Choosing Wisely:

Don’t order continuous telemetry monitoring outside of the intensive care unit without using a protocol that governs continuation.

Rationale and Comments: Telemetric monitoring is of limited utility or measurable benefit in low-risk cardiac chest pain patients with normal electrocardiogram. Published guidelines provide clear indications for the use of telemetric monitoring in patients, which are contingent upon frequency, severity, duration, and conditions under which the symptoms occur. Inappropriate use of telemetric monitoring is likely to increase cost of care and produce false positives potentially resulting in errors in patient management.
Sponsoring Organizations:
  • Society of Hospital Medicine (Adult)
  • Sources:
  • ACC/AHA guidelines
  • Disciplines:
  • Cardiovascular
  • References: • Drew BJ, et al. Practice standards for electrocardiographic monitoring in hospital settings. Circulation. 2004;110:2721-46.
    • Crawford MH, et al. ACC/AHA guidelines for ambulatory electrocardiography. Circulation. 1999;100:886-93.
    • Snider A, et al. Is telemetry monitoring necessary in low-risk suspected acute chest pain syndromes? Chest. 2002;122:517-23.
    • Marshaleen N, et al. Is telemetry overused? Is it as helpful as thought? Cleve Clin J Med. 2009;368-72.
    • Adams HP Jr, et al. Guidelines for the early management of adults with ischemic stroke. Stroke. 2007;38(5):1655-711.

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