Garg Rakesh, Bhalotra Anju R, Goel Nitesh, Pruthi Amit, Bhadoria Poonam, Anand Raktima
Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India.
Indian J Anaesth. 2010 Nov;54(6):522-4. doi: 10.4103/0019-5049.72640.
Intensive care unit (ICU) monitors have alarm options to intimate the staff of critical incidents but these alarms needs to be adjusted in every patient. With this objective in mind, this study was done among resident doctors, with the aim of assessing the existing attitude among resident doctors towards ICU alarm settings. This study was conducted among residents working at ICU of a multispeciality centre, with the help of a printed questionnaire. The study involved 80 residents. All residents were in full agreement on routine use of ECG, pulse oximeter, capnograph and NIBP monitoring. 86% residents realised the necessity of monitoring oxygen concentration, apnoea monitoring and expired minute ventilation monitoring. 87% PGs and 70% SRs routinely checked alarm limits for various parameters. 50% PGs and 46.6% SRs set these alarm limits. The initial response to an alarm among all the residents was to disable the alarm temporarily and try to look for a cause. 92% of PGs and 98% of SRs were aware of alarms priority and colour coding. 55% residents believed that the alarm occurred due to patient disturbance, 15% believed that alarm was due to technical problem with monitor/sensor and 30% thought it was truly related to patient's clinical status. 82% residents set the alarms by themselves, 10% believed that alarms should be adjusted by nurse, 4% believed the technical staff should take responsibility of setting alarm limits and 4% believed that alarm levels should be pre-adjusted by the manufacturer. We conclude that although alarms are an important, indispensable, and lifesaving feature, they can be a nuisance and can compromise quality and safety of care by frequent false positive alarms. We should be familiar of the alarm modes, check and reset the alarm settings at regular interval or after a change in clinical status of the patient.
重症监护病房（ICU）监护仪设有报警选项，以便在发生危急情况时通知工作人员，但这些警报需要针对每个患者进行调整。出于这一目的，本研究在住院医生中开展，旨在评估住院医生对ICU警报设置的现有态度。本研究借助一份印刷问卷，在一家多专科中心的ICU工作的住院医生中进行。该研究涉及80名住院医生。所有住院医生完全同意常规使用心电图、脉搏血氧仪、二氧化碳监测仪和无创血压监测。86%的住院医生认识到监测氧浓度、呼吸暂停监测和呼出分钟通气监测的必要性。87%的研究生和70%的专科住院医生会定期检查各种参数的警报限值。50%的研究生和46.6%的专科住院医生会设置这些警报限值。所有住院医生对警报的最初反应是暂时禁用警报并试图查找原因。92%的研究生和98%的专科住院医生了解警报优先级和颜色编码。55%的住院医生认为警报是由于患者干扰引起的，15%认为警报是由于监护仪/传感器的技术问题，30%认为警报与患者的临床状况真正相关。82%的住院医生自己设置警报，10%认为警报应由护士调整，4%认为技术人员应负责设置警报限值，4%认为警报级别应由制造商预先调整。我们得出结论，尽管警报是一项重要、不可或缺且能挽救生命的功能，但它们可能会造成困扰，并可能因频繁出现的误报而影响护理质量和安全。我们应该熟悉警报模式，定期或在患者临床状况发生变化后检查并重置警报设置。
