There are many reasons that the numbers of physiologic monitoring system alarms that clinicians must respond to can grow out of control. This article identifies the most common reasons and delivers recommendations for handling them. Although alarms are an important part of patient care and safety, they can easily reach quantities that overwhelm nurses, thereby compromising alarm effectiveness. Excessive quantities of alarms may desensitize nurses, leading them to not promptly respond to alarms or to inappropriately inactivate them. And alarms that ultimately prove to have been unnecessary can needlessly distract nurses or pull them away from other tasks. ECRI doesn't believe that there is a single "cure-all" for controlling alarm quantities. Rather, the way to combat alarm overload is to first identify the various sources of excessive alarms and to then take actions to individually address each source. This article recommends key actions to take and describes how these actions can be organized into a systematic plan. The effect of these efforts should be better clinical efficiency and improved patient safety.