When do patients need admission to a telemetry bed?
Non-intensive telemetry units are utilized for monitoring patients at risk for life-threatening dysrhythmias and sudden death. Physicians often use monitored beds for patients who might only require frequent nursing care. When 70% of the top 10 diseases admitted through the emergency department (ED) are clinically indicated for telemetry, hospitals with limited resources will be overwhelmed and admitted patients will be forced to wait in the ED. We examine the evidence behind admitting patients to telemetry. There is evidence for monitoring in patients admitted for implantable cardioverter-defibrillator firing, type II and complete atrio-ventricular block, prolonged QT interval with ventricular arrhythmia, decompensated heart failure, acute cerebrovascular event, acute coronary syndrome, and massive blood transfusion. Monitoring is beneficial for selected patients with syncope, gastrointestinal hemorrhage, atrial tachyarrhythmias, and uncorrected electrolyte abnormalities. Finally, telemetry is not indicated for patients requiring minor blood transfusion, low risk chest pain patients with normal electrocardiography, and stable patients receiving anticoagulation for pulmonary embolism.
Chen
Esther H
EH
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Hollander
Judd E
JE
D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D018579:Patient Selection; D020521:Stroke / Q000175:diagnosis; D013686:Telemetry / Q000706:statistics & numerical data*