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Telemetry Monitoring (telemetry + monitoring)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Telemetry Monitoring during Transport of Low-risk Chest Pain Patients from the Emergency Department: Is It Necessary?

ACADEMIC EMERGENCY MEDICINE, Issue 10 2005
Adam J. Singer MD
Abstract Background: Low-risk emergency department (ED) patients with chest pain (CP) are often transported by nurses to monitored beds on telemetry monitoring, diverting valuable resources from the ED and delaying transport. Objectives: To test the hypothesis that transporting low-risk CP patients off telemetry monitoring is safe. Methods: This was a secondary analysis of a prospective, observational cohort of ED patients with low-risk chest pain (no active chest pain, normal or nondiagnostic electrocardiogram, normal initial troponin I) admitted to a non,intensive care unit monitored bed who were transported off telemetry monitor by nonclinical personnel. A protocol allowing transportation of low-risk CP patients off telemetry monitoring to a monitored bed was developed, and an ongoing daily log of patients transported off telemetry was maintained for the occurrence of any adverse events en route to the floor. Adverse events requiring treatment included dysrhythmias, hypotension, syncope, and cardiac arrest. The study population included patients who presented during September,October 2004, whose data were abstracted from the medical records using standardized methodology. A subset of 10% of the medical records were reviewed by a second investigator for interrater reliability. Death, syncope, resuscitation, and dysrhythmias during transport or immediately on arrival to the floor were the outcomes measured. Descriptive statistics and confidence intervals (CIs) were used in data analysis. Results: During the study period, 425 patients had CP of potentially ischemic origin, of whom 322 (75.8%) were low risk and met the inclusion criteria and were transported off monitors. Their mean (±standard deviation) age was 58.3 (±16.0) years; 48.1% were female. During transport from the ED, there was no patient with any adverse events requiring treatment and there was no death (95% CI = 0% to 0.93%). Conclusions: Transportation of low-risk ED chest pain patients off telemetry monitoring by nonclinical personnel to the floor appears safe. This may reduce diversion of ED nurses from the ED, helping to alleviate nursing shortages. [source]

Smoking Cessation a Byproduct of EEG Telemetry Monitoring

EPILEPSIA, Issue 4 2005
Syed Nizamuddin Ahmed
Summary:, Smoking is a common problem in epilepsy patients. The inpatient video-EEG monitoring (VEEG) unit provides a unique and conducive environment for epilepsy patients to participate actively in a smoking-cessation program. The restrictions and confinement to the telemetry bed impose a forced abstinence from smoking. It has been suggested that patients who are hospitalized may be more receptive to smoking-cessation advice. We report two patients who were successfully able to quit smoking after admission for VEEG. [source]

Telemetry Monitoring during Transport of Low-risk Chest Pain Patients from the Emergency Department: Is It Necessary?

ACADEMIC EMERGENCY MEDICINE, Issue 10 2005
Adam J. Singer MD
Abstract Background: Low-risk emergency department (ED) patients with chest pain (CP) are often transported by nurses to monitored beds on telemetry monitoring, diverting valuable resources from the ED and delaying transport. Objectives: To test the hypothesis that transporting low-risk CP patients off telemetry monitoring is safe. Methods: This was a secondary analysis of a prospective, observational cohort of ED patients with low-risk chest pain (no active chest pain, normal or nondiagnostic electrocardiogram, normal initial troponin I) admitted to a non,intensive care unit monitored bed who were transported off telemetry monitor by nonclinical personnel. A protocol allowing transportation of low-risk CP patients off telemetry monitoring to a monitored bed was developed, and an ongoing daily log of patients transported off telemetry was maintained for the occurrence of any adverse events en route to the floor. Adverse events requiring treatment included dysrhythmias, hypotension, syncope, and cardiac arrest. The study population included patients who presented during September,October 2004, whose data were abstracted from the medical records using standardized methodology. A subset of 10% of the medical records were reviewed by a second investigator for interrater reliability. Death, syncope, resuscitation, and dysrhythmias during transport or immediately on arrival to the floor were the outcomes measured. Descriptive statistics and confidence intervals (CIs) were used in data analysis. Results: During the study period, 425 patients had CP of potentially ischemic origin, of whom 322 (75.8%) were low risk and met the inclusion criteria and were transported off monitors. Their mean (±standard deviation) age was 58.3 (±16.0) years; 48.1% were female. During transport from the ED, there was no patient with any adverse events requiring treatment and there was no death (95% CI = 0% to 0.93%). Conclusions: Transportation of low-risk ED chest pain patients off telemetry monitoring by nonclinical personnel to the floor appears safe. This may reduce diversion of ED nurses from the ED, helping to alleviate nursing shortages. [source]

Resting Echocardiography for the Early Detection of Acute Coronary Syndromes in Chest Pain Unit Patients

ECHOCARDIOGRAPHY, Issue 6 2010
Vito Maurizio Parato M.D.
Aim: The purpose of this study is to assess the ability of resting echocardiography to detect an acute coronary syndrome (ACS) before the occurrence of ischemic electrocardiogram (ECG) changes or troponin-T elevations. Methods: Four hundred and three patients who presented to the emergency room (ER) with chest pain, normal ECGs, and normal troponin-T levels were admitted to the cardiologist-run Chest Pain Unit (CPU) for further monitoring. They underwent serial resting echocardiography for monitoring of left ventricle wall motion (LVWM), ECG telemetry monitoring, and serial troponin-T measurements. Results: An ACS was detected in 49 patients (12.1%). These 49 patients were then subdivided into three different groups based on the initial mode of detection of their ACS. In group A, 16 of 49 (32.6%) patients had ACS shown by echocardiographic detection of LVWM abnormalities. In group B, 24 of 49 (48.9%) patients had an ACS detected by ischemic ECG changes. In group C, 9 of 49 (18.3%) patients had an ACS detected by troponin-T elevations. The shortest time interval between CPU-admission and ACS-detection occurred in group A (A vs. B, P < 0.003; A vs. C, P < 0.0001). In group A, cardiac angiogram showed that the culprit coronary lesion was more frequent in the circumflex artery (11 out of 16; 68.7%) (LCx vs. LAD, P < 0.02; LCx vs. RCA, P < 0.001) and of these 11 patients with circumflex lesions, the ECG was normal in eight (72.7%) patients. Conclusion: This study demonstrates the utility of LVWM monitoring by serial echocardiography as part of a diagnostic protocol that can be implemented in a CPU. Furthermore, echocardiography could become an essential tool used in the diagnosis of ACS secondary to circumflex lesions. (Echocardiography 2010;27:597-602) [source]

Continuous Electrocardiographic Monitoring and Cardiac Arrest Outcomes in 8,932 Telemetry Ward Patients

ACADEMIC EMERGENCY MEDICINE, Issue 6 2000
Michael J. Schull MD
Abstract. Objective: To estimate the benefit of routine electrocardiographic (ECG) telemetry monitoring on in-hospital cardiac arrest survival. Methods: In a tertiary care hospital, all telemetry ward admissions and cardiac arrests occurring over a five-year period were reviewed. Ward location and survival to discharge were determined for all patients outside of critical care areas. Results: During the study period, 8,932 patients were admitted to the telemetry ward, and 20 suffered cardiac arrest (0.2%; 95% CI = 0.1 to 0.3). Telemetry monitors signaled the onset of cardiac arrest in only 56% (95% CI = 30 to 80) of monitored arrests. Three patients survived to discharge, and in two of these three patients the arrest onset was signaled by the monitor. This yields a monitor-signaled survival rate among telemetry ward patients of 0.02% (95% CI = 0 to 0.05). All survivors suffered significant arrhythmias prior to their cardiac arrests. Conclusions: Cardiac arrest is an uncommon event among telemetry ward patients, and monitor-signaled survivors are extremely rare. Routine telemetry offers little cardiac arrest survival benefit to most monitored patients, and a more selective policy for telemetry use might safely avoid ECG monitoring for many patients. [source]