BALTIMORE, MD – Suffering potentially anything from low batteries to a life-threatening cardiac arrhythmia, a hospitalist at The Hoppin’ Johns Hospital in Baltimore is playing it safe by placing his patient’s telemetry box on tele for at least 24 hours though it more likely will remain on for the entirety of the hospitalization.
“We could simply test out new batteries on the telemetry box, but that just doesn’t seem as satisfying,” explained hospitalist Lucius Williams, watching as an ECG tech places no less than 230 leads onto the tele box. “This is modern medicine. We don’t check pulses, we place everyone on tele. So why should I check its battery? I’m placing it on tele. That’s ludicrous. Maybe it has syncope. Maybe I should order an echo. I’ll order an echo.”
Williams is notorious for thinking outside of the box, which interestingly in this case involved looking inside of a box. For example, he once drew stat labs on his patient’s phlebotomist.
“We might have to cath this little guy,” Williams said. “It really is the only way to truly know.”
“Who me?” asked Williams’ patient with the tele box on tele. He seemed a bit nervous, understandably so.
“Oh no, not you sir, you’ve already been ruled out for any evidence of cardiac chest pain,” Williams reassured his patient. “I’m talking about the monitor on your chest. That monitor needs more of a cardiac work-up.” Williams takes a few seconds to auscultate the box. “The lack of heart sounds in this thing is very, very concerning.”
Troponins are pending.
