A Happy Hospitalist: Is Telemetry Overused?

A Happy Hospitalist: Is Telemetry Overused?.

In a short answer: yes.

Does an elder with stable chronic atrial fib being admitted for a UTI need tele?  Nope.  ETOH withdrawal without cardiac history?  Nope.  Too often folks admitted to tele don’t truly need it, and those that may benefit, don’t get admitted (at least right away…).

Happy makes the case of a patient having 12-beat run of SVT.  Remember, supraventricular tachycardia and ventricular tachycardia are 2 very different beasts.  Any good tele nurse should know this.  One is an abberrant rapid rhythm, that when it is self-limited while notable, is not life threatneing (SVT).  The other, is the same way when self-limited, but can be a very bad thing if not (VT).

If it was my patient who had  a 12-beat run of SVT what would I do?  Check them, make sure they’re ok.  Document it and go on my merry way.  If it is something that is happening regularly and with increasing frequency, I might text page the doc an FYI.  But an isolated 12-beat run isn’t even enough to get my heart rate up.

On ther other hand, the delirious UTI patient with a pacemaker on tele who spends the entire night ripping tele leads off may cause me to call the doc for a “d/c tele” order though!

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