDougall, S.J.P., Schlesinger, J.J., Bolton, M.L., Edworthy, J.D.R., Özcan, E., Boyd, A.D., Reid, S.K.J., Rayo, M.F., Wright, M.C., Osborn, D.: Getting better hospital alarm sounds into a global standard. Ergon. Des.: Q. Hum. Factors Appl. 26(4), 4–13 (2018)

    Google Scholar 

  7. ECRI Institute. https://www.ecri.org/. Last accessed 09 Feb 2019

  8. Block, F.E.: ‘For if the trumpet give an uncertain sound, who shall prepare himself to the battle?’ (I Corinthians 14:8, KJV). Anesth. Analg. 106(2), 357–359 (2008)

    Article  Google Scholar 

  9. Patterson, R.D.: Guidelines for Auditory Warning Systems on Civil Aircraft. Eindhoven, The Netherlands (1982)

    Google Scholar 

  10. Chandra, D., Tessler, M.J., Usher, J.: Audio spectrum and sound pressure levels vary between pulse oximeters. Can. J. Anesth. 53(S1), 26–32 (2006)

    Article  Google Scholar 

  11. Bennett, C., McNeer, R., Leider, C.: Urgency analysis of audible alarms in the operating room. In: 12th International Society for Music Information Retrieval Conference (ISMIR 2011), pp. 771–775 (2011)

    Google Scholar 

  12. Sanderson, P.M.: Auditory alarms for medical equipment: How do we ensure they convey their meanings? In: Human Factors and Ergonomics Society Annual Meeting Proceedings, vol. 53(4), pp. 264–268 (2009)

    Article  Google Scholar 

  13. Meredith, C., Edworthy, J.: Are there too many alarms in the intensive care unit? An overview of the problems. J. Adv. Nurs. 21(1), 15–20 (1995)

    Article  Google Scholar 

  14. ISO: ISO 7731–Ergonomics–Danger signals for public and work areas—Auditory danger signals (2003)

    Google Scholar 

  15. Begault, D., Godfroy, M.: Auditory alarm design for NASA CEV applications. In: 13th International Conference on Auditory Displays, pp. 131–138 (2007)

    Google Scholar 

  16. Haas, E., Edworthy, J.: Designing urgency into auditory warnings using pitch, speed and loudness. Comput. Control. Eng. J. 1, 193–198 (1996)

    Article  Google Scholar 

  17. Patterson, R., Edworthy, J., Lower, M.: Alarm Sounds for Medical Equipment in Intensive Care Areas and Operating Theatres. London (1986)

    Google Scholar 

  18. Brown, Z., Edworthy, J., Sneyd, J.R., Schlesinger, J.: A comparison of linear and logarithmic auditory tones in pulse oximeters. Appl. Ergon. 51, 350–357 (2015)

    Article  Google Scholar 

  19. Patterson, R.D., Mayfield, T.F: Auditory warning sounds in the work environment. Philos. Trans. R. Soc. Lond. 327(1241), 485–492 (1990)

    Google Scholar 

  20. NXP Semiconductors: AN10875 IEC 60601-1-8 audible alert generator using the LPC1700. AN10875 (2009)

    Google Scholar 

  21. Edworthy, J., Hellier, E., Titchener, K., Naweed, A., Roels, R.: Heterogeneity in auditory alarm sets makes them easier to learn. Int. J. Ind. Ergon. 41(2), 136–146 (2011)

    Article  Google Scholar 

  22. R. S. and S. Board: Alarms and Alerts Evaluation Tool Version 1.0 (2009). https://www.rssb.co.uk/toolkits/T326/main.html. Last accessed 09 Feb 2018

  23. Begault, D.R.: Guidelines for nextgen auditory displays. J. Audio Eng. Soc. 60(7/8), 519–530 (2012)

    Google Scholar 

  24. Hsu, T.Y.: Relating Acoustics and Human Outcome Measures in Hospitals. Georgia Institute of Technology (2012)

    Google Scholar 

  25. Cvach, M.: Monitor alarm fatigue: an integrative review. Biomed. Instrum. Technol. 46(4), 268–277 (2012)

    Article  Google Scholar 

  26. Busch-Vishniac, I., West, J.E., Orellana, D., Barnhill, C., Hunter, T., Chivukula, R.: Noise levels in Johns Hopkins hospital. J. Acoust. Soc. Am. 118(6), 3629–3645 (2005)

    Article  Google Scholar 

  27. Ryherd, E.E., West, J.E., Ackerman, J., Zimring, C., Waye, K.P.: Evaluating and improving hospital soundscapes. Inter. Noise 2012, 2512–2517 (2012)

    Google Scholar 

  28. Mondor, T.A., Finley, G.A.: The perceived urgency of auditory warning alarms used in the hospital operating room is inappropriate. Can. J. Anaesth. 50(3), 221–228 (2003)

    Article  Google Scholar 

  29. Vieira, J., Santos, J.A., Noriega, P.: Using semantic differential scales to assess the subjective perception of auditory warning signals. In: Proceedings of the 21st International Conference on Digital Audio Effects (DAFx-18), pp. 126–132 (2018)

    Google Scholar 

  30. Edworthy, J., Loxley, S., Dennis, I.: Improving auditory warning design: relationship between warning sound parameters and perceived urgency. Hum. Factors 33(2), 205–231 (1991)

    Article  Google Scholar 

  31. Gillard, J., Schutz, M.: Improving the efficacy of auditory alarms in medical devices by exploring the effect of amplitude envelope on learning and retention. In: Proceedings of the 18th International Conference on Auditory Displays, pp. 240–241 (2012)

    Google Scholar 

  32. McIntire, J.P., Havig, P.R., Watamaniuk, S.N.J., Gilkey, R.H.: Visual search performance with 3-D auditory cues: effects of motion, target location, and practice. Hum. Factors: J. Hum. Factors Ergon. Soc. 52(1), 41–53 (2010)

    Article  Google Scholar 

  33. Nelson, W., Bolia, R., Ericson, M., McKinley, R.: Monitoring the simultaneous presentation of spatialized speech signals in a virtual acoustic environment (1998)

    Google Scholar 

  34. Begault, D.R., Wenzel, E.M.: Headphone localization of speech. Hum. Factors 35(2), 361–376 (1993)

    Article  Google Scholar 

  35. Quinn, M.: Modular operating rooms–how do they really sound? Acoust. Bull. Ecophon (2017)

    Google Scholar 

  36. Edworthy, J.: Medical audible alarms: a review. J. Am. Med. Inform. Assoc. JAMIA 20(3), 584–589 (2013)

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by grant no. POCI-01-0145-FEDER031943, co-financed by COMPETE2020 under the PT2020 program, and supported by FEDER.

Author information

Authors and Affiliations

  1. CIAUD Research Centre for Architecture Urbanism and Design, Lisbon School of Architecture, Universidade de Lisboa, Lisbon, Portugal

    Joana Vieira & Paulo Noriega

  2. CCG: Centre for Computer Graphics, Guimarães, Portugal

    Joana Vieira & Jorge Almeida Santos

  3. Ergonomics & Human Factors Group, ALGORITMI Research Centre, University of Minho, Guimarães, Portugal

    Joana Vieira & Jorge Almeida Santos

  4. School of Psychology, University of Minho, Braga, Portugal

    Jorge Almeida Santos

  5. ErgoUX Ergonomics and UX Lab, Lisbon School of Architecture, Universidade de Lisboa, Lisbon, Portugal

    Paulo Noriega

Authors
  1. Joana Vieira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Almeida Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo Noriega
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joana Vieira .

Editor information

Editors and Affiliations

  1. Faculdade de Motricidade Humana, Laboratório de Ergonomia, CIAUD, Universidade de Lisboa, Lisbon, Portugal

    Teresa Patrone Cotrim

  2. Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal

    Florentino Serranheira

  3. Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal

    Paulo Sousa

  4. Loughborough Design School, Loughborough University, Loughborough, UK

    Sue Hignett

  5. Centre for Patient Safety, Tuscany, Italy

    Sara Albolino

  6. Careggi University Hospital, Clinical Risk Management and Patient Safety Center, Tuscany, Italy

    Riccardo Tartaglia

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Vieira, J., Santos, J.A., Noriega, P. (2019). A Review of Design Guidelines for Clinical Auditory Alarms. In: Cotrim, T., Serranheira, F., Sousa, P., Hignett, S., Albolino, S., Tartaglia, R. (eds) Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors. HEPS 2019. Advances in Intelligent Systems and Computing, vol 1012. Springer, Cham. https://doi.org/10.1007/978-3-030-24067-7_37

Download citation

Publish with us

Policies and ethics

Search

Navigation