Telemetry Monitor Errors

Specialties Cardiac

Published

I was in a situation the other day where the monitor on my patient was showing up to 20 PVC's per minute yet, the patient seemed fine. Then the PVC's went back down again.

When I asked about this I was told that the monitor frequently makes these kinds of errors. There were occassional PVC's but not as many as the monitor was counting. Apparently any movement by the patient could throw the machine off.

Has anybody else run into this problem? How do you deal with it?

:typing

A monitor cannot usually distinguish between artifact and movement so if someone has an "irregular" complex that mimics that of a PVC or a PAC the monitor will title as such and alert the monitor tech or nurse to review the strip. There's been many times that monitors label a rythym and are completely wrong.

LCRN

Specializes in ICU, telemetry, LTAC.

A patient scratching his leads, brushing his teeth, or snoring really loudly, can produce v-tach and/or SVT on the monitor. Sometimes the monitor can read pacer spikes as beats and hand over a false high heart rate. When in doubt, check the patient.

I agree with Indy... check the patient. Our monitors frequently are incorrect due to the patient moving about or coughing hard, etc. Check the patient and then if you have time go back and check the recording too.

I will ask the patent if they were moving around or anything, if they feel all right and then go look at the monitor again, just in case!!

Always check patient first.

The ones that are frequent flyers know that if they tap on their chest in just the right fashion, it will mimic V-tach, and they can always get a nurse to respond right away.

Specializes in Combat Support Hospital; Geriatrics.
Always check patient first.

The ones that are frequent flyers know that if they tap on their chest in just the right fashion, it will mimic V-tach, and they can always get a nurse to respond right away.

We used to do that for "fun" back in the day.[EVIL][/EVIL]

Specializes in ICU, telemetry, LTAC.

Yah. We had a guy scratch his leads for three hours once. We couldn't NOT respond, just in case. My charge nurse took her MAR's and a notebook, went into his room, sat down and did her next day MAR's for about twenty minutes or so in there. Monitor was all good, no problems. She came out, SVT.

Telemetry people were about standing on their heads and switched leads to read over and over, swearing up and down it was real SVT. EKG tech came in to work. SVT just prior to her entering the room, none while in there, SVT as soon as she came back up the hall. I took the EKG and compared it to the previous one. It was normal, no changes. That's when steam started coming out of our ears. We begged the next cardiologist we saw to interpret the many SVT strips we had piled up on the desk. He had to take a minute or so but finally said, it's really good artifact.

I so wanted to wring that dude's neck. :angryfire

Has anybody else run into this problem? How do you deal with it?

:typing

change leads, change ekg pads, decrease sensitivity on your monitor. I work in the unit, and can play with my settings on the monitor, I don't know if you can do that on telemetry.

if you know for a fact that its the pt doing it on purpose. I have ran into this before , and as kindly as you can tell them if you continue to play with your monitor and thump on your chest making it look like something is going on with youthen when something really is going on noone will know and you may end up dead. This usually does the trick , unless of course if they are confused then you have a problem.Try mittens.

Specializes in ICU/CVU.

"a false alarm is better than no alarm" -- is what i always say. just as an example, our hospital decided to get a new tele system (going from spacelabs to -name withheld out of risk of embarrasment to the new company-). it was a brand new teechnology and system they were implementing on our unit (it was installed and used at 1 or 2 ny hospitals already)

well, while i was sitting at the monitors one night, i saw a run of about 6 beats of vt go across the screen with no alarms sounding! i said to myself, "i know i just saw that, didn't i?" well, i sent the nearest nurse into the room and then i went back in to check the full disclosure of the strips. sure enough, vt in every lead.

my floor manager brought this up to the tele rep/tech and his answer? "well the first event won't alarm as it stores this as a basline for future events."

"what?!?!?!?"

this certainly left my manager and myself scratching our heads and after trying to get him to clarify what he was talking about, we gave up.

this is not the only prob we have had and are still in the process of trying to get a new system installed and this new one out. (for obvious reasons)

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