i-Care / Telemetry Guidelines

• On GIM wards we have higher acuity beds available on Unit 5D3 WMC

• Senior residents and ED consults attending physicians will be triaging patients in emergency to determine whether patients need to be admitted to these beds 

• Patients can also be transferred/swapped between units to i‐Care or telemetry beds if deemed necessary 

General indications for i‐Care / telemetry patients include SEVERE cases of: 

• ACS (if not a candidate for revascularization or CCU (M1 or lower GOC) 

• Diabetic ketoacidosis

• EKG changes (acute cardiac arrhythmias, prolonged QT) 

• Electrolyte disturbances o GI bleed (active) 

• Hemodynamic instability (sepsis) 

• Syncope (with high risk features) 

• Medications requiring monitoring (hypertensive emergency/urgency, cardiac arrhythmias) 

• Neurologic instability (TIA, stroke (nonthrombolysis treated); Alcohol withdrawal, agitation requiring high doses of sedation

• Respiratory failure (severely hypoxic or hypercarbic, requiring BiPAP) 

Physician Responsibilities 

All patients admitted to i‐Care or telemetry beds will be on 5D3 WMC (currently 6 beds) and under the care of the attending physician and medical team assigned to CTU-B

• The only exception to above will be if patient is transferred for <24 hour monitoring and both unit and transferring physicians agree to leave patient under primary physician 

• The attending physician will assess the need for i‐Care or telemetry daily 

i‐Care Capacity 

• 6 available beds on 5D3 WMC (2 of the beds have isolation capacity)

• 2:1 patient to RN/LPN ratio 

• Can take patients requiring: 

  • Continuous monitoring 

  • BP, HR, O2 sat, rhythm 

  • Higher amount of nursing care and/or monitoring 

  • BiPAP