(736) Effect of Introduction of a Visual Alarm on Noise Levels in Cesarean Delivery Operating Rooms

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective:

Excessive intra-operative noise exposure is a problem in operative settings and has been associated with an increased risk of adverse events. The WHO recommends 45 dBA (ambient decibels) as a threshold level for noise in procedural hospital areas. This study investigates the effect of introducing a visual alarm system on noise levels during cesarean delivery cases.

Study Design:

This prospective observational study measured continuous sound pressure levels before and after activation of a visual alarm (SoundEar 3-300) during cesarean deliveries in two obstetrics operating rooms (ORs). Both case-attributable and background non-human noise were analyzed during these time periods. Descriptive information for cesarean delivery cases, as well as timestamp data for major timepoints throughout the case was collected via manual review of electronic health records.

Results:

Activation of visual alarm systems was associated with a statistically significant reduction of median noise level by 0.7 dBA, from 61.8 dBA to 61.1 dBA. However, upon analysis of background non-human noise, this reduction was secondary to a decline in background rather than case-attributable noise. The median dBA for the cases was significantly higher in cases with NICU presence, NICU admission, 5-minute APGAR score less than 7, multiple gestations, and intra-operative tubal sterilizations.

Conclusion:

While noise reduction was noted over the study period with introduction of the visual alarms, an analysis of background noise revealed steady high levels in both operating rooms that account for the majority of noise variation independent of specific case or team-specific influences. Thus, isolated introduction of visual alarms in operating rooms is unlikely to be a satisfactory noise mitigation strategy. However, with availability of relatively inexpensive sound level meters, similar analysis may be employed across multiple surgical environments in an effort to target various noise elements specific to certain operations.

Primary & Presenting Author(s)

Gabrielle K. Smith, MD (she/her/hers)
Resident
University of Virginia
Charlottesvle, Virginia, United States

Coauthor(s)

Adam Schettler, MD (he/him/his)
University of Virginia
Charlottesvle, Virginia, United States

BW
Brett Whalen, MD
University of Alabama
Birmingham, Alabama, United States

AA
Alexis Allihien, MD
Barnes Jewish Hospital and Washington University
St. Louis, Missouri, United States

AU
Amanda Urban, MS
Clinical Research Coordinator
University of Virginia
Charlottesville, Virginia, United States

DD
Donald J. Dudley, MD
University of Virginia
Charlottesville, Virginia, United States

Megan Whitham, MD
Fellow
University of Virginia
Charlottesville, Virginia, United States