Novel Pulse Oximetry Sonifications for Neonatal Oxygen Saturation Monitoring: A Laboratory Study

Objective We aimed to test whether the use of novel pulse oximetry sounds (sonifications) better informs listeners when a neonate's oxygen saturation (SpO(2)) deviates from the recommended range. Background Variable-pitch pulse oximeters do not accurately inform clinicians via sound alone when SpO(2) is outside the target range of 90% to 95% for neonates on supplemental oxygen. Risk of blindness, organ damage, and death increase if SpO(2) remains outside the target range. A more informative sonification may improve clinicians' ability to maintain the target range. Method In two desktop experiments, nonclinicians' ability to detect SpO(2) range and direction of change was tested with novel versus conventional sonifications of simulated patient data. In Experiment 1, a shoulder sonification used larger pitch differences between adjacent saturation percentages for SpO(2) values outside the target range. In Experiment 2, a beacon sonification used equal-appearing pitch differences, but when SpO(2) was outside the target range, a fixed-pitch reference tone from the center of the target SpO(2) range preceded every fourth pulse tone. Results The beacon sonification improved range identification accuracy over the control display (85% vs. 60%; p < .001), but the shoulder sonification did not (55% vs. 52%). Conclusion The beacon provided a distinct auditory alert and reference that significantly improved nonclinical participants' ability to identify SpO(2) range. Application Adding a beacon to the variable-pitch pulse oximeter sound may help clinicians identify when, and by how much, a neonate's SpO(2) deviates from the target range, particularly during patient transport situations when auditory information becomes essential.