Continuous ECG monitoring in hospital: part 1, indications

Continuous monitoring of the electrocardiogram (ECG) is a common intervention in people admitted to hospital, especially when the cause of admission has a cardiovascular origin. Although widely considered a simple, routine procedure, ECG monitoring requires expert knowledge and sound clinical judgement for it to be used safely. Incorrect use of monitoring equipment can result in suboptimal care, and adverse patient outcomes, including death. Patient selection, correct set-up of equipment, and careful alarm management are all important in ensuring that monitoring is conducted safely. In this article, the first of two, the indications for monitoring are discussed and evaluated. For most patients, this will be arrhythmia monitoring; however, some will have an additional requirement for ischaemia or QT interval monitoring. The practical aspects of ECG monitoring will be addressed in the second article in this series.