Robust alarm system

A patient monitoring device, the device comprising:

• a driving circuit configured to drive one or more light emitters;
• a front end processing circuit configured to receive a signal from a detector responsive to light from the one or more emitters after the light is attenuated by body tissue;
• a first alarm configured to provide an alert to a caregiver, the first alarm comprising a sound transducer;
• a processor responsive to the front end processing circuit to process the signal to determine one or more measurement values for one or more physiological parameters of a patient being monitored, the processor further configured to trigger the first alarm when one or more of the one or more measurement values require caregiver review, wherein when triggered, the sound transducer is configured to output a first tone;
• an alarm detector configured to verify alarm integrity by sensing vibrations or movements of the sound transducer;
• and
• a malfunction indicator configured to provide an indication that the sound transducer was nonresponsive when triggered by the processor in response to the alarm detector,
• wherein the device is a portable instrument configured to be docked into a docking station, wherein when docked, the processor is further configured to concurrently trigger a second alarm in the docking station to output a second tone when one or more of the one or more measurement values require caregiver review.