Inpatient Telemetry Does Not Need To Be Used in the Management of Older Patients Hospitalized With Chest Pain at Low Risk for In-Hospital Coronary Events and Mortality

Abstract

Inpatient telemetry was of no value in predicting short-term coronary events or mortality or long-term mortality in low-risk patients hospitalized with chest pain.

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

“…112 In a number of studies, investigators have ques tioned the value of continuous monitoring of patients presenting with chest pain and a low risk of ACS while in the ED, during transport, and after admission for workup and observation. 106,107,[198][199][200][201] The goal in each of these investigations was to ensure the safe allocation of monitoring resources so that these resources were available for patients with a clear, evidencebased need without unnecessary risk to the population of patients with chest pain in general.…”

Strategies for Improving Survival After In-Hospital Cardiac Arrest in the United States: 2013 Consensus Recommendations

“…57 Class I indications for monitoring include the following: Selected low-risk patients admitted with chest pain may not need ECG monitoring. 58,59 ECG monitoring must be of high quality in capturing the trigger of true arrests (sensitivity) and for avoidance of false alarms (specificity). Sufficient staffing is critical to allow a prompt and appropriate response to the alarms by a nurse or technician.…”

Guideline‐based intervention to reduce telemetry rates in a large tertiary centre

“…3,[5][6][7][8]14,15 Hence, by avoiding telemetry in these patients, we do not compromise patient care but instead allocate our resources to patients who will benefit the most from them. 3,[5][6][7][8]14,15 Hence, by avoiding telemetry in these patients, we do not compromise patient care but instead allocate our resources to patients who will benefit the most from them.…”

“…[3][4][5][6][7] The main role of telemetry is in patients with high clinical risk or suspicion of arrhythmia in whom management will change as a result of detection. Widespread inpatient telemetry use has not demonstrated clear benefits in clinical outcomes.…”