In 2012, Yoko Sen was in a hospital emergency room. As she lay there tethered to a cardiac monitor, it rang out in a tone close to the musical note of C, clashing with a distant device wailing in a high-pitched F sharp, creating what’s called the devil’s interval, a dissonance so chilling that medieval churches forbade it.
Sen, a musician, asked a nurse about the clamor, only to be assured that it was normal.
Hospitals can be sonic hellscapes. Nurses can respond to hundreds of alarms a day. And while Sen understands the need for the alarms, she doesn’t understand why the sound has to be so jarring.
Judy Edworthy, a professor of applied psychology at the University of Plymouth in Britain, is leading a group of specialists, including Sen, to develop tones that replace the blare of the alarms with whistles and even music. (A proposal to have “I Left My Heart in San Francisco” as a signal for cardiac problems has been rejected,)
“Unnecessary noise is the cruelest absence of care,” Sen said to a room full of medical professionals at a conference last year about end-of-life management. The words came from the mother of modern nursing, Florence Nightingale, who worked in the Crimean War in the 19th century.
Deep in the rule book for safety and performance of medical devices is IEC 60601-1-8, which sets the standards for medical device alarm sounds. Among other specifications, the standard sets forth tones for six critical functions: cardiovascular, drug administration, ventilation, oxygen, temperature and artificial perfusion (the flow of blood and oxygen), also known as “the six ways people die.”
Audio technology has changed drastically since the tones were created, said Edworthy. “It’s now possible to produce pretty much any sound you want from a medical device,” she said.
The sounds her team is proposing are called auditory icons, which means they represent their functions, like the crumpling paper sound that a computer makes when you throw files in the trash. In this case, the sounds represent critical organ functions and imitate the lub-dub sound of a heartbeat, or a rattling pill bottle for a drug infusion or a whistling teakettle for temperature.