From the Department of Anesthesiology (R.R.M., R.D.) the Department of Anesthesiology, Jackson Memorial Hospital (D.B.H.) Miller School of Medicine, and Music Engineering Technology Program, Frost School of Music (C.L.B.), University of Miami, Miami, Florida the Cognition Institute, Plymouth University, United Kingdom (J.R.E.).
Anesthesiology. 2018 Jul;129(1):58-66. doi: 10.1097/ALN.0000000000002234.
Current standard audible medical alarms are difficult to learn and distinguish from one another. Auditory icons represent a new type of alarm that has been shown to be easier to learn and identify in laboratory settings by lay subjects. In this study, we test the hypothesis that icon alarms are easier to learn and identify than standard alarms by anesthesia providers in a simulated clinical setting.
Twenty anesthesia providers were assigned to standard or icon groups. Experiments were conducted in a simulated intensive care unit. After a brief group-specific alarm orientation, subjects identified patient-associated alarm sounds during the simulation and logged responses via a tablet computer. Each subject participated in the simulation twice and was exposed to 32 alarm annunciations. Primary outcome measures were response accuracy and response times. Secondary outcomes included assessments of perceived fatigue and task load.
Overall accuracy rate in the standard alarm group was 43% (mean) and in the icon group was 88% (mean). Subjects in the icon group were 26.1 (odds ratio [98.75% CI, 8.4 to 81.5; P < 0.001]) times more likely to correctly identify an alarm. Response times in the icon group were shorter than in the standard alarm group (12 vs. 15 s, difference 3 s [98.75% CI ,1 to 5; P < 0.001]).
Under our simulated conditions, anesthesia providers more correctly and quickly identified icon alarms than standard alarms. Subjects were more likely to perceive higher fatigue and task load when using current standard alarms than icon alarms.
目前的标准听觉医疗警报难以学习，且彼此之间难以区分。听觉图标代表了一种新型的警报，在实验室环境中，非专业人士已经证明其更容易学习和识别。在这项研究中，我们通过模拟临床环境下的麻醉师来验证图标警报比标准警报更容易学习和识别的假设。
将 20 名麻醉师分配到标准或图标组。实验在模拟重症监护病房进行。在进行简短的特定组别的警报定向培训后，受测者在模拟期间识别与患者相关的警报声音，并通过平板电脑记录反应。每位受测者参与两次模拟，共接受 32 次警报宣告。主要结局指标是响应准确性和响应时间。次要结局指标包括感知疲劳和任务负荷评估。
标准警报组的整体准确率为 43%（平均值），图标组为 88%（平均值）。图标组的受测者正确识别警报的可能性是标准警报组的 26.1 倍（比值比[98.75%可信区间，8.4 至 81.5；P < 0.001]）。图标组的响应时间短于标准警报组（12 秒与 15 秒，差异 3 秒[98.75%可信区间，1 至 5；P < 0.001]）。
在我们的模拟条件下，麻醉师更正确和快速地识别图标警报而非标准警报。与使用当前标准警报相比，受测者使用图标警报时更有可能感到更高的疲劳和任务负荷。
