ROLE OF TELEMETRY MONITORING IN THE NON-INTENSIVE CARE UNIT

To determine the outcomes of patients admitted to a non-intensive care telemetry unit and to assess the role of telemetry for guiding patien t management decisions, data from 2,240 patients admitted to a telemet ry unit were collected prospectively during 7 months. Physicians recor ded the outcomes (intensive care unit transfer and mortality) and asse ssed whether telemetry assisted in guiding patient management. Indicat ions for admission to the telemetry unit included chest pain syndromes (55%), arrhythmias (14%), heart failure (12%), and syncope (10%). Tel emetry led to direct modifications in management in 156 patients (7%; 95% confidence interval [CI] 5.9% to 8%). Telemetry was perceived as u seful but did not alter management for 127 patients (5.7%; 95% CI 4.7% to 6.6%). Two hundred forty-one patients were transferred to an inten sive care unit from the telemetry unit (10.8%; 95% CI 9.5% to 12%). Ni neteen patients (0.8% of all admissions; 95% CI 0.5% to 1.2%) were tra nsferred because of an arrhythmia identified by telemetry. Routine tra nsfer after cardiac revascularization or surgery accounted for 134 tra nsfers; clinical deterioration accounted for 88 transfers. There were 20 deaths in the unit (0.9%; 95% CI 0.5% to 1.3%): 4 of the 20 deaths occurred while patients were being monitored. The role of telemetry in guiding patient management may be overestimated by physicians, since it detected significant arrhythmias that led to change in medications or urgent interventions in a small fraction of patients.