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It doesn't matter very much how awesome your device is. You need at least a second person who would also get the alert as a backup (assuming this is a critical system that you really care about, otherwise you wouldn't want to be on-call for it in the first place).

As the primary responder, your responsibility is to acknowledge any alert within a minute or so. Otherwise, the backup person would have to jump in.

To ensure "accountability," you may have a manager who would be a third backup and can escalate up from there.

Yes, a good escalation policy would have a primary responder, a backup or secondary, and then one or managers, going up the hierarchy. PagerDuty supports that and my next post will be on that topic.

Having a good device is important too though; if you sleep through or miss an alert, it may take another 10-20 minutes or so (depending on the escalation policy) before the alert escalates to the next person. This slack time could be pretty important depending on the severity of the problem.

I would recommend against "picking sharp or piercing ringtones". I once had a horrific on-call schedule and, like any mammal, I developed a Pavlovian response to the sound of my pager which resembled those door buzzers that retail stores use. Friends of mine told me that I used to jump when I heard them go off.

So realize that whatever that ringtone is you'll associate it with this kind of anger: http://www.jeckels.com/photoDetail?PhotoId=4586&Category...

Nice; it looks like that pager was an Amazon one too.

There was a time when the sound of my pager (or even my cell phone's SMS ringtone) would get my heart beating faster.

Maybe this would be a good ringtone for being on-call: http://www.youtube.com/watch?v=5bNE-5TVAmg

Forgot to mention that you also need a patient spouse.