 |  ... FOR CARDIAC EVENT MONITORING All arrhythmias marked with an asterisk (*) will usually not be triaged until we have followed the patient with one or two succeeding follow-up transmissions (depending on the severity of SX) with intervals between 20 and 60 minutes (unless PT is highly symptomatic). Physician will not be informed by phone of EKG findings unless significant morphologies or SX are noticed... or unless patient is insistent. Triage actions will not be taken if we have been notified that certain changes listed below are chronic. Please Note: If severe or life-threatening conditions are seen, we will triage the PT first, then notify the physician. |
| ARRHYTHMIA | CALL DURING BUSINESS HOURS |
CALL AFTER BUSINESS HOURS |
|---|---|---|
| SUSTAINED SVT* SUSTAINED SB, ATRIAL FIB OR AV JUNC RHYTHM* |
HR>150 BPM HR>40 BPM |
>160 BPM <36 BPM |
| SINUS ARREST (OR REPETITIVE PAUSES OF UNCERTAIN ORIGIN)* |
HR>2.5 SECONDS | >3 SECONDS |
| SINO-ATRIAL BLOCK (3:1+ OR IF HR <50 BPM)* |
YES | YES |
| AV BLOCK II DEGREE (BOTH TYPES) IF HIGHLY SX OR NOT NOTED BY US PREVIOUSLY* |
YES | YES |
| III DEGREE AV BLOCK | YES | YES |
| HIGH DEGREE (ADVANCED) AV BLOCK INCLUDING ATRIAL FIB/FLUTTER IF V RATE <40) |
YES | YES |
| V-TACHY (ALL TYPES) W/>6 BEAT RUN OR IF HIGHLY SX OR REPETITIVE | YES | YES |
| ACTIVE VENTRICULAR ECTOPY OTHER THAN VENTRICULAR TACHY (I.E. VENTTRICULAR COUPLETS, TRIPLETS, FREQUENT ISOLATED PVC’S OR SUSTAINED BI AND TRIGEMINY) IF HIGHLY SX OR NOTED BY US PREVIOUSLY* | YES | YES |
| AIVR (ACCEL IDIOVENTRICULAR RHYTHMS) | >6 BEATS | >10 BEATS |
| VENTRICULAR ESCAPE RHYTHM | >5 BEATS | >5 BEATS |
| VENTRICULAR PARASYSTOLE IF HIGHLY SX OR NOT PREVIOUSLY NOTED W/NO SX | YES | YES |
| VENTRICULAR-FIBRILLATION | YES | NO |
| VENTRICULAR-CHAOTIC RHYTHM | YES | YES |
| HIGHLY SX INTERMITTENT INTRA-VENTRICULAR CONDUCTION DELAY | YES | YES |
| PROGRESSIVE INTRA-VENTRICULAR CONDUCTION DELAY | YES | YES |
| OBVIOUS QRST CHANGES IF SX OR NOT NOTED BY US PREVIOUSLY | YES | YES |
| ANGINA PECTORIS STRONG SX W/>-2.00MM, >+1.5MM NONE OR MILD SX W/<2.00MM. <+1.5MM |
SEE *NOTE BELOW YES YES |
SEE *NOTE BELOW YES NO |
| *NOTE: Due to the subjective nature of chest pain, each incidence will be handled on an individual basis, taking into account ST changes, quality and quantity of pain, related SX (such as diaphoresis, radiating pain, nausea, etc.) We may also institute such maneuvers as deep inspirations, observing any changes, anti-acids, noting any changes, etc. | ||
| PACEMAKERS: ANY INDICATION OF “UNSAFE PACING,” PACEMAKER INDUCED TACHY | YES | YES |
| PLEASE NOTE: CHANGES TO THE ABOVE PROTOCOL MAY BE MADE BY MAKING NOTE OF THE CHANGES DESIRED AND RETURNING THE PROTOCOL SHEET TO THE MONITORING CENTER. | ||
PO Box 307
Glenelg, MD 21737
1-800-551-4354
FAX: 410-442-3610
