A recent Joint Commission Sentinel Event Alert (and even Charleston's own Post and Courier editorial) focuses on alarm frequency and alarm fatigue. We've all been annoyed by alarms. In one study, 94% of alarms in an ICU were false positives. This annoyance may lead practitioners to turn off or mute alarms, in response to "alarm fatigue". What can be done? Some technical fixes are possible; manufacturers of devices strive to improve the signals from monitors to decrease artifact. Alarms can also be designed to create cross checks. For example, a patient in ventricular fibrillation would not have a strong pulse oximetry reading signal; thus a ventricular fibrillation alarm with a strong signal would likely be a false positive. Sophisticated programming of devices that attempt to statistically validate alarms is another possibility. Although some technical fixes may exist, it will be a while until the monitor near you has the latest technology. Clinicians will still have to contend with this difficult problem.

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