Continuous ST-Segment Monitoring: 3 Case Studies in Progressive Care

Sandau, Kristin E.; Smith, Maureen

doi:10.4037/ccn2009953

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…Use of a voice badge significantly short ened the time to first contact, time to completion, and rate of closedloop communication, resulting in more timely bedside care. 433 The number of waveforms a monitor watcher can effectively and safely observe is not known, although a recent study used simulation to compare response time of monitor watchers to VF over 5 different pa tient loads (16,24,32,40, and 48 patients). As patient loads increased, response times increased significantly.…”

Section: Alarm Fatiguementioning

confidence: 99%

“…Continuous STsegment monitoring has the potential to identify ischemia be fore the onset of symptoms. This may be particularly important for patients who are unable to perceive angina symptoms 12,13 (eg, patients with diabetes mel litus who did not experience angina with a prior MI) or patients who cannot communicate that they are having angina symptoms [14][15][16][17] (eg, patients who are intubated and sedated or with impaired mental sta tus). Alternatively, the absence of dynamic changes on continuous STsegment monitoring after revascu larization can help provide reassurance that chest dis comfort does not represent coronary reocclusion.…”

Section: Overview Of Continuous St-segment Ischemia Monitoringmentioning

confidence: 99%

“…Knowledge can be enhanced by collaborative activities such as preceptorships, skill validations, and case studies, 16,[481][482][483][484][485][486] and studies have demonstrated no differences in knowledge or confidence with faceto face classes versus a hybrid approach (ie, online course combined with facetoface classes). 482,487,488 Hospital, service line, or unitbased nurse educa tors or clinical nurse specialists can provide this edu cation.…”

Section: Education Of Staffmentioning

confidence: 99%

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Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

Self Cite

207

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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Section: Alarm Fatiguementioning

confidence: 99%

Section: Overview Of Continuous St-segment Ischemia Monitoringmentioning

confidence: 99%

Section: Education Of Staffmentioning

confidence: 99%

See 1 more Smart Citation

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

Self Cite

207

214

View full text Add to dashboard Cite

show abstract

“…This reduces the number of electrodes that must be placed on the patient, as well as the complexity of the monitoring equipment required. It also reduces the number of electrical views obtained; careful lead selection is therefore required, especially when ischaemia monitoring is initiated (Sandau and Smith, 2009). The lead(s) selected will depend on the monitor being used, the number of electrodes, and the indication for monitoring.…”

Section: Leads and Electrodesmentioning

confidence: 99%

“…For example, to monitor V4, the white electrode must be placed in the fifth intercostal space, in the mid-clavicular line (Campbell et al, 2017). As 5-electrode monitors often allow two ECG leads to be displayed and monitored, leads II and V1 are recommended for arrhythmia monitoring (Sandau and Smith, 2009). …”

Section: Figure 5 5-electrode Monitoringmentioning

confidence: 99%

Continuous ECG monitoring in hospital: part 2, practical issues

Sampson

2018

British Journal of Cardiac Nursing

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Continuous monitoring of the electrocardiogram (ECG) is a common intervention performed by cardiac nurses. In the first article of this two-part series, we evaluated the principal indications for ECG monitoring. These are the detection of arrhythmias, monitoring for myocardial ischaemia, and measurement of the QT interval. In this second article, the practical issues surrounding ECG monitoring are evaluated. The use of 3-and 5-electrode systems is discussed, and is related to ECG theory and normal coronary artery anatomy. Recommendations are made for lead selection, correct electrode placement, and the recording of 12-lead ECGs. The article concludes with a consideration of safe practice in respect of alarm management, and considers both individual and organisational approaches to reducing inappropriate alarms.

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Classification of ST segment in ECG signals based on cross correlated supervised data

et al. 2020

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This paper describes an automated selection of the ST segment in 12 leads electrocardiogram (ECG) as well as its classification based on cross correlation. Our proposed method classifies five categories of ST segment which are (a) Up slop (b) Down slop (c) Horizontal (Normal) (d) Concave (e) Convex using cross correlation process. We compare the main ECG (patient ECG) ST segment with the above-mentioned reference ST segments. In this work we have used MIT-BIH ST change database and European ST-T change database where every database contains minimum 30 min and maximum 1-h episode. Our method contains the following steps (1) Filtering ECG signal and Detrending it (2) R peak and S peak detection (3) Starting and ending point detection of ST segment (4) Comparing with ST segment supervised data (5) Classifying the ST segment. We have used total 1,34,879 beats where 58,331 beats from MIT-BIH ST change database and 74,609 beats from European ST-T change database. We have correctly selected total 126,608 ST segments. ST segment classification accuracy is 88.20% for MIT-BIH ST change database and 96.18% for European ST-T change database. The method confirms satisfactory performance with an overall accuracy of 92.1% which is helpful to the detection of major heart diseases like myocardial ischemia.

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Continuous ST-Segment Monitoring: 3 Case Studies in Progressive Care

Cited by 10 publications

References 29 publications

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Continuous ECG monitoring in hospital: part 2, practical issues

Classification of ST segment in ECG signals based on cross correlated supervised data

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