difference cardiac rehab, cardiovascular, cardiac medicine, telemetry, Cardiovascular

turnforthenurse, MSN, NP · May 1, 2012

Cardiovascular, telemetry, and cardiac medicine are interchangeable, I think. It depends on the institution, though. Cardiac rehab units help patients recover from heart attacks, heart surgery, heart failure or procedures such as a PCI, which could include stenting or angioplasty. Physical therapy programs are included to find an exercise level tailored to the patient's needs and education is provided on how to manage their disease/illness including medications. A lot of health promotion and wellness.

A step-down unit usually refers to a telemetry unit and could be considered as an ICU step-down. Some step-down/telemetry units deal strictly with cardiac diagnoses (such as heart failure, cardiac tamponade, atrial fibrillation with RVR, etc), but of course you have to take into account patient comorbidities. Other step-down/telemetry units will admit patients for cardiac diagnoses in addition to other things (such as DKA, hyperkalemia, renal failure, acute alcohol intoxication, etc...) but the patient will or may have underlying cardiac problems. Some patients are admitted just for observation for a cardiac work-up. They may complain of chest pain but the work-up is negative and then they find out that pneumonia is causing their symptoms. There are meds given on a step-down/telemetry unit that cannot be given on a med-surg floor. For example, med-surg nurses at my hospital are not allowed to push cardiac medications IV (hydralazine, labetalol, digoxin, metoprolol, cardizem). Step-down/telemetry units may also get drips, such as nitroglycerin, cardizem or dopamine. Those are drips you see in critical care.

Esme12, ASN, BSN, RN · May 1, 2012

can you please tell me what the differences among these units? Please tell me if I am right in the way I understand them.
I am thinking telemetry unit handles all patients with telemonitoring needs. And cardiovascular is same as cardiac medicine, and they deal with patients who have heart issues or cardiac surgeries. So, for example, tele units will have post colon resection patients whereas cardiovascular or cardiac medicine will not. And I don't even know the difference between cardiac and cardiac rehab. Is cardiac rehab a cardiac step down? If so, why have a separate rehab? why don't any cardiac patients with step down need go to med surg?

The "true definition of these will vary from facility to facility and area of the country to another area of the country.

Generally speaking........

A telemetry unit is a unit that monitors all patients that require heart monitoring regardless of diagnosis. A PCU while taking care of mostly Cardiac patient also takes care of patients who require monitoring but also require more intensive care with certain drugs or drips.

Cardiovascular interferes surgical procedures involving vascular surgery from aortic repairs to open heart to carotid endarectomy. Cardiac medicine means patient with cardiac diagnosis like an Acute MI but are not requiring surgical intervention at present OR it means where the MD's offices are housed within the facility. Cardiac rehab is a physical therapy area that rehab patient post heart attacks and surgical procedures to ready them for discharge and post discharge rehabilitation post surgical/medical event. They do teaching and life style changes post cardiac event.

Cardiac patients post event or procedure tend to have their own unique events in the form of cardiac arrhythmias and that requires a specially trained staff.

GitanoRN, BSN, MSN, RN · May 1, 2012

the "true definition of these will vary from facility to facility and area of the country to another area of the country.

once again esme12, i couldn't have convey it better myself...aloha~

simonemyheart · May 2, 2012

The "true definition of these will vary from facility to facility and area of the country to another area of the country.
Generally speaking........
A telemetry unit is a unit that monitors all patients that require heart monitoring regardless of diagnosis. A PCU while taking care of mostly Cardiac patient also takes care of patients who require monitoring but also require more intensive care with certain drugs or drips.
Cardiovascular interferes surgical procedures involving vascular surgery from aortic repairs to open heart to carotid endarectomy. Cardiac medicine means patient with cardiac diagnosis like an Acute MI but are not requiring surgical intervention at present OR it means where the MD's offices are housed within the facility. Cardiac rehab is a physical therapy area that rehab patient post heart attacks and surgical procedures to ready them for discharge and post discharge rehabilitation post surgical/medical event. They do teaching and life style changes post cardiac event.
Cardiac patients post event or procedure tend to have their own unique events in the form of cardiac arrhythmias and that requires a specially trained staff.

My telemetry unit deals with all cardiac pt's. Most cardiac pt's have several other medical prm's from DM, PE, stroke, HTN, cancer, dementia, and extensive medical hx's. With that being said you are caring for more than just a cardiac pt.

I get pt's with any and all cardiac issues, drips, procedures, we get it all. We also get ICU overflow.

I think it truly depends on the facility.

Esme12, ASN, BSN, RN · May 2, 2012

My telemetry unit deals with all cardiac pt's. Most cardiac pt's have several other medical prm's from DM, PE, stroke, HTN, cancer, dementia, and extensive medical hx's. With that being said you are caring for more than just a cardiac pt.
I get pt's with any and all cardiac issues, drips, procedures, we get it all. We also get ICU overflow.
I think it truly depends on the facility.

I claified this at the begining of my psot.........

The "true definition of these will vary from facility to facility and area of the country to another area of the country.

Generally speaking........

tcvnurse, BSN, RN · May 2, 2012

In my facility:

Cardiac medicine = preop CABG, MI, ACS, chest pain, VADs, CHRers. They can do lots of drips like dopamine and stuff on the floor. Post cath, prepare for cath, and PCI's

TCV =Cardiothoracic surgery, post open heart, CEA, thoracotomies, heart and lung transplants. Very much a progressive care unit with dedicated beds for IMU/stepdown.

Tele = units that are monitored, not necessarily acute cardiac conditions

Cardiac rehab is an outpatient thing as far as I know, like physical therapy, to build up patient endurance and stamina.

wyosamRN · May 2, 2012

Generally, there are 3 phases to cardiac rehab- Phase I is done prior to discharge after initial event- MI, surgery, etc..

Phase II is generally done as an outpatient- in the case of the unit I float to, patients come in and perform prescribed exercise while being monitored on tele, with nurse assessment ongoing throughout the regimen. Education is huge- diet, exercise, medication, etc.. Phase 3 is a lower level of monitoring of the same- no tele, but we'll help them track weight and vitals, educate as needed, give them a place to exercise where they feel safe in that if they have another cardiac event, help is immediately available.

simonemyheart · May 2, 2012

I claified this at the begining of my psot.........
The "true definition of these will vary from facility to facility and area of the country to another area of the country.

Generally speaking........

Oh, my bad......I think you misinterpreted what I said.

I agreed with you. I was just elaborating on what you said not debating.

I thought what you put was good.

simonemyheart · May 2, 2012

I also think it varies on the size of facility.

Larger hospitals telemetry units often do not deal with cardiac issues all the time.

When I worked at a county facility the telemetry unit took alcoholic and drug addicts to monitor their hearts while they were "detoxing". It also took the HIV/AIDS pt's.

I work in a 115-120 bed facility so our tele unit takes anyone with cardiac issues.