As the COVID pandemic continues and flu season begins, proper utilization of hospital resources becomes a priority. We wanted to take a moment to highlight key components of the most recent American Health Association’s (AHA) 2017 recommendations regarding telemetry use.
Cardiac conditions where telemetry is not required:
- Frequent PVC’s or non-sustained VT in the absence of other indications for arrhythmia monitoring telemetry may be considered, but is not required
- Known permanent atrial fibrillation with adequate rate control
- However, it may be considered if a medical condition is present that may affect rate
- Asymptomatic, hemodynamically stable patients with bradycardia
- Asymptomatic patients with Wenckebach
- Arrhythmia monitoring following a noncardiac surgery in an asymptomatic patients
- Patients with an ICD or pacemaker without another indication for telemetry
Non-Cardiac Indications for Telemetry
- Arrhythmia monitoring 24-48 hours following a stroke. Prolonged arrhythmia monitoring may be considered in patients with cryptogenic stroke
- Patients with moderate to severe imbalance of potassium or magnesium
- Patients with drug overdose until patient is “free of the influence of the drug”
Of note, the author’s of the most recent guidelines found insufficient evidence to make a recommendation for the following populations: patients with pneumonia not requiring ICU level care, patients with a COPD exacerbation or patients on chronic hemodialysis.
A more detailed report of the AHA’s current recommendations can be found here.
Please refer to the post on 11/17/2020 for a list of indications for telemetry at NMH!