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False alarms during patient monitoring in clinical intensive care units are highly related to poor quality of the monitored electrocardiogram signals

Lookup NU author(s): Professor Harris Tsimenidis, Emeritus Professor Alan MurrayORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Electrocardiograms (ECGs) recorded from patients in intensive care wereinvestigated to quantify any relationship between ECG signal quality and falsemonitoring alarms. False alarms are a considerable problem for nursing andmedical staff as they distract from clinical care, and are also a problem forpatients as they disturb rest, which is important for clinical recovery. ECG andalarm data were obtained for 750 patient alarms from the PhysioNet database.The final 8 s period before the alarm was triggered was investigated. All but oneECG channel in 38 ECG recordings with out-of-range data were associated withfalse positive alarms ( p < 0.0001). The frequency contributions for baseline (BL)instability, electromyogram (EMG) muscle noise, and high frequency (HF) noisewere calculated. For all three frequency bands, the contributions associated withfalse positive alarms were very significantly greater than for true positive alarms( p < 0.0001). The greatest difference was for BL with a mean level for falsepositive alarms 4.0 times greater than for true positive alarms, followed by EMGand HF at 1.6 times and 1.4 times respectively. These results confirm that attentionneeds to be taken to improve ECG signal quality to reduce the frequency ofclinical false alarms, and hence improve conditions for clinical staff and patients.

Publication metadata

Author(s): Tsimenidis C, Murray A

Publication type: Article

Publication status: Published

Journal: Physiological Measurement

Year: 2016

Volume: 37

Issue: 8

Pages: 1383-1391

Online publication date: 25/07/2016

Acceptance date: 09/05/2016

Date deposited: 03/08/2016

ISSN (print): 0967-3334

ISSN (electronic): 1361-6579

Publisher: Institute of Physics Publishing


DOI: 10.1088/0967-3334/37/8/1383


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