As hospital intensive care units grapple with the problem of noise pollution from medical device alarms, a research team at Vanderbilt University Medical Center has devised a solution to shield patients’ ears from the oppressive sounds and to create a care environment that is more conducive to healing.
While the noise from medical device alarms has become a major distraction for clinicians in ICUs, it also takes a toll on patients who are similarly bombarded with a constant barrage of alarms—most of which are false or not clinically actionable.
Although auditory medical alarms are “loud, annoying and shrill” for providers, at the same time they pose potential hazards for patient recovery, according to Joseph Schlesinger, MD, assistant professor of anesthesia in the Division of Critical Care Medicine at Vanderbilt in Nashville, Tenn.
These alarms can have negative consequences for patients in the ICU, says Schlesinger, including disruption of sleep as well as contributing to psychological conditions such as post-traumatic stress disorder and delirium. “My approach to this was, why can’t we take alarms out of the patient experience?” he adds. “Why not stop letting patients suffer?”
To address the problem, Schlesinger’s team has developed an in-ear device worn by patients that eliminates alarm sounds by digitally filtering sound waves while preserving their ability to hear human speech. The device has been tested in a simulated ICU environment, with results demonstrating clinical and statistical improvement in alarm filtering.
A paper presented last week at the 2017 International Conference on Auditory Display contends that the device “enables patients to hear everything occurring around them and to communicate effectively without experiencing the negative consequences of audible alarms.”
Schlesinger points out that headphones or earplugs that block all environmental noise entirely would not have been a workable solution because patients need to hear clinicians’ voices. He says a lack of stimulation of the auditory sense can also contribute to PTSD and delirium, so that would be counterproductive as well.
“We wanted to make sure that patients in the hospital could communicate, not just have earplugs,” adds Schlesinger. “We wanted to make sure speech comprehension wasn’t harmed.”
His team’s solution is a wearable device that in real time silences the frequencies corresponding to alarm noises—primarily patient monitor or red/crisis alarms—by leveraging Raspberry Pi single-board computers and digital filters, while not muffling or distorting any normal environmental sounds.
“This was really a proof-of-concept to see if it could be done,” he concludes. Ultimately, Schlesinger envisions the effort leading to the development of devices that are “comfortable, affordable and reusable—because if you had to buy one for every patient, that could get prohibitively expensive.”
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