Due to adverse events occurring in the absence of audible alarms and due to efforts initiated by the Anesthesia Patient Safety Foundation, effective October 25, 2005, the American Society of Anesthesiologists Standards for Basic Anesthetic Monitoring have been modified as follows:
Under Standard 2, Oxygenation, the following has been added:
When the pulse oximeter is utilized, the variable pitch pulse tone and the low threshold alarm shall be audible to the anesthesiologist or the anesthesia care team personnel.
Under Standard 2, Ventilation, the following has been added:
When capnography or capnometry is utilized, the end tidal CO2 alarm shall be audible to the anesthesiologist or the anesthesia care team personnel.
As with several other standards, under extenuating circumstances, the responsible anesthesiologist may waive these requirements. It is recommended that if this is done a notation should be made in the patient’s record, including the reason that this/these requirements were waived.
In a similar fashion, the American Association of Nurse Anesthetists has incorporated new language into Standard V of The Scope and Standards for Nurse Anesthesia Practice as follows:
When any physiological monitoring device is utilized, variable pitch and low threshold alarms should be turned on and audible in most circumstances. The omission of any monitoring standards shall be documented and the reason stated on the patient’s anesthesia record.
Please be aware of these changes and keep your alarms on!