At the center of every hospital's telemetry cardiac monitoring support system are the men and women who sit in front of these telemetry cardiac monitors 24 hours a day, seven days a week. I have no idea what all these green, orange, purple and yellow sticky tags are for on each and every monitor. It looks like organized chaos to me. I'm sure there is a method to the madness.
This is nothing like the central telemetry cardiac monitoring support at the VA hospital I trained at ten years ago. Their idea was to slap a bunch of telemetry monitors in the nurses station 20 feet away from the break room with no 24 hour support staff. Guess what happened if the patient went into sustained ventricular tachycardia. The monitor would start beeping but nobody would pay attention, because the darn things were beeping all day long and there was nobody sitting there watching deadly heart rhythms fly by.
Contrast that with this monitoring system were nothing gets past them. Lord knows I've had my fair share of 3 am calls from the floor nurse letting me know that the telemetry nurse experts called to notify her of a one beat run of SVT and asking me what I want to do about it. That's when it's time to discontinue the telemetry.
We put way too many people on telemetry in the hospital. Why, I ask. Why do we do it? We are just going to find something we don't want to find. What are we going to do about that 17 beat asymptomatic burst of SVT in an 87 year old admitted with cellulitis? Nothing. Just leave it alone. And all those cardiac patients with paced rhythms. Day after day after day of paced telemetry rhythm strips. For the love of God, just stop it already. Do you know how much money we are wasting every day we write for telemetry? Just stop it already. One thing our hospitalist group has done is implement a daily telemetry check list we evaluate on our morning rounds to decide whether telemetry should be discontinued on that day. Reducing telemetry usage is one of the things I'd like to implement in my desires for a hospital wide daily medical checklist. This original Happy Hospitalist ecard helps explain.