Technology, Computing, and Simulation Section Editor: Jeffrey M. Feldman Are Melodic Medical Equipment Alarms Easily Learned?

BACKGROUND: We tested melodic auditory alarms recommended in the IEC 60601-1-8 standard for medical electrical equipment for ease of learning and discrimina-tion, and for effectiveness during a timeshared task. METHODS: Twenty-two critical care nurses learned the IEC 60601-1-8 melodic alarms over two training sessions more than a week apart, with or without mnemonics suggested in the standard. Subsequently, the nurses identified alarms arriving at quasi random intervals while performing a timeshared arithmetic task. RESULTS: Only one nurse (4.5%) identified the alarms with 100 % accuracy after two training sessions. Mnemonics did not improve overall alarm identification accuracy (mnemonic 56%, nonmnemonic 55%) but led to a narrower range of confusions between alarms. Nurses responded faster (P 0.0001) and more accurately (P 0.032) to medium priority than high priority alarms, despite rating high priority alarms as sounding more urgent (P 0.0001). Nurses with at least 1 yr of formal musical training identified the alarms much more accurately (musical training 73%, no musical training 38%, P 0.0001), perceived a greater distinction between high and medium priority alarms (P 0.002), and found identifying the alarms easier overall (P 0.023). During the timeshared task, nurses ’ responses were slower (P 0.002) and became less accurate (P 0.02). CONCLUSIONS: The slow rate of learning and persistent confusions suggest that the IEC 60601-1-8 melodic alarms should be redesigned before they are adopted for clinical practice. (Anesth Analg 2008;106:501–8) The design and use of auditory alarms in medical electrical equipment has recently received attention from many organizations. The Joint Commission on Accreditation of Healthcare Organizations included alarm safety on a list of national patient safety goals i