Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses

Clinical auditory alarms are often found in hospital wards and operating rooms. In these environments, regular daily tasks can result in having a multitude of concurrent sounds (from staff and patients, building systems, carts, cleaning devices, and importantly, patient monitoring devices) which eas...

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Main Authors: Vasco Ribeiro Ferreira, Ana Rita Pereira, Joana Vieira, Frederico Pereira, Rui Marques, Guilherme Campos, Adriana Sampaio, Alberto Crego
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934403/?tool=EBI
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author Vasco Ribeiro Ferreira
Ana Rita Pereira
Joana Vieira
Frederico Pereira
Rui Marques
Guilherme Campos
Adriana Sampaio
Alberto Crego
author_facet Vasco Ribeiro Ferreira
Ana Rita Pereira
Joana Vieira
Frederico Pereira
Rui Marques
Guilherme Campos
Adriana Sampaio
Alberto Crego
author_sort Vasco Ribeiro Ferreira
collection DOAJ
description Clinical auditory alarms are often found in hospital wards and operating rooms. In these environments, regular daily tasks can result in having a multitude of concurrent sounds (from staff and patients, building systems, carts, cleaning devices, and importantly, patient monitoring devices) which easily amount to a prevalent cacophony. The negative impact of this soundscape on staff and patients’ health and well-being, as well as in their performance, demand for accordingly designed sound alarms. The recently updated IEC60601-1-8 standard, in guidance for medical equipment auditory alarms, proposed a set of pointers to distinctly convey medium or high levels of priority (urgency). However, conveying priority without compromising other features, such as ease of learnability and detectability, is an ongoing challenge. Electroencephalography, a non-invasive technique for measuring the brain response to a given stimulus, suggests that certain Event-Related Potentials (ERPs) components such as the Mismatch Negativity (MMN) and P3a may be the key to uncovering how sounds are processed at the pre-attentional level and how they may capture our attention. In this study, the brain dynamics in response to the priority pulses of the updated IEC60601-1-8 standard was studied via ERPs (MMN and P3a), for a soundscape characterised by the repetition of a sound (generic SpO2 “beep”), usually present in operating and recovery rooms. Additional behavioural experiments assessed the behavioural response to these priority pulses. Results showed that the Medium Priority pulse elicits a larger MMN and P3a peak amplitude when compared to the High Priority pulse. This suggests that, at least for the applied soundscape, the Medium Priority pulse is more easily detected and attended at the neural level. Behavioural data supports this indication, showing significantly shorter reaction times for the Medium Priority pulse. The results pose the possibility that priority pointers of the updated IEC60601-1-8 standard may not be successfully conveying their intended priority levels, which may not only be due to design properties but also to the soundscape in which these clinical alarms are deployed. This study highlights the need for intervention in both hospital soundscapes and auditory alarm design settings.
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spelling doaj.art-6ecae96d2bf043a794c2a03e0d9c4bea2023-02-19T05:31:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulsesVasco Ribeiro FerreiraAna Rita PereiraJoana VieiraFrederico PereiraRui MarquesGuilherme CamposAdriana SampaioAlberto CregoClinical auditory alarms are often found in hospital wards and operating rooms. In these environments, regular daily tasks can result in having a multitude of concurrent sounds (from staff and patients, building systems, carts, cleaning devices, and importantly, patient monitoring devices) which easily amount to a prevalent cacophony. The negative impact of this soundscape on staff and patients’ health and well-being, as well as in their performance, demand for accordingly designed sound alarms. The recently updated IEC60601-1-8 standard, in guidance for medical equipment auditory alarms, proposed a set of pointers to distinctly convey medium or high levels of priority (urgency). However, conveying priority without compromising other features, such as ease of learnability and detectability, is an ongoing challenge. Electroencephalography, a non-invasive technique for measuring the brain response to a given stimulus, suggests that certain Event-Related Potentials (ERPs) components such as the Mismatch Negativity (MMN) and P3a may be the key to uncovering how sounds are processed at the pre-attentional level and how they may capture our attention. In this study, the brain dynamics in response to the priority pulses of the updated IEC60601-1-8 standard was studied via ERPs (MMN and P3a), for a soundscape characterised by the repetition of a sound (generic SpO2 “beep”), usually present in operating and recovery rooms. Additional behavioural experiments assessed the behavioural response to these priority pulses. Results showed that the Medium Priority pulse elicits a larger MMN and P3a peak amplitude when compared to the High Priority pulse. This suggests that, at least for the applied soundscape, the Medium Priority pulse is more easily detected and attended at the neural level. Behavioural data supports this indication, showing significantly shorter reaction times for the Medium Priority pulse. The results pose the possibility that priority pointers of the updated IEC60601-1-8 standard may not be successfully conveying their intended priority levels, which may not only be due to design properties but also to the soundscape in which these clinical alarms are deployed. This study highlights the need for intervention in both hospital soundscapes and auditory alarm design settings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934403/?tool=EBI
spellingShingle Vasco Ribeiro Ferreira
Ana Rita Pereira
Joana Vieira
Frederico Pereira
Rui Marques
Guilherme Campos
Adriana Sampaio
Alberto Crego
Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
PLoS ONE
title Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
title_full Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
title_fullStr Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
title_full_unstemmed Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
title_short Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses
title_sort capturing the attentional response to clinical auditory alarms an erp study on priority pulses
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934403/?tool=EBI
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