Warning

Telemetry indications

THIS IS A GUIDELINE ONLY – UNSTABLE patients should always be monitored in WARD 5.
Telemetry must only be used in Ward 4, Ward 5 and Ward 6
This List Is Not Exhaustive
REGISTERED NURSES CAN MAKE THE DECISION TO MONITOR A PATIENT WITH TELEMETRY

Chest Pain
  • Normal ECG and Negative Baseline Troponin -I with low probability of
    ACS/NSTEMI
  • Patients awaiting urgent PCI or CABG
Assessment of Arrhythmias
  • SVT, VT, Atrial Fibrillation with fast ventricular response
  • Bradycardia
  • Haemodynamically stable patients with Heart Block awaiting PPM
Assessment of syncope – thought to be cardiac in nature

Assessment of patients with drug/chemical or electrolyte imbalance
  • Overdose of drugs known to cause cardiac arrhythmias
  • Digoxin toxicity
  • Hypokalaemia/Hyperkalaemia
  • Antiarrhythmic drugs
Assessment of patients with a suspected malfunctioning PPM or AICD

Assessment of patients with Heart failure at risk of arrhythmias or electrolyte
imbalance

Acute medical illness with a cardiac history

Discontinuation of telemetry

THIS IS A GUIDELINE ONLY - All decisions to discontinue telemetry must be discussed with medical staff


Chest Pain

  • Pain free for 24-48 hours or until reviewed by Chest pain team/Cardiology
  • 2 –ve Troponin I
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHG or baseline for patient)
  • Cardiac origin excluded


Arrhythmias

  • 48 hours free from significant arrhythmia
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHG or baseline for patient)
  • No requirement for IV medications rate/rhythm control

Syncope

  • 48 hours free from significant arrhythmia
  • 48 hours free of syncope episodes
  • Cardiac/Cerebrovascular origin ruled out
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHg or baseline for patient)

Congestive Heart Failure

  • 24 hours free of significant arrhythmia
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHg or baseline for patient)


Toxic/Metabolic Disturbance

  • 24 hours free of significant arrhythmia
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHg or baseline for patient)
  • Drug/toxin levels normalised
  • Electrolyte disturbance corrected or returned to baseline


Acute Medical Illness with Cardiac History

  • 24 hours free of significant arrhythmia
  • Haemodynamically stable (HR 60-100 bpm, Systolic BP>90mmHg or baseline for patient)

Mindray TM80 telemetry

Instructions for use: PDF

  • Skin Prep – Do not store Electrodes in theTelemetry Box
  • Preparing The TM80 Telemetry For Use
  • Admitting A Patient On The TM80 Telemetry
  • How To Print Real Time/Previous Events
  • Discharging A Patient From Telemetry

Mandatory documentation for nursing staff

  • PLEASE ENSURE YOU HAVE ADDED THE PATIENT DETAILS TO THE LOG BOOK IN WARD 5 – IF PATIENT IS DISCHARGED OR TRANSFERRED - THE LOG NEEDS UPDATED AT ALL TIMES.
  • Ensure a Rhythm strip is recorded from Ward 5 main monitor each 12 HOUR SHIFT and given to medical staff for review – this should also include a discussion / decision to continue telemetry.
  • A telemetry label should be inserted into the unitary record and completed each 12 HOUR SHIFT.

Use the enclosed Telemetry Indication list for information - Registered Nurses can make the decision to monitor a patient with Telemetry

Editorial Information

Last reviewed: 30/06/2020

Next review date: 30/06/2022

Author(s): Hall F.

Version: CAR001/003

Author email(s): fiona.hall@borders.scot.nhs.uk.

Reviewer name(s): Hall F.

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