So here I am in the ER with my mom*…waiting…and it occurred to me that this would be a good time to ask something that I’ve wondered about a few times.
Before I describe the situation – The staff here has been unfailingly pleasant, helpful, and attentive. The ER happens to be wildly overcrowded, with patients lining the halls like it was a 3rd world clinic, but they are still finding time to provide extra attention and care.
There was some guy nearby with some machine with a really loud beeping alarm that just kept going off over and over. I mean, really loud, like dire emergency loud. Like THIS PATIENT NEEDS ATTENTION RIGHT THIS SECOND OR HE’S GONNA DIE" loud. But nobody seemed to be addressing it. This went on for about 3 hours. It would stop for a few minutes and then re-start. I’ve observed similar alarms apparently unanswered on other occasions as well.
So what was going on?
It can’t have been an emergency that needed attention because given what I said above, they certanly wouldn’t have left an emergency unaddressed for even a moment.
But if it wasn’t an emergency that needed immediate attention, why was the alarm so damn loud and persistent?
She’s ok, thanks. Hernia. Being kept for observation.
Probably the O2 monitor. If it drops below a certain level it’ll do that, but it usually comes back up. If it stays like that for quite a while, they probably would come rushing in.
There are many sources of beeping the ER, among them are those from oxygen monitors (as mentioned), heart monitors, and also IV pumps. Each has its own sound (at least where I work).
Likewise, at least where I work, the readings for oxygen level, heart rate and rhythm, and BP are displayed on monitors simultaneously at both the bedside and at the ‘nursing station’ (central desk area). So, at a glance, without getting up, you can tell what’s going on (or, more likely, what’s not going on).
IV pump beeps are incessant and a real nuisance. Even the nurses often take their time in addressing them (as anyone who’s been a patient in a hospital can attest). I would bet they comprised a lot of the beeps you heard.
One thing is worth emphasizing. Even if a cardiac alarm goes a) you can quickly look up at the monitor and see that it’s just ‘noise’ or a wire has come off the patient and/or b) look up and see that the patient is happily chatting on his phone or eating lunch. Other than quieting things down, there’s not a lot of incentive to rush over in such a situation, especially when you’ve got a million other things going on at the same time.
Is she on Medicare? Be careful, because if she is not admitted to the hospital, but kept in “observation” status, you will eat the bill for the entire hospital stay.
Since they are attentive, I don’t know. I do know when I was taken to the ER last year, that beeping went on and off every few minutes for hours without anyone checking on me so I finally just turned it off. No one came in to ask why it was turned off. So I am glad you and your mom are in a good hospital.
It’s probably a sensor that got disconnected. Monitoring machines get very upset when you take away one of their inputs. That’s actually s good thing if you think about it, but still annoying in most circumstances.
Thanks for the input, everybody. My mom has been sprung from the joint and is doing fine. She’ll need surgery within the next few weeks, though. Eeek!
That was an excellent answer!
My question remains (rephrased in light of the new info) - If the alarm is determined not to be an emergency, why is it allowed to keep ringing loudly for long periods over and over?
I’m guessing these factors contribute:
the nurses don’t have the ability to shut it off from the central nurse’s station, meaning they would have to go the actual machine to do it.
they have other stuff to do and if they had to keep running over to shut off the alarms, they’d never get anything else done (as mentioned by KarlGauss above)
they’re so used to hearing the alarms that they can tune them out, reducing their own personal urgency to shut them off
This all raises the question - can the machines be adjusted so they don’t give so many false positives?
The guy who’s alarm kept going off seemed to be lying absolutely still - perhaps unconscious - and the staff was going in and out so he was being looked after. Let’s assume nothing was being inadvertently disconnected. If one of his vital signs was consistently below the level that was normally considered OK, but the doctors and nurses had determined that that was fine in the case of this particular patient, wouldn’t there be a way to adjust the threshold where the alarm goes off?
What does this all matter? Well, I see two major negatives to allowing this situation to continue. The first is that it makes it much harder for the other patients to rest as best they can given that they’re in an ER. The second is that it gives the impression that the hospital is ignoring patients in major distress. That can’t be good for the hospital’s reputation. I overheard a lot of conversations because of all the people out in the hall, and a lot of people were commenting negatively about it.
Also, I’m just curious.
For what it’s worth, the staff was commenting that the number of people in the ER was unusually high, and compared it to the rush they had during Hurricane Sandy! There was no apparent reason for the surge, either. I guess it was just an especially high point in the normal fluctuations. She was “admitted” early on, but there were literally no rooms in which to put her! They did move her to an upstairs hallway, which was much less unpleasant. They finally got her into a room 36 hours after she arrived at the hospital. That really sucked, but they did they best they could and she was a pretty good sport about it. Weird situation though, made even more surreal by the movie-star looks of half the guys that worked there. My mom fell halfway in love with Nathan the ER nurse, and couldn’t stop commenting on how adorable the ER doc was (but she was female so the admiration was academic). Then the chief resident showed up. swoon The upstairs head nurse looked like Yul Brynner, and her surgeon looks like Anderson Cooper.
Purely guessing (and I am NOT an MD but have been an ER patient numerous times). Particularly if they are running around like heads with their chickens cut off they may not want to twiddle the standard settings of instruments in a busy ER in case they forget to put them back to the standard settings. Even if it’s not critical for a given patient it encourages staff to keep an eye on ones that need keeping an eye on.
It’s a basic tenet of systems safety design in aviation that you never ignore a beep or boop. Nor do you permit designers to build things which make unnecessary noises, or noises indicating normality.
In aviation silence is normal and all alerting sounds are attended to immediately. Accepting anything less in a hospital setting is simply sloppy workmanship leading directly to avoidable errors. That alarms may be ignored in hospitals due to overtasking / understaffing is just excuse-making. If so, it would indicate the system is broken, not the workers.
The constant beeping was probably an oxygen monitor.
The O2 monitor measures the amount of oxygen in the blood stream through a small gadget clipped to a patient’s finger, but it also records the patient’s pulse and beeps with each pulse.
The nurses were probably watching the oxygen percentage displayed on a screen and also listening to the heart rate and rhythm.
I usually turn the beeping off since I can see both the oxygen saturation and the pulse rate on the screen or in the computer, and I find the noise annoying. I’m pretty sure most patients find the constant beeping annoying, too.
We call it ‘alarm fatigue’ and it can be a problem if the staff is not trained to respond to alarms. They then learn to ignore alarms, which can be dangerous.
Is there any risk of missing a real issue if the various sensors aren’t working/attached/etc? For instance, if the issue is that the O2 sensor isn’t connected properly, isn’t there a risk that they might miss a sudden drop?
If not, then why is the sensor there in the first place?
silence is not always good. a beep periodically indicating function is good.
sick people and airplanes are not the same. pilots don’t leave the cockpit and hang out in the galley until they hear an alarm. they stay in the cockpit monitoring a huge amount of things.
patients are in multiple rooms. medical people will have multiple patients.
there are also levels of alert some indicating caution and others massive failure.
i think you learn to react in your environment. the direction, frequency and level of alarm all would dictate the response.
Something related. At my office sometimes hospital staff come in and are wearing a device that beeps about every minute. I think I heard somebody say they do that because the device is “out of range.” What’s the deal with that?