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At least 19 recordsLinked to original sources
PubMed1984

Long-term supervised domiciliary EEG monitoring in epileptic patients employing radio telemetry and telephone telemetry. II. Radio telemetry system.

A miniaturized 8-channel EEG amplifier- submodulator unit is used in combination with a standard radio transmitter/receiver system for long-term ambulatory EEG recording at the patient's residence. The EEG frequency response (0.16-30 Hz) and amplitude range (1:1000) of the system are in accordance with the object in view, the recording of seizures. The submodulator characteristics conform to regulations for radio telemetry.

Electroencephalography↗
PubMed1984

Long-term supervised domiciliary EEG monitoring in epileptic patients employing radio telemetry and telephone telemetry. I. Telephone telemetry system.

A PCM system provides digital transmission of 8 EEG channels over conventional voice graded telephone lines. Transmission of the EEG from the patient's residence to the clinical centre enables the use of existing monitoring facilities for carrying out continuously supervised long-term domiciliary EEG monitoring. Secondary channels simultaneously enable exchange of information for quality and performance control. The ease of use and the flexibility of the public telephone system enable recording from almost any place desired.

Electroencephalography↗
PubMed1989

Design dependent loss of telemetry: uplink telemetry hold.

Bidirectional telemetry in cardiac pacing is the ability of the programmer to communicate with the pacemaker and vice versa. It is an essential capability if one is to interrogate the pacemaker as to its programmed parameters and to access the diagnostic capabilities incorporated in the present generation pacemakers. Pacemaker to programmer telemetry capability was lost in two Medtronic SymbiosR pacemakers due to a design eccentricity termed "uplink telemetry hold". It is initiated by a complex sequence of spontaneous sensed and internal timing events, once activated it cannot be reversed in the clinical setting. It is potentially dangerous in that the subsequent application of a magnet over the pacemaker can result in total output inhibition. The initiating sequence of events included activation of the "cancel magnet" command. If that command is not activated, "uplink telemetry hold" cannot occur. Once telemetry uplink hold does occur, the pulse generator should be replaced.

Equipment Design↗
PubMed2000

Same-day transfer of patients to the cardiac telemetry unit after surgery: the Rapid after Bypass Back into Telemetry (RABBIT) program.

Early data from this project suggest that the RABBIT program fulfilled the process improvement goals of decreasing costs of cardiac surgery and maintaining high quality. Decreased cost was achieved by decreasing time to extubation and decreasing length of stay in the ICU and the total length of stay in the hospital. The cost savings were achieved without compromising the quality of care, which was assessed by measuring rates of readmission to the ICU and to the hospital and by surveying patients about their level of satisfaction. The success of the RABBIT program can be attributed to several factors. First, members of the cardiac surgery quality improvement team worked well together to solve problems and overcome obstacles, particularly after the pilot program. Second, naming the program helped to motivate staff, physicians, and patients. Outcome data was shared with the staff quarterly, and successes were celebrated. Finally, the use of a facilitator early in the process to establish the process with the surgeons and the staff was invaluable. Opportunities for continued improvement include resolving operational difficulties related to availability of beds and staffing, continuing work with physicians in changing practice patterns, increasing efficiency in scheduling operating rooms, and adjusting the preoperative education provided to patients and their families about the length of stay to expect. Quarterly outcome analysis continues, with reports to the cardiac surgery quality improvement team. The team continues to explore creative solutions to the aforementioned issues, as the goal of having 25% of patients who undergo cardiac surgery be transferred to the CTU on the day of surgery has remained elusive.

Coronary Artery Bypass↗
PubMed1998

Telemetry outside critical care units: patterns of utilization and influence on management decisions.

BACKGROUND: Guidelines for the use of telemetry in hospitalized patients have been proposed by the American College of Cardiology (ACC). However, there have been only a few studies which have investigated the usefulness of these guidelines in clinical practice. HYPOTHESIS: This study assessed the role of telemetry in the decision making process outside the critical care units. METHODS: The observational study, lasting 4 weeks, was conducted in the telemetry unit of a tertiary care teaching hospital and included 61 male patients (age range 40-61 years). They had been directly admitted to the telemetry unit or transferred from a critical care unit and were followed for as long as telemetry was active. Indication for telemetry and the contribution of telemetry to management decisions were assessed by a physician not involved in the care of the patient. RESULTS: Cumulative number of telemetry days was 379 with a mean of 6.2 days per patient. Total number of telemetry events was 297. According to the ACC classification, 14 patients (22.9%) had class I indication, 21 patients (34.4%) had class II indication, and 26 patients (42.6%) had class III indication. Telemetry events were seen in 18.2% of class I patients, in 39.7% of class II patients, and in 42.1% of class III patients. Only 12 telemetry events (4%) resulted in patient management, with none belonging to class III. CONCLUSION: Telemetry findings in patients outside the critical care units are not usually responsible for major therapeutic changes. The value of telemetry in such patients may be overrated.

Adult↗
PubMed1995

Role of telemetry monitoring in the non-intensive care unit.

To determine the outcomes of patients admitted to a non-intensive care telemetry unit and to assess the role of telemetry for guiding patient management decisions, data from 2,240 patients admitted to a telemetry unit were collected prospectively during 7 months. Physicians recorded the outcomes (intensive care unit transfer and mortality) and assessed whether telemetry assisted in guiding patient management. Indications for admission to the telemetry unit included chest pain syndromes (55%), arrhythmias (14%), heart failure (12%), and syncope (10%). Telemetry led to direct modifications in management in 156 patients (7%; 95% confidence interval [CI] 5.9% to 8%). Telemetry was perceived as useful but did not alter management for 127 patients (5.7%; 95% CI 4.7% to 6.6%). Two hundred forty-one patients were transferred to an intensive care unit from the telemetry unit (10.8%; 95% CI 9.5% to 12%). Nineteen patients (0.8% of all admissions; 95% CI 0.5% to 1.2%) were transferred because of an arrhythmia identified by telemetry. Routine transfer after cardiac revascularization or surgery accounted for 134 transfers; clinical deterioration accounted for 88 transfers. There were 20 deaths in the unit (0.9%; 95% CI 0.5% to 1.3%): 4 of the 20 deaths occurred while patients were being monitored. The role of telemetry in guiding patient management may be overestimated by physicians, since it detected significant arrhythmias that led to change in medications or urgent interventions in a small fraction of patients.

Aged↗
PubMed1985

The effect of telemetry on urban prehospital cardiac care.

A three-year, controlled trial of the use of telemetry in the prehospital care of cardiac patients was conducted in a major metropolitan area. Five of the ten paramedic squads in the city used telemetry; the other five squads did not. We studied the effect of telemetry on the following: paramedics' abilities to recognize ECGs in a written test; paramedics' abilities to identify ECG arrhythmias in the field; length of time spent by paramedics in the field; survival rates of patients with ventricular fibrillation (VF) cared for by paramedics; abilities of base station physicians to interpret telemetered ECGs; and attitudes of paramedics toward using telemetry. Telemetry was not found to affect the abilities of paramedics to read ECGs in either test or field situations. Paramedics who used telemetry spent more time in the field with their patients than did paramedics who did not use telemetry (P less than .02). We found no statistically significant effect of telemetry on survival rates of VF patients. Using matched ECGs, readings by base station physicians were found to be more accurate than were those by paramedics (P less than .01). Paramedics overwhelmingly reported that telemetry did not help them to save patients' lives, but that it did help them to treat patients with certain arrhythmias. The results suggest that telemetry may not improve either paramedics' abilities to identify arrhythmias or prehospital care for all cardiac patients. The implications for emergency services researchers are discussed.

Allied Health Personnel↗
PubMed2003

The use and effectiveness of electrocardiographic telemetry monitoring in a community hospital general care setting.

UNLABELLED: The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort study on 1097 telemetry admissions between January 1, 2000 and March 31, 2000. A convenience sample of 218 patients generated 236 telemetry admissions. One-hundred-sixty-two arrhythmic events were detected during 400 "indicated" telemetry days. Nine arrhythmic events were detected during 345 "not indicated" telemetry days. The relative rate for arrhythmic events was significantly different, at P < 0.0001, with the incidence rate ratio of 15 indicating a very large effect size. Consequently, current use of ECG telemetry may not be optimal, and a prospective analysis of the application of rigorous indications for ECG telemetry needs to be undertaken. IMPLICATIONS: The application of standard criteria to electrocardiogram telemetry admissions found that the majority of abnormal heart rhythms were found when patients met appropriate criteria.

Aged↗
PubMed1982

The monitoring of labor by telemetry.

Telemetry and conventional cardiotocography were compared by monitoring the labor of 60 patients with an uneventful pregnancy and delivery in the 38th-42nd week of pregnancy. 31 patients were monitored by telemetry and 29 by cardiotocography. The patients were matched for age (+/- 5 years), duration of pregnancy (+/- 7 days) and parity (I or II). The husband attended labor and delivery in 42% of the cases in the telemetry group and in 59% of the cases in the control group. Induction of labor by amniotomy was performed in 32% of the cases in the telemetry group and in 24% of the cases in the cardiotocography group. The patients monitored subjective pain every half hour during the opening phase. The telemetric patients were encouraged to sit or walk during the first stage. No maternal or fetal complications occurred. All infants were born in good condition with APGAR scores greater than or equal to 7 recorded at one and five minutes. There were 4 operative deliveries in the telemetry group and 5 in the control group. Indications for these were maternal or uterine exhaustion with the exception of two control patients where fetal asphyxia was suspected. The duration of the first stage of labor did not differ significantly between the telemetry and the cardiotocography groups. The telemetric patients received less analgesics than the controls but this difference was not significant. In spite of less analgesia in the telemetry group, the secondparas of the telemetry group experienced significantly less (p less than 0.01) labor pain than the controls. In addition, the secondparas of the telemetry group considered the present labor less painful than the previous one significantly more often than the controls. Among the primiparous patients there was no difference in the amount of pain experienced by the patients.

Adult↗
PubMed1994

Outcomes of patients hospitalized to a telemetry unit.

To describe the clinical course of patients admitted to a nonintensive care telemetry unit and to determine whether telemetry identifies patients at risk for transfer to the intensive care unit (ICU), 467 patients hospitalized for cardiac monitoring in a nonintensive care telemetry unit were followed until death or discharge. The American College of Cardiology guidelines for telemetry use were applied: 65% of patients were class I (monitoring definitely indicated); 33% class II (probably indicated); and 2% class III (not indicated). In 5 patients (1%), telemetry contributed to the decision for a transfer to the ICU. In 462 patients, telemetry added no significant information. Thirty-eight patients (8.1%) were transferred to an ICU: 22 because of cardiac deterioration and 16 because of noncardiac clinical deterioration. Eighteen percent of patients in class I (95% confidence interval [CI], 14.1 to 22.8), 12% in class II (95% CI, 6.7 to 17), and none in class III (95% CI, 0 to 26) were transferred to the ICU (p = 0.03). Nine patients died (1.9%), 4 with terminal illness. Three patients died while on telemetry: 1 had metastatic lung cancer and 2 died suddenly of cardiac causes during initial evaluation on the ward. Telemetry identified the terminal rhythm in the 3 patients. Patients admitted to a non-ICU monitored ward with ischemic syndromes, heart failure, and arrhythmia rarely deteriorated. Patients who did deteriorate were recognized clinically without appreciable contribution from the monitoring process. It remains unproven that heart rhythm monitoring in general practice units improves patient care.

Arrhythmias, Cardiac↗
PubMed2002

A nurse practitioner intervention model to maximize efficient use of telemetry resources.

BACKGROUND: Telemetry monitoring is widely used in hospitals; the importance of being able to monitor and examine dysrhythmias has been universally accepted. Yet it is often used for patients who do not actually require this technology. A model to improve the efficiency of telemetry use entailed the use of an advanced practice nurse (APN; identical to a nurse practitioner) to provide concurrent review and intervention of floating telemetry, which is available for patients independently of the floor location and who do not need an intensive care unit bed. ADDRESSING OVERUSE: The demand for floating telemetry at Hackensack University Medical Center had equaled or exceeded the telemetry availability virtually 100% of the time, even after local guidelines had been disseminated in 1998. The APN carried out concurrent monitoring and intervened with the attending physician when patients were on telemetry for longer than 48 hours and did not meet the local telemetry guidelines. RESULTS: The mean number (standard error [SE]) of hours per patient declined from 65.2 +/- 0.7 hours (95% confidence interval, 63.8 to 66.6 hours) for the 11 months before the intervention to a mean of 49.6 +/- 0.4 hours (95% confidence interval, 48.7 to 50.2 hours) for the 29 months after intervention--representing a decrease of 34% (p < 0.0001). This decrease led to an increase in the number of patients per month put on telemetry. DISCUSSION: The APN model, an aggressive approach that induced change almost immediately, was then applied to other quality improvement projects.

Adult↗
PubMed2000

Continuous electrocardiographic monitoring and cardiac arrest outcomes in 8,932 telemetry ward patients.

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.

Aged↗
PubMed2002

Ambulatory telemetry systems.

Ambulatory telemetry systems allow patients to move around the hospital while certain physiologic parameters are monitored. Traditionally, telemetry systems have used compact transmitters worn by the patient to take readings and transmit them to a central station. More recently, to expand telemetry's capabilities without adding excessive size and weight to the patient-worn transmitters, some suppliers have provided certain parameters using small wireless portable bedside monitors that are wheeled around on a roll stand by the patient. In this Evaluation, we judge the capabilities of 18 telemetry systems--14 that are intended for general telemetry use, 2 that are designed specifically for use in cardiac rehabilitation programs, and 2 that are marketed for both applications. For the general systems, we looked for the ability to provide electrocardiogram, pulse oximetry, and noninvasive blood pressure measurements as needed without making the patient transmitter too big and heavy for practical use. Cardiac rehab systems generally need to provide only ECG readings, so our ratings focus principally on patient comfort and the appropriateness of the systems' capabilities for this application. We also revisit some of the issues surrounding telemetry transmission techniques: Whether it's better to operate in the new Wireless Medical Telemetry Service (WMTS) frequencies than in the Industrial, Scientific, and Medical (ISM) bands, and whether bidirectional transmissions provide better telemetry capabilities than unidirectional ones.

Blood Pressure Monitoring, Ambulatory↗
PubMed2002

Sensitivity of rhythm disturbance detection by community hospital telemetry.

Telemetry is done in a variety of settings with different levels of sophistication. The American College of Cardiology has made suggestions for telemetry monitoring but these are not in place in many smaller community hospitals that do telemetry monitoring. The objective of this study was to compare prospectively telemetry without a dedicated monitor watcher or full disclosure to results obtained on full disclosure. Patients included were admitted to a single community hospital with an indication for telemetry as judged by their primary physician. Telemetry results reported by the hospital staff were compared to over-read of full disclosure traces by an academic cardiology service and the patient was used as his own control. Significant rhythm disturbances including pauses of 2 seconds or greater and short runs of ventricular and supraventricular tachycardia were frequently missed when a dedicated monitor watcher and full disclosure were not in use. When a dedicated monitor watcher and full disclosure are not in use, telemetry results should be accepted with caution and attempts should be made to improve monitoring.

Aged↗
PubMed1981

Evaluation of Corometrics 315 telemetry system for fetal monitoring.

The Corometrics 315 telemetry system is a commercially available unit which can transmit both fetal heart rate (FHR) and intrauterine or external pressure data to a standard fetal monitor. This system was evaluated in 40 patients, ten of whom were monitored simultaneously by telemetry and direct-wire fetal monitoring. Because of some differences in electronic engineering between the telemetry and direct fetal monitoring systems, the following differences were found: Comparison of the simultaneously obtained FHR recordings revealed that the telemetry system rejected most of the motion artifacts while maintaining true variability. There were no differences as regards readability, FHR, and beat-to-beat variability. The intrauterine pressure values were the same, although the telemetry system gave a smoother waveform with less motion artifact. The main advantages of the telemetry system were found to be: (1) The patient was free to move about and ambulate during labor. (2) It was possible to obtain uninterrupted monitoring while the patient was moved from the labor room to the delivery room and throughout the second stage of labor.

Evaluation Studies as Topic↗