Chen Esther H, Hollander Judd E
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
J Emerg Med. 2007 Jul;33(1):53-60. doi: 10.1016/j.jemermed.2007.01.017. Epub 2007 May 30.
Non-intensive telemetry units are utilized for monitoring patients at risk for life-threatening dysrhythmias and sudden death. Physicians often use monitored beds for patients who might only require frequent nursing care. When 70% of the top 10 diseases admitted through the emergency department (ED) are clinically indicated for telemetry, hospitals with limited resources will be overwhelmed and admitted patients will be forced to wait in the ED. We examine the evidence behind admitting patients to telemetry. There is evidence for monitoring in patients admitted for implantable cardioverter-defibrillator firing, type II and complete atrio-ventricular block, prolonged QT interval with ventricular arrhythmia, decompensated heart failure, acute cerebrovascular event, acute coronary syndrome, and massive blood transfusion. Monitoring is beneficial for selected patients with syncope, gastrointestinal hemorrhage, atrial tachyarrhythmias, and uncorrected electrolyte abnormalities. Finally, telemetry is not indicated for patients requiring minor blood transfusion, low risk chest pain patients with normal electrocardiography, and stable patients receiving anticoagulation for pulmonary embolism.
非强化遥测单元用于监测有危及生命的心律失常和猝死风险的患者。医生通常会为那些可能仅需要频繁护理的患者使用监测病床。当通过急诊科（ED）收治的前10种疾病中有70%临床上需要遥测时，资源有限的医院将不堪重负，收治的患者将被迫在急诊科等待。我们研究了将患者收治入遥测病房背后的证据。有证据表明，对于因植入式心脏复律除颤器放电、II型和完全性房室传导阻滞、伴有室性心律失常的QT间期延长、失代偿性心力衰竭、急性脑血管事件、急性冠状动脉综合征和大量输血而入院的患者，需要进行监测。监测对某些患有晕厥、胃肠道出血、房性快速心律失常和未纠正的电解质异常的患者有益。最后，对于需要少量输血的患者、心电图正常的低风险胸痛患者以及接受抗凝治疗的稳定肺栓塞患者，不需要进行遥测。
