Abstract

Are we getting alarm fatigue from the facial nerve monitor?

OBJECTIVE

To study the frequency of alerts from facial nerve monitors during otologic surgery.

DESIGN

Prospective series

SETTTING

Tertiary referral center

PATIENTS

Surgical cases involving any type of ear surgery

INTERVENTION

Diagnostic

MAIN OUTCOME MEASURE

Each of 55 otologic cases was monitored in a standard manner with the NIM-3 facial nerve monitor and the alerts were recorded. After each case, the file was downloaded and the alert recordings were transferred to an Excel spreadsheet. The individual stimulation alerts were grouped into events and the frequency was analyzed.

RESULTS

Monitoring was performed for a total of 8107 minutes and there were an average of 18.4 stimulation events per case. This is an average of 6.9 stimulation events recorded every hour of surgery. No case had a facial nerve injury and most events were ‘false alarms’.

CONCLUSION

The facial nerve monitor might be causing alarm fatigue. The alarm sound frequently and most alerts are not associated with injury to the facial nerve. A comparison with other alarm systems indicates that the frequency of alerts is high enough with the NIM-3 that it may be a source of alarm fatigue. Other observations associated with monitoring were made as a result of the study.