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Anesth Analg 2003;97:1483-1487
© 2003 International Anesthesia Research Society

CRITICAL CARE AND TRAUMA

The Use and Effectiveness of Electrocardiographic Telemetry Monitoring in a Community Hospital General Care Setting

J. Paul Curry, MD*, C. William Hanson, III, MD FCCM{dagger}, Michael W. Russell, MD{dagger}, Cheryl Hanna, RN*, Gayle Devine, BSN CCRN{dagger}, and E. Andrew Ochroch, MD{dagger}

*Department of Anesthesiology and Critical Care, Hoag Memorial Presbyterian Hospital Newport Beach, CA, and the {dagger}Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA

Address correspondence to E. Andrew Ochroch, MD, Department of Anesthesiology, UPHS, 416c Ravdin Ct., 3400 Spruce St., Philadelphia, PA 19104. Address email to ochrocha{at}uphs.upenn.edu

The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort study on 1097 telemetry admissions between January 1, 2000 and March 31, 2000. A convenience sample of 218 patients generated 236 telemetry admissions. One-hundred-sixty-two arrhythmic events were detected during 400 "indicated" telemetry days. Nine arrhythmic events were detected during 345 "not indicated" telemetry days. The relative rate for arrhythmic events was significantly different, at P < 0.0001, with the incidence rate ratio of 15 indicating a very large effect size. Consequently, current use of ECG telemetry may not be optimal, and a prospective analysis of the application of rigorous indications for ECG telemetry needs to be undertaken.

IMPLICATIONS: The application of standard criteria to electrocardiogram telemetry admissions found that the majority of abnormal heart rhythms were found when patients met appropriate criteria.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.