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 (SpO₂) deviates from the recommended range. Background Variable-pitch pulse oximeters do not accurately inform clinicians via sound alone when SpO₂ is outside the target range of 90% to 95% for neonates on supplemental oxygen. Risk of blindness, organ damage, and death increase if SpO₂ 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 SpO₂ 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 SpO₂ values outside the target range. In Experiment 2, a "beacon" sonification used equal-appearing pitch differences, but when SpO₂ was outside the target range, a fixed-pitch reference tone from the center of the target SpO₂ 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 SpO₂ range. Application Adding a beacon to the variable-pitch pulse oximeter sound may help clinicians identify when, and by how much, a neonate's SpO₂ deviates from the target range, particularly during patient transport situations when auditory information becomes essential.