Physiological monitors in hospitals generate many false alarms, up to 90%, which causes caregivers to ignore alarms or turn them off entirely, endangering patient safety. To address this, the authors developed an algorithm combining electrocardiograms and photoplethysmograms to reduce false alarms. Initial results show promise in suppressing false alarms while allowing clinically important alarms. The algorithm has potential to improve patient safety by making alarms more accurate for nurses and hospitals.

1. AN ALARMING PROBLEM
Renée Hovenier & Silvana Riphagen

2. Example of a physiological monitor. [4]
Current problem
• The alarms generated by the physiological
monitors in hospitals are important in
lifetreathing situations, but several studies
show that up to 90% of these alarms is false,
and therefore undesirable. [1; 2; 3]
• Caregivers become less sensitive for the alarms
and the alarms are sometimes even turned off
completely. This endangers patient safety.
2
1) Imhoff, M. & Kuhls, S. (2006). Alarm algorithms in critical care monitoring. Anesthesia & Analgesia, 102, 1525-1537. doi:10.1213/01.ane.0000204385.01983.61
2) Siebig, S., Kuhls, S., Imhoff, M., et al. (2010). Collection of annotated data in a clinical validation study for alarm algorithms in intensive care - a methodologic framework. Journal of Critical
Care, 25, 128-135. doi:10.1016/j.jcrc.2008.09.001
3) Schmid, F., Goepfert, M.S. & Reuter, D.A. (2013). Patient monitoring alarms in the ICU and in the operating room. Critical Care, 17(2), 216-223. doi:10.1186/cc12525
4) Philips (2017, 03 juli). Philips IntelliVue MP50 Multiparameter Monitors [foto]. Geraadpleegd van https://www.somatechnology.com/Philips-Intellivue-MP50-P1617.aspx

3. Solution
3
• To reduce the amount of false alarms, an algorithm is developed which
combines the electrocardiogram and photoplethysmogram.
• Electrocardiogram (ECG)
• Photoplethysmogram (PPG)

4. Results
4
• The first results are promising and show the potential for suppressing
false alarms.

5. Market
5
• Potential users of the algorithm are nurses on different departments of
the hospital.
• Initially it comes to Dutch academic hospitals, but later also to local
hospitals and hospitals abroad.

6. Competitors
6
• Alternative solutions for the current problem include muting of the
alarms, decreasing clinically irrelevant alarms by changing thresholds
and accurate application of the electrodes.
• These solutions will reduce the amount of alarms. However, our
algorithm focuses on the false alarms which originated by a mistake in
the analysis.

7. Team
7
• The team includes two Master Technical Medicine students.
Silvana Riphagen Renée Hovenier
s.riphagen@student.utwente.nl r.hovenier@student.utwente.nl

8. Take Home Message
Reducing false alarms at the Emergency Department using the photoplethysmogram
appears to be a promising method for improving patient safety.
8

9. AN ALARMING PROBLEM
Renée Hovenier & Silvana Riphagen