Reviewed and approved by the AAEM Board of Directors. (4/19/2020)
Recommendations:
- Insufficient data exist to support telemetry use in low-risk chest pain patients. (unchanged from 2011)
- The HEART score can identify patients at low-risk of short-term major adverse cardiovascular events. These patients are unlikely to benefit from telemetry monitoring.
- Emergency departments and inpatient units may benefit from collaboration in implementing the AHA guidelines for telemetry use for admitted patients.
Introduction:
In 2011, the Clinical Practice Committee (CPC) of the American Academy of Emergency
Medicine (AAEM) published a statement on Telemetry Bed Usage for Patients with Low Risk
Chest Pain. The high-level conclusions of this statement were:
- Insufficient data exist to support telemetry use in low-risk chest pain patients.
- Patients who are at low risk for significant 30-day morbidity and mortality and are therefore unlikely to benefit from telemetry monitoring should have a normal first set of cardiac enzymes and a Goldman risk score of zero (normal/non-diagnostic ECG plus none of the following: hypotension, rales above the bases, or pain worse than baseline angina).