Research Horizons


Some Relief From ‘Alarm Fatigue’?

National expert panel agrees that some conditions, such as children hospitalized with mild to moderate asthma, do not require constant pulse oximetry monitoring.

In some cases, the minimal benefit of constant automated medical monitoring devices can be outweighed by the risk of contributing to “alarm fatigue.”

That’s the key finding of a study led by Amanda Schondelmeyer, MD, several colleagues from Cincinnati Children’s, and Christopher Bonafide, MD, of Children’s Hospital of Philadelphia, published online July 17, 2020, in Pediatrics.

Alarm fatigue is the result of monitoring devices sending out so many alerts due to shifting vital sign readings that doctors and nurses begin to ignore the alarms, potentially causing them to overlook or react slowly to alarms indicating genuine changes in health status. Pulse oximeters are among the most common sources of false alarms in pediatric settings.

In this study, co-authors convened a national expert panel to conduct a detailed review of when continuous oximetry measurement remains necessary, and under what conditions intermittent readings can provide all the information clinicians need. The panel included experts in fields relevant to clinical care of these patient populations as well as human factors engineering and family advocacy.

“To our knowledge, there are no published expert recommendations on the indications for continuous monitoring of the most common conditions seen in children’s hospitals,” the co-authors wrote. “We combined the best available evidence with the skills and insights of a diverse national expert panel to develop monitoring recommendations.”

The study details those recommendations for seven conditions that often involve continuous monitoring outside of intensive care units.

See more coverage in Medscape
Publication Information
Original title: Cardiorespiratory and Pulse Oximetry Monitoring in Hospitalized Children: A Delphi Process
Published in: Pediatrics
Publish date: July 17, 2020
Read the Study

Research By

Amanda Schondelmeyer, MD
Division of Hospital Medicine
Her research focuses on improving the quality, safety, and value of care provided to hospitalized children by evaluating and reducing overuse.