The evidence of benefit of current strategies remains sparse. Given the complex pathophysiology of cerebral ischemia and hypoxia, a multimodal approach to neuroprotective strategies seems sensible. The many variables and confounds associated with the clinical setting of patients, their comorbidities and concurrent medications, pose challenges to translate from experimental studies to clinical practice.

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Remote monitoring of the heart rhythm using telemetry is an important part of diagnosis and treatment of cardiac patients. Nurses are responsible for electrode placement and correct handling of the telemetry, and therefore have a central role in ensuring the best possible result of monitoring. The aim of the study was to investigate i) whether electrode placement during telemetry monitoring was correct, ii) whether the quality of electrode attachment was satisfactory, iii) whether hygiene was ensured by using a telemetry cover, and iv) whether patients had received the information needed. Methods: This pilot study is part of a larger study on telemetry use at a Norwegian university hospital. The survey was conducted during two weeks on patients connected to telemetry (n = 55) in two coronary care units. This was 64% of all patients monitored during this period. Patients participating in the study did not differ from those not participating on important variables; arrhythmia events and interventions performed during monitoring. A registration form with ten variables regarding Electrode placement, Electrode attachment, Hygiene, and Patient information was developed particularly for this study. Results: The majority of patients (47%) were admitted due to chest pain. During telemonitoring, 34% of patients had arrhythmia events, and 18% underwent interventions due to this. One patient suffered sudden cardiac death. The study revealed that 30% of the electrodes were misplaced. Although 21 patients needed shaving before electrode placement, this was only performed in nine. However, in the majority of the patients (78%) the electrodes were optimally attached. In 71% of the patients telemetry covers were used in order to ensure a hygienic practice. Most of the patients (76%) had received information about the intent of monitoring, but only two patients had received information about caution of mobile telephone use. Conclusion: Current practice of telemetry monitoring highlights the need for better education of nursing staff, and clearer guidelines to be developed and implemented. A larger study in the area is recommended.