Hospitals are sonic hellscapes

Wednesday, July 17th, 2019

Hospitals are some of the least restful places imaginable:

Hospitals today can be sonic hellscapes, which studies have shown regularly exceed levels set by the World Health Organization: droning IV pumps, ding-donging nurse call buttons, voices crackling on loudspeakers, ringing telephones, beeping elevators, buzzing ID scanners, clattering carts, coughing, screaming, vomiting.

Then there are the alarms. A single patient might trigger hundreds each day, challenging caregivers to figure out which machine is beeping, and what is wrong with the patient, if anything. (Studies have shown that as many as 99 percent of alarms are false.)

The proliferation of pinging and bleeping can contribute to patient delirium and staff burnout. And because caregivers know that many devices are crying wolf, they might be less responsive or apathetic, a potentially fatal safety issue known as alarm fatigue.

From 2005 to 2008, more than 500 patients in the United States had adverse outcomes, mostly death, because an alarm was ignored, or a device was silenced or mismanaged in some way, according to the Food and Drug Administration, which tracks adverse events involving medical devices.

[...]

Dr. Ozcan, who has had practice translating vast quantities of data into audio cues for the European Space Agency’s mission control dashboards, said her group at the lab was developing devices to hush the intensive care unit, which can be louder than a vacuum cleaner, and challenging conventional device design, possibly even making alarms “beautiful,” she said.

One of her group’s projects, called CareTunes, is a speculative, even quixotic, melodic design.

The device transcribes a patient’s physiological condition into songs that sound a bit like chill electronic dance music. (Ms. Sen was an artistic adviser to the project.)

The melody is derived from a patient’s vital signs: drums for the heartbeat, guitar for oxygen saturation and piano for blood pressure. When a patient is stable, the tune is harmonious, but it becomes dissonant when a patient’s status changes for the worse, ideally grabbing a caregiver’s attention.

Comments

  1. Handle says:

    I’ve spent months in intensive care units, and yes, the alarms are indeed constant, deafening, annoying, and mostly ignored. While most people would like to fix that, it’s impossible. The legal incentives are such that one has little choice but to favor 1,000 false positives over one false negative. And the kind of positive we’re talking about is quickly fatal, so requires an alarm consonant with the necessary urgency of reaction.

  2. Isegoria says:

    I’m sorry to hear that you’ve had to spend so much time in ICUs, Handle. In my few short visits to hospitals, I’ve found the cacophony extremely stressful — especially when I’ve seen its effect on someone sick, tired, and desperate to get better, but unable to rest.

    Come to think of it, they should probably pipe all the audio alerts to a speaker outside the door. It’s not the patient who wants or needs to hear them at full volume.

  3. Alrenous says:

    The legal incentives are such that one has little choice but to favor 1,000 false positives over one false negative.

    If the pattern holds from all other instances of legal incentives like this, the outcome is in fact killing vastly more people, like 15x or something, than allowing a few false negative would.

  4. Sam J. says:

    I spent some time in the hospital and by the time I got out of there I was utterly exhausted and so angry I couldn’t wait to get away. Waking you up every two hours to stick you for blood, constant bleeping. I suspect people in ICU give up and die to stop the abuse. I’m serious about this. It’s horrible. It’s HAS to completely destroy the immune system to be so angry and stressed.

  5. Alistair says:

    On all 3 occasions my wife has given birth, I’ve noticed just how noisy and stressful the wards are. Daytime noise is constant; nights are a bit quieter, but still broken by constant monitoring, crying infants, and distant slamming doors. Hard, washable floors and surfaces don’t help at all.

    On all three occasions my wife’s mental welfare deteriorated sharply after 72 hours of exhausted exposure. This of course, made her a “risk” for even more invasive monitoring and to be kept for additional nights. The self-perpetuating nature of the problem was apparent to everyone but the clinical staff.

    After 5 days, I got her to sign herself out against medical advice. 16 hours later after proper sleep at home she was completely recovered. I’ve not respected doctors since.

    Maybe they could give patients ear defenders, but I think the staff are so de-sensitised to the environment they don’t realise how much it is ‘effing patients up.

  6. Alrenous says:

    Seems it’s still legal to get a midwife and give birth at home.

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