ICU wards are indeed noisy
Critically ill patients lying down to rest in quiet wards is the impression that many people have of the intensive care unit (ICU). However, after receiving complaints about noise from patients, the ICU of a Belgian hospital used a sound detector to measure the noise level in the ward, and found that the average sound by the bedside during the day was 52.8 decibels, and at night it was 54.6 decibels, which is equivalent to the sound of a dishwasher at work, and the noisiest one even reached 101 decibels, which is equivalent to a motorcycle accelerating at a fast speed.
This situation is not unique to one hospital. The Department of Critical Care Medicine of the First Affiliated Hospital of Nanjing Medical University has tested the ICU wards of a tertiary hospital, and the results showed that the average ICU sound was 57.57 decibels, and the highest value was 85.1 decibels. This result and the data detected by the Belgian researchers is almost comparable.
The International Noise Society stipulates that daytime noise should be less than 45 decibels and nighttime noise should be no higher than 20 decibels. Healthcare professionals often emphasize the cleanliness of the air between rooms, but neglect to control noise in the ICU.
Equipment is the main source of noise
Where does all this noise in the ICU come from? A major source is a variety of medical equipment!
There are many types of ICU equipment, such as monitors, infusion pumps, ventilators and so on. Shanghai Changzheng Hospital Emergency Department has ICU 124 patients did a survey, the results show that in all medical equipment noise, instrument alarm sound accounted for 67.5% of all noise sources.
"When a patient uses multiple instruments such as cardiac monitors, ventilators, injection pumps, etc. at the same time, there may be multiple alarm parameters, and this doesn't exclude the alarm sound of the instruments used by patients in the next bed." He Zhongjie, chief physician of the intensive care unit of the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA), said that in addition to the sound of alarms, the sound generated by medical staff during the shift handover is also a major source of noise.
Usually, these man-made noises are concentrated from 9 to 11 p.m. in a day, as this is also the busiest time in the ICU. Medical staff picking up and placing items, moving and using equipment, and handing over work inevitably make noise. In addition, the noise may also originate from a portion of family members who are eager to visit. "Some critically ill patients will have relatives and friends, or even unit leaders to visit after surgery, not only to wake up the patient, but also to say a few words, seriously interfering with the patient's rest." He Zhongjie believes that this noise is a kind of hidden noise, which only satisfies the psychology of the visitors and harms the patient's own recovery.
Noise is not conducive to patients' recovery
For normal people, being in a noisy environment for a long time is hard to bear, and for patients suffering from critical illnesses, noise is even worse. Noise not only stimulates the sympathetic nerves of the human body, accelerating the heart rate and blood pressure, but also makes the pain of the patient's pain intensify, seriously affecting sleep.
A survey showed that 86.7% of the patients on the rescue staff footsteps, the sound of moving instruments, a variety of instruments issued by the sound of the alarm and other undesirable auditory stimuli feel uneasy, nervous and fear. He Zhongjie pointed out that noise stimulation for ICU patients can psychologically lead to irritability, panic, anxiety and other negative emotions, and physiologically lead to insomnia, elevated blood pressure, accelerated heart rate, easy to fatigue, etc., and even lead to ICU delirium, which affects the patient's prognosis. "Repeated stimulation of this type of noise can cause patients to gradually lose the concept of time, unable to distinguish between day and night, and the patient may have difficulty falling asleep, or even day and night."
Valuing artificial noise in ICU wards
Noise from medical equipment is inevitable, but artificial noise can be controlled. Critical care medicine experts suggest that ICU noise levels can be effectively reduced by increasing the level of attention and service to medical staff noise.
He Zhongjie suggests that in ICUs, medical staff should limit their conversations to what is necessary for patient care, and that wards should strive to do the "three littles": walk softly, talk softly, and move softly.
"Visiting time periods must control the number of visiting family members, soothe their emotions, and avoid them crying out loud." Yang Dandan, Department of Critical Care, The First Affiliated Hospital of Nanjing Medical University, suggests that treatment operations should try to focus on the daytime, and reduce unnecessary operations at night.