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Physicians Requesting 12-lead Telemetry Monitoring for Patients at Halifax Medical Center

MILWAUKEE, Wis. USA,
27 April 2001

Halifax Medical Center, located in Daytona Beach, Florida has served the surrounding community for over 70 years. The facility has grown over that time from a modest 28 beds to over 550 beds today. In November 1997, a cardiac surgery program was initiated and since that time, the hospital also added a second cardiac catheterization lab. The cardiac surgery program, combined with the cardiac cath lab expansion, has increased the need for monitored beds at Halifax. To support this growth, Halifax has adopted technology solutions which positively impact both clinical outcomes and patient length of stay.

Halifax Medical Center’s DOC (Diagnostic Outpatient Cardiology) Unit provides care for a variety of cardiac patients. These include pre- and post-cardiac cath and intervention patients, chest pain patients from the emergency room, and patients with new onset atrial fibrillation. This patient population is excellently served by 12-lead telemetry monitoring, which provides minute to minute discoverable 12-lead documentation as well as continuous ST segment templating in all or selected leads. The 12-lead telemetry technology lends itself exceptionally well to the interventional patient, revealing changes in the ECG sometimes before a patient has clinical symptoms. This facilitates the earliest possible intervention and preservation of myocardium.

In evaluating which telemetry technology to implement, Dr. Don Stoner (Medical Director) and Lori Myers (Nurse Manager) required a system that could provide the greatest information, accurately, in a user friendly presentation. The capability of choosing 12-lead or 7-lead acquisition with the same transmitter provided incredible flexibility for an ever changing clinical environment. Regarding the importance of 12-lead monitoring, Lori noted "There is the ability to readily assess all electrical areas of the heart in a continuous mode. This provides excellent documentation and therefore treatment of patients. Physicians appreciate the clinical changes when we are able to back them up with the 12-lead documentation."

Halifax was not unfamiliar with Mortara Instrument’s 12-lead telemetry technology which is incorporated in the Datex-Ohmeda S/5 Telemetry System. As users of Mortara Instrument’s X-Scribe wireless stress testing system, the Halifax staff were already familiar with the diagnostic quality 12-lead capability of the X-12 telemetry transmitter.

Since the installation of the S/5 Telemetry System, the DOC unit has observed multiple instances where the 12-lead capability of the system provided additional information, facilitating more efficient care thus better outcomes for patients.

CASE 1

Patient presented from the cath lab. An angioplasty of the RCA had been performed. Several hours after the procedure the ST segment alarm sounded. There were changes in the inferior leads. When the patient was assessed he denied any discomfort for the first 20 minutes. During that time the physician was notified, the 12-lead from the system was faxed to him and the patient was taken back to the lab. It was not until the patient was in the cath lab that he acknowledged any discomfort. The RCA had closed to 99%, it was subsequently stented and the patient was discharged home the next day. The physician stated that the monitoring system saved the patient from a very large MI.

CASE 2

A patient was admitted from the cardiologist office. The admitting diagnosis was PSVT, causing syncopal episodes. The patient arrived on the DOC unit at 1100, she was placed on 12- lead telemetry. The initial rhythm was sinus. At 1300 while standing at the nursing station her monitor began to alarm and at the same time she identified that she was not feeling well. The 12-lead monitor revealed a third degree heart block with a rate of 36. We immediately stabilized the patient and notified the physician. We faxed the EKG from the system, the patient went to the OR at 1700 and had a permanent pacemaker placed. She did well and was discharged the next day. Once again, the technology in place allowed for accurate and immediate intervention.

CASE 3

A patient presented from the ER with new onset atrial fibrillation. The patient was symptomatic SOB, and a lower than his normal BP. Once 12-lead monitoring had been established it was identified that the patient was actually going in and out of atrial flutter and fib. At this point, the cardiologist decided to immediately cardiovert the patient to avoid any thrombotic complications. The patient underwent electrical cardioversion successfully. He was monitored for an additional 4 hours and then discharged home the same evening. The physician identified that had the patient been on a simple 2-lead system that the changing rhythm would not have been picked up. Stating further that it could have been a very devastating patient outcome.

"Today we have physicians specifically requesting that their patients be admitted to the DOC unit for 12-lead telemetry monitoring. Being a part of positive patient outcomes has continually boosted the enthusiasm that the staff have for this new technology. We look forward to expanding it to other areas in our facility."

About Mortara

Mortara Instrument's headquarters are located in Milwaukee, Wis., with European operations based in Bologna, Italy. Mortara Instrument is distinguished in the field of non-invasive cardiology for the innovations that are the core of the company's complete line of ECG products. These product innovations include the integration of 12-lead ECG technology in bedside monitoring, wireless stress testing, Holter and telemetry monitoring systems. The company's web site is www.mortara.com.