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Continuous Electrocardiographic Monitoring and Cardiac Arrest Outcomes in 8,932 Telemetry Ward Patients
Author(s) -
Schull Michael J.,
Redelmeier Donald A.
Publication year - 2000
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2000.tb02038.x
Subject(s) - telemetry , medicine , cardiac monitoring , emergency medicine , medical emergency , cardiology , engineering , aerospace engineering
. Objective: To estimate the benefit of routine electrocardiographic (ECG) telemetry monitoring on in‐hospital cardiac arrest survival. Methods: In a tertiary care hospital, all telemetry ward admissions and cardiac arrests occurring over a five‐year period were reviewed. Ward location and survival to discharge were determined for all patients outside of critical care areas. Results: During the study period, 8,932 patients were admitted to the telemetry ward, and 20 suffered cardiac arrest (0.2%; 95% CI = 0.1 to 0.3). Telemetry monitors signaled the onset of cardiac arrest in only 56% (95% CI = 30 to 80) of monitored arrests. Three patients survived to discharge, and in two of these three patients the arrest onset was signaled by the monitor. This yields a monitor‐signaled survival rate among telemetry ward patients of 0.02% (95% CI = 0 to 0.05). All survivors suffered significant arrhythmias prior to their cardiac arrests. Conclusions: Cardiac arrest is an uncommon event among telemetry ward patients, and monitor‐signaled survivors are extremely rare. Routine telemetry offers little cardiac arrest survival benefit to most monitored patients, and a more selective policy for telemetry use might safely avoid ECG monitoring for many patients.