Taking Telemetry Out of the Hospital Improves Outcomes, Reduces Alarm Fatigue

A new study suggests the use of an off-site cardiac telemetry central monitoring unit (CMU) could improve telemetry alarms for non-intensive care unit patients and reduce the number of monitored patients—without increasing cardiopulmonary arrest events.

The study, published August 2 in the Journal of the American Medical Association, studied all non-intensive care unit patients at Cleveland Clinic and three other regional hospitals over a period of thirteen months. An off-site CMU applied "standardized cardiac telemetry" for 99,048 patients during that time.

The Data

Among the study's population, emergency response team (ERT) activation occurred for 3,243 patients. 979 of those patients had rhythm or rate changes occurring up to one hour prior to the ERT activation. The CMU detected and provided accurate notification for 772—or 79 percent—of those events, according to the study's abstract.

For 105 patients, the CMU provided "discretionary direct ERT notification" for events requiring urgent clinical intervention, reads the abstract. Slightly more than one in four of those patients went on to experience cardiopulmonary arrest events—27 patients, or 26 percent. Return to circulation was achieved in 25 of those patients, or 93 percent.

Telemetry standardization also reduced the number of patients monitored by 15.5 percent per week through eliminating low-risk patients.

How the Central Monitoring Unit Works

The study's model used one monitoring technician to provide continuous cardiac monitoring for up to 48 patients, providing blood pressure, pulse oximetry, and respiratory rate notifications on request, according to the JAMA media release. A lead technician also provided oversight and supervision for real-time rhythm interpretation.

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“Absorb” Approved; Bioresorbable, Drug-coated Stent to Roll Out “in a Phased Way”

Yesterday, the Food and Drug Administration approved Abbott's Absorb stent, the first fully dissolving stent to be approved by the FDA.

A 10-person FDA advisory panel, including Dr. George Vetrovec of Virginia Commonwealth University, voted unanimously in March to affirm that the stent's benefits and efficacy outweigh its risks. The same panel voted 9-1 in favor of its safety profile, despite the risk of blood clots for some patients.

"This is presumably a better technology going forward - at least that's the theory - but it will take years to prove," said Vetrovec to the Associated Press.

FDA approves Absorb with advisory panel warning

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Is heart failure over-diagnosed? and other stories

Is heart failure over-diagnosed?

A common problem in elderly men, obstructive uropathy, can look a lot like heart failure.

When pulmonary edema is present, heart failure is often the "scapegoat" says Melissa Walton-Shirley, MD in a commentary on Medscape. Approaching heart failure with "an air of skepticism" might help.

I've seen a handful of obstructive uropathy cases masquerading as heart failure in elderly men in recent years. I shudder to think how many times I've missed it. I suspect that it's not just men who suffer. Some of our female patients with "diastolic dysfunction" and overflow incontinence seem to suffer from backpressure that finds its way into the pulmonary vasculature.

Melissa Walton-Shirley, MD
Read more on Medscape.


NYU Langone tests new transcatheter device.

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New cardiology-specific EHR & diagnostic software suite unveiled

In March, the Cardiovascular Institute of the South (CIS), a multi-center and high volume cardiology practice in Louisiana, completed system-wide implementation of a brand new cardiovascular information system.

The cardiovascular information system is a stage 2 meaningful use certified electronic health records (EHR) solution that comes complete with 15 diagnostic test suites across invasive and non-invasive cardiology.

The kicker for CIS? It was designed by two CIS cardiologists, Vinod Nair, MD and Peter Fail, MD with input from their entire team.

Nair and Fail are the chief officers of Objective Medical Systems (OMS) and recently unveiled their cardiology software suite at the American College of Cardiology's 65th Annual Scientific Session & Expo.

Frustrated with usability and workflow? Try specialty-specific.

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