We all have heard the low pitch noise of the oximeter indicating that a patient’s oxygen saturation has fallen. Is the change in pitch easy to detect when the surgeon is speaking to us. How about when music is playing? Is there a technique that can help increase our attentiveness to the oximeter’s tone?
Dr. Joseph J. Schlesinger, Department of Anesthesia, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, and colleagues assessed whether training to make use of combined visual and auditory cues might improve resident physicians’ ability to detect frequency changes due to oxygen saturation. Their work is published in this month’s edition of Anesthesia & Analgesia in the article “Improving Pulse Oximetry Pitch Perception with Multisensory Perceptual Training.”
Fifteen anesthesiology residents with normal hearing and normal or corrected-to-normal vision underwent multisensory perceptual training regimens where visual rings and auditory beeps were presented with varying stimulus onset asynchronies. Both environmental noise and attentional load impaired response time to detect changes in tones representative of decreasing oxygen saturation. Environmental noise also impaired accuracy of tone determination. Perceptual training improved the residents’ ability to detect changes in oxygen saturation determined by auditory pitch changes. Perceptual training also improved their response time in a noisy and attention-demanding environment similar to that of an operating room.
Although there are case reports that suggest that distractions might contribute to poor outcomes, surprisingly little data support this conclusion. Now, just imagine suggesting that someone play load music during a MOCA® simulator run. The mere thought is laughable! It will be interesting to see whether care is improved if this training is expanded to more operating rooms and whether the advantages of this training persist over time.