• Linda K Bawua, Christine Miaskowski, Sukardi Suba, Fabio Badilini, George W Rodway, Xiao Hu, and Michele M Pelter.
• Linda K. Bawua is a former PhD student, School of Nursing, University of California, San Francisco, California.
• Am. J. Crit. Care. 2022 Sep 1; 31 (5): 355365355-365.

BackgroundRespiratory rate (RR) alarms alert clinicians to a change in a patient's condition. However, RR alarms are common occurrences. To date, no study has examined RR alarm types and associated patient characteristics, which could guide alarm management strategies.ObjectivesTo characterize RR alarms by type, frequency, duration, and associated patient demographic and clinical characteristics.MethodsA secondary data analysis of alarms generated with impedance pneumography in 461 adult patients admitted to either a cardiac, a medical/surgical, or a neurological intensive care unit (ICU). The RR alarms included high parameter limit (≥30 breaths/min), low parameter limit (≤5 breaths/min), and apnea (no breathing ≥20 s). The ICU type; total time monitored; and alarm type, frequency, and duration were evaluated.ResultsOf 159 771 RR alarms, parameter limit alarms (n = 140 975; 88.2%) were more frequent than apnea alarms (n = 18 796; 11.8%). High parameter limit alarms were most frequent (n = 131 827; 82.5%). After ICU monitoring time was controlled for, multivariate analysis showed that alarm rates were higher in patients in the cardiac and neurological ICUs (P = .001), patients undergoing mechanical ventilation (P = .005), and patients without a ventricular assist device or pacemaker (P = .02). Male sex was associated with low parameter limit (P = .01) and apnea (P = .005) alarms.ConclusionHigh parameter limit RR alarms were most frequent. Factors associated with RR alarms included monitoring time, ICU type, male sex, and mechanical ventilation. Although these factors are not modifiable, these data could be used to guide management strategies.©2022 American Association of Critical-Care Nurses.

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