Well, things Escalated quickly...
The patient is transmitting, but battery is low. How long do I wait to call a telemetry alert?
5 minutes of no resolution
A patient’s rhythm stops transmitting. You call the primary nurse, but after 5 minutes you still have no resolution. What is your next action?
Tele Alert
True or False. I can leave blank spaces on my documentation log.
False! (If you didn't document it, you didn't do it)
My patient's rhythm changed from sinus tach to V-Fib. What is my next step in escalation?
Call Code Blue. This is a lethal rhythm.
How many minutes should a monitor be applied from the order?
30 minutes
My patient just converted to Afib RVR. What do I do first?
Call primary nurse.
You see a new non-lethal rhythm change. You attempt to reach the primary nurse but cannot. Who is next in the escalation pathway?
Charge nurse
A nurse calls back and tells you the patient has been assessed and is stable. What is your responsibility before you consider the alarm resolved?
Document the notification/communication through the facility-approved pathway and notification log.
Your patient has a 32-beat run of ventricular tachycardia. What do you do first?
Immediately activate a Code Blue. Policy defines >30 beats of VT as a potentially lethal rhythm.
True or False. My algorithm is posted and easily visible.
True! (Above monitors in CMS and ED)
Patient was reading artifact and I couldn't read the rhythm. No one is not answering. How long to I wait to call a Tele alert?
5 minutes
When is it appropriate to call the PCT first during the escalation process?
Transmitting, but risk of losing signal. (Low battery, artifact or lead off)
A patient is being discontinued from telemetry. The unit tells you the monitor is off and sends the box back. What documentation item specifically needs to be entered into the EHR as part of discontinuation?
The monitoring STOP time.
You identify a potentially lethal rhythm, activate the Code Blue through the operator. Now what?
Notified RN. Document!
True or False. Patients with active telemetry orders should not be removed from telemetry unless they have an order for pause.
True! Please ensure the patient has an order, remind nurse, and document.
A patient's monitor shows LEAD OFF, but you can still see their rhythm. You notified the nurse 3 minutes ago. Suddenly, you completely lose the rhythm. Do you wait the remaining 2 minutes?
Yes, they have 5 minutes to correct before calling a tele alert.
My patient went to CT. I haven't gotten notification that they have returned to their room, and I see a lethal rhythm. Where do I call the Code Blue to?
CT (Last known location)
One of your patients will not keep tele box on and nurse says they are refusing. What do you do?
Document on your log and refusal log. Assure with RN that patient is able to refuse. (Not confused)
Your patient has had a second-degree block and maintaining a HR of 50 but now appears to have a 3rd degree block with a HR of 30. What is your next move?
Call Code Blue
Unless explicitly ordered otherwise by a provider, how should cardiac arrhythmia and heart-rate alarms be maintained?
ON and always audible, Brady alarm <45., Tachy >150
You have called a tele alert after waiting 5 minutes and you still don't have a resolution after another 5 minutes. What do you do next?
Call a tele rapid.
I received an order for CCM. Who do I call?
Radio to ED staff
I have a patient on the monitor with a CCM order. I received an "Initial Tele" order. What do I document?
Complete ED admits log and document start time in Meditech.
Name the four potentially lethal rhythms specifically identified in the Monitor Tech escalation policy.
Sustained ventricular tachycardia, ventricular fibrillation, new-onset third-degree heart block, and asystole.
When admitting a patient to the monitor, the nurse and monitor tech must verify what?
Two patient identifiers, room and bed number, and tele box number