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

Kelly Hinckfuss, Penelope Sanderson, Robert G. Loeb, Helen G. Liley, David Liu

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)344-359
Number of pages16
JournalHuman Factors
Issue number2
StatePublished - Mar 1 2016


  • auditory displays
  • critical care
  • medical devices and technologies
  • pediatrics and neonatology
  • sonification

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Applied Psychology
  • Behavioral Neuroscience


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