Melodic algorithms for pulse oximetry to allow audible discrimination of abnormal systolic blood pressures.

An anesthesiologist must remain vigilant of the patient's clinical status, incorporating many independent physiological measurements. Oxygen saturation and heart rate are represented by continuous audible tones generated by the pulse oximeter, a mandated monitoring device. Other important clinical p...

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Published in:Journal of Clinical Monitoring & Computing Vol. 28; no. 6; pp. 597 - 604
Main Authors: Chima, Ranjit S, Ortega, Rafael, Connor, Christopher W
Format: research Journal Article
Published: Springer Nature Dec2014
Online Access:View this record in EBSCOhost
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      dt: Dec2014
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      pub: Springer Nature
      place: New York, New York
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        atl: Melodic algorithms for pulse oximetry to allow audible discrimination of abnormal systolic blood pressures.
      aug:
        au:
          Chima, Ranjit S
          Ortega, Rafael
          Connor, Christopher W
      sug:
        subj:
          Algorithms
          Blood Pressure Determination Methods
          Laboratory Equipment and Supplies
          Diagnosis, Computer Assisted Methods
          Hypertension Diagnosis
          Hypotension Diagnosis
          Music
          Acoustic Stimulation Methods
          Auditory Perception
          Blood Pressure
          Female
          Human
          Male
          Intraoperative Monitoring Methods
          Oximetry Methods
          Reproducibility of Results
          Sensitivity and Specificity
          Female
          Male
      ab: An anesthesiologist must remain vigilant of the patient's clinical status, incorporating many independent physiological measurements. Oxygen saturation and heart rate are represented by continuous audible tones generated by the pulse oximeter, a mandated monitoring device. Other important clinical parameters--notably blood pressure--lack any audible representation beyond arbitrarily-configured threshold alarms. Attempts to introduce further continuous audible tones have apparently foundered; the complexity and interaction of these tones have exceeded the ability of clinicians to interpret them. Instead, we manipulate the tonal and rhythmic structure of the accepted pulse oximeter tone pattern melodically. Three melodic algorithms were developed to apply tonal and rhythmic variations to the continuous pulse oximeter tone, dependent on the systolic blood pressure. The algorithms distort the original audible pattern minimally, to facilitate comprehension of both the underlying pattern and the applied variations. A panel of anesthesia practitioners (attending anesthesiologists, residents and nurse anesthetists) assessed these algorithms in characterizing perturbations in cardiopulmonary status. Twelve scenarios, incorporating combinations of oxygen desaturation, bradycardia, tachycardia, hypotension and hypertension, were tested. A rhythmic variation in which additional auditory information was conveyed only at halftime intervals, with every other "beat" of the pulse oximeter, was strongly favored. The respondents also strongly favored the use of musical chords over single tones. Given three algorithms of tones embedded in the pulse oximeter signal, anesthesiologists preferred a melodic tone to signal a significant change in blood pressure.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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