Signaling Patient Oxygen Desaturation with Enhanced Pulse Oximetry Tones

Penelope M Sanderson; Robert G Loeb; Helen Liley; David Liu; Estrella Paterson; Kelly Hinckfuss; Jelena Zestic

doi:10.2345/0899-8205-56.2.46

Signaling Patient Oxygen Desaturation with Enhanced Pulse Oximetry Tones

Biomed Instrum Technol. 2022 Apr 1;56(2):46-57. doi: 10.2345/0899-8205-56.2.46.

Authors

Penelope M Sanderson¹, Robert G Loeb², Helen Liley³, David Liu⁴, Estrella Paterson⁵, Kelly Hinckfuss⁶, Jelena Zestic⁷

Affiliations

¹ Penelope M. Sanderson, PhD, is professor of cognitive engineering and human factors in the Schools of Psychology, Clinical Medicine, and Information Technology and Electrical Engineering at The University of Queensland in Queensland, Australia. Email: p.sanderson@uq.edu.au.
² Robert G. Loeb, MD, is an honorary professor in the School of Psychology at The University of Queensland in Queensland, Australia, and an emeritus clinical professor at University of Florida-Gainesville.
³ Helen Liley, MBCh, FRACP, is a senior staff specialist at Mater Mothers' Hospital and a professor in the Faculty of Medicine at The University of Queensland in Queensland, Australia.
⁴ David Liu, MBBS, PhD, is an anaesthetics registrar at Sunshine Coast University Hospital in Queensland, Australia, and a senior lecturer in the Faculty of Medicine at The University of Queensland in Queensland, Australia.
⁵ Estrella Paterson, PhD, is a postdoctoral fellow in the School of Psychology at The University of Queensland in Queensland, Australia.
⁶ Kelly Hinckfuss, MPhil, is a clinical masters student in the School of Psychology at The University of Queensland in Queensland, Australia.
⁷ Jelena Zestic, PhD, is a human systems engineer at Boeing Research and Technology in Brisbane, Australia.

Abstract

Manufacturers could improve the pulse tones emitted by pulse oximeters to support more accurate identification of a patient's peripheral oxygen saturation (SpO2) range. In this article, we outline the strengths and limitations of the variable-pitch tone that represents SpO2 of each detected pulse, and we argue that enhancements to the tone to demarcate clinically relevant ranges are feasible and desirable. The variable-pitch tone is an appreciated and trusted feature of the pulse oximeter's user interface. However, studies show that it supports relative judgments of SpO2 trends over time and is less effective at supporting absolute judgments about the SpO2 number or conveying when SpO2 moves into clinically important ranges. We outline recent studies that tested whether acoustic enhancements to the current tone could convey clinically important ranges more directly, without necessarily using auditory alarms. The studies cover the use of enhanced variable-pitch pulse oximeter tones for neonatal and adult use. Compared with current tones, the characteristics of the enhanced tones represent improvements that are both clinically relevant and statistically significant. We outline the benefits of enhanced tones, as well as discuss constraints of which developers of enhanced tones should be aware if enhancements are to be successful.

MeSH terms

Adult
Humans
Infant, Newborn
Oximetry*
Oxygen*

Substances

Oxygen

Grants and funding

Funding Funded by the Australian Research Council (through Discovery Project grants DP140101822 and DP170102611) and the Australian and New Zealand College of Anaesthetists (grant S18/003 to E.P.).