News and Tribune

April 5, 2013

STAWAR: This is alarming news

By TERRY STAWAR
Local columnist

— Last week, most of Southern Indiana was preoccupied with March Madness and didn’t notice that the National Weather Service had proclaimed it Indiana’s Severe Weather Preparedness Week. You may have heard sirens at 10:15 a.m. Wednesday signaling the week’s highlight — a statewide tornado drill. 

 Since we are inundated with digital devices, people are constantly being bombarded by alarms. With our smart phones, we even carry them around with us. They alert, remind, warn and protect us. They also can be annoying, confusing and distracting. For many people, an alarm is the first thing they hear in the morning and the last thing they check at night. 

British psychologist Meredith Edworthy, from the University of Plymouth, studied the use of medical monitoring equipment and found that the overuse of devices with auditory alarms can be counterproductive and even dangerous. In 2010, a cardiac patient died at Massachusetts General Hospital after one alarm had been turned off and another had been beeping for more than 20 minutes without being noticed. According to the Food and Drug Administration, from 2005 to 2010 there were 216 reported deaths directly related to medical alarms.

Psychologists call the failure to notice alarms “alarm fatigue.” In intensive-care units there can be several hundred alarms per patient per day. One study found that, on the average, a warning alarm went off in ICUs every minute and a half. 

Other studies have shown that more than 85 percent of these are false alarms, in which the patient is not in any real danger. In many cases, the sounds soon blend in as background noise. Besides alarm fatigue, other frequently cited problems include: staff members forgetting to turn on devices or using the wrong settings; patients and staff turning down the volume or disabling alarms; and alarm failure due to dead batteries.

In 2004, the Joint Commission on Accreditation of Healthcare Organizations included safer monitors as ones of its national patient safety goals. The Joint Commission suggested that hospitals had become too dependent on alarms. They advised them to routinely test monitors and develop better staff training. 

Unfortunately, this initiative was dropped the very next year. Along with the Joint Commission, the FDA, which has jurisdiction over medical appliances, is still struggling with this complex challenge.

More effective staff and patient education, assuring proper settings for every patient, coordination of multiple alarms and making monitors more user friendly are among the key strategies being adopted. 

Possibly the most frequently encountered alarms are those that have been incorporated into our vehicles. As electronic sensors have become cheaper and more reliable, most autos now feature a variety of sounds, lights and even voices announcing when you are low on gas, the engine is overheating, the battery is not charging, a tire has low pressure, you left the lights on or your keys in the ignition, a door is open or you didn’t fasten your seat belt. 

There is also that frequently embarrassing red button on your car key that starts the car’s horn alarm whenever you accidentally press it. I know these are all great safety devices, but they can be a little overwhelming. It took me several minutes the other day to discover that an unlatched trunk was the reason that the dome light wouldn’t go out. 

When I was a child, I was captivated by the flashing lights and sirens of emergency vehicles. I think I’ve mentioned how I got to operate a real ambulance siren once when I was in the second grade. I wasn’t exactly an advanced student and during recess one day, I was playing “slot machine” with my milk money and swallowed a nickel. I casually mentioned this to Miss Doyle, my teacher, who was in her first year at the school. She flew into a panic and physically carried me to the principal’s office, where they dispatched an ambulance. The nice driver let me turn on the siren on the way to the emergency room. 

Sirens were part of everyday life even in the small Illinois town where I lived. Every night, you could hear the 9 o’clock whistle blow. This was intended to test the city’s fire alarm and also signal curfew. To this day, whenever I hear a fire whistle, the next thing I expect to hear is the opening to “Gunsmoke,” my father’s favorite television show that always started promptly at 9 p.m.

My father was a fireman and this was the same siren that was used to notify firefighters when there was a fire in town. When I was in junior high, he was given a special radio designed to replace the whistle. These red boxes with their long antenna made a sound like a diving submarine just before a dispatcher blurted out the address of the fire. They tested them every night and it never failed to make you jump out of your skin. I recently put a weather alert radio in our guest room and I’m waiting to hear how it compares with those red boxes. 

My two biggest regrets in elementary school were both safety related. First, I was never selected to be a safety patrol boy and second I never got to slide down the school fire escape chute. I would have given anything to proudly wear that white cloth Sam Browne belt and that silver AAA badge, just like Presidents Carter and Clinton, and 21 of the astronauts, but it just wasn’t in the cards. 

The year my classroom was downstairs they only picked patrol boys from upstairs. The next year when my classroom was upstairs, they only chose kids from downstairs. I was always in the wrong place at the wrong time — the story of my life. 

As for the fire escape chute, this was a metal structure that fit the Midwestern profile, as it looked exactly like a small silo attached to the corner of the school. Inside was a spiral slide that only the children whose classroom was located on that corner were allowed to use. There was a small sliding door in the back of the classroom that the teacher would open during fire drills and the lucky kids in that room would get to slide down the chute. In the third grade, I was elated to finally find myself in the chute classroom. Unfortunately, this was also the year some spoil-sport fire marshal declared the slide unsafe and ordered it permanently sealed. 

 Researchers have shown that most people fail to respond quickly to fire and other emergency alarms. 

Norman Groner, a psychologist at John Jay College in New York says, “People’s natural inclination is to want to define a situation before they respond ... an alarm bell is inherently ambiguous.”

Studies have shown that almost two-thirds of the time that it takes people to evacuate a building is spent milling about trying to gather further information. 

In many cases, people don’t realize what alarms mean. Daniel Ellis from Columbia University found that only 14 percent of people correctly interpreted the sound of a fire alarm as a genuine emergency. Excessive drills and false alarms can lead to “The Boy Who Cried Wolf” scenario. People may inaccurately conclude that alarms are meaningless, like that “check engine light” on your car. 

This tendency is further reinforced by our own wishful thinking. When we lived in Florida, people who had lived through a lot of past hurricanes often failed to take warnings seriously. 

 According to Groner, vocal alarms are much more effective than sound alarms, since they can tell people the location and nature of the threat, as well as the best action to take. Where I work, we recently initiated an emergency notification system that broadcasts text messages, e-mails and voicemails to all employees, depending on what they have signed up to receive. 

 I believe that if the authorities are really serious about wanting people to evacuate buildings in response to fire alarms, they need to bring back the fire escape chute. No one can resist them. 

Also, if someone would like to appoint me as senior patrol boy, I’d be happy to boss everyone around to make sure they obeyed. Just don’t forget my badge and belt.

— Terry L. Stawar, Ed.D., lives in Georgetown and is the CEO of LifeSpring, the local community mental health center in Jeffersonville. He can be reached at tstawar@lifespr.com. Checkout his Welcome to Planet-Terry blog and podcast at www.planetterry.wordpress.com