Cardiac monitoring of critically ill patients enables 3 basic features to be detected: rate abnormalities, rhythm disturbances, and ischemic patterns. When it was developed, continuous computerized ST-segment monitoring proved an invaluable resource for detecting ischemia in critically ill cardiac patients. Considered a technological bonus if instituted correctly, this essential device for detection of myocardial ischemia is underused in the United States. Experts in the field of electrocardiographic (ECG) monitoring are currently advocating for continuous ST-segment monitoring for detection of silent myocardial ischemia (SMI) in all areas where patients undergo cardiac monitoring because ST-segment monitoring is a simple, inexpensive, and noninvasive means of providing valuable diagnostic information.

In 2004, The American Association of Critical Care Nurses (AACN) issued a practice alert on ST-segment monitoring; a revised alert was reissued in 2008. These practice alerts are periodically released on the AACN Web...

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