Telemetry bed usage for patients with low-risk chest pain: review of the literature for the clinician.

BACKGROUND Telemetry monitoring in patients with low-risk chest pain is highly utilized, despite the lack of quality data to support its use. STUDY OBJECTIVES To review the medical literature on the utility of telemetry monitoring in patients with low-risk chest pain and to offer evidence-based recommendations to emergency physicians. METHODS A PubMed literature search was performed and limited to human studies written in English language articles with keywords of "telemetry" and "chest pain." Studies identified then underwent a structured review from which results could be evaluated. RESULTS There were 114 paper abstracts on telemetry monitoring screened; 30 articles were considered relevant. Twelve appropriate articles were rigorously reviewed and recommendations given. CONCLUSIONS Insufficient data exist to support telemetry use in low-risk chest pain patients. Telemetry monitoring is unlikely to benefit low-risk chest pain patients with a normal/nondiagnostic electrocardiogram, a normal first set of cardiac enzymes, and none of the following: hypotension, rales above the bases, or pain worse than baseline angina.