SHM Converge Scientific Abstract ePoster Gallery-Telemetry Monitoring Trends During Covid-19 Pandemic: An Observational Study

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This observational study examined telemetry use in COVID-19 patients admitted to Emory University Hospital Midtown during July 2020, a peak period of the pandemic. The goal was to understand telemetry ordering patterns, reasons for monitoring, duration of monitoring, troponin elevation, and whether telemetry helped identify patients who clinically worsened and required ICU transfer.<br /><br />A total of 161 COVID-19 encounters with telemetry orders were reviewed. Telemetry duration varied, with most patients monitored for 36 hours (52%), while 14% were ordered for 72 hours and 34% had “do not remove” monitoring. The average telemetry duration was 3.08 days, compared with an average hospital length of stay of 9.96 days.<br /><br />The study found that telemetry indications were often poorly documented or nonspecific, with “COVID” frequently listed as the reason in free text. Troponin elevation occurred in some patients, but telemetry rarely changed management. Only one encounter (<1%) involved detection of an arrhythmia that led to escalation of care.<br /><br />There were 29 ICU transfers among the 161 patients. In 86% of these cases, the reason for ICU transfer was hypoxic respiratory failure. Telemetry data was not mentioned in most of these transfers. Other ICU transfer causes included NSTEMI, worsening heart failure, new atrial fibrillation, and pulmonary embolism, each accounting for one case.<br /><br />Overall, the study suggests that telemetry may have been overused in hospitalized COVID-19 patients as a tool for detecting deterioration. The authors propose that continuous pulse oximetry may be more useful than cardiac telemetry for monitoring COVID-19 patients at risk of decompensation.

Asset Subtitle

Patricia Hwang

Meta Tag

Author List Patricia Hwang, Tanya Khasnavis, Viniya Patidar

Category Research

Concept Telemetry Monitoring

Concept COVID-19

Concept Cardiac Arrhythmia

Concept Clinical Deterioration

Concept Hospitalization

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine/ Division of Hospital Medicine

Presenting Author Patricia Hwang

Track Value in Hospital Medicine

Keywords

COVID-19

telemetry

Emory University Hospital Midtown

ICU transfer

troponin elevation

arrhythmia

hospitalized patients

observational study

continuous pulse oximetry

hypoxic respiratory failure

Telemetry Monitoring

COVID-19

Cardiac Arrhythmia

Clinical Deterioration

Hospitalization