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July 2010

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Subject:
From:
Joe Swenson <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Date:
Sat, 3 Jul 2010 22:12:44 -0400
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Seeking thoughts, theories and comments regarding the use of torniquets for 
the mapping of first time fistula patients. If resolution capabilities allow 
visulization of veins a little less than 1 mm, and torniquets almost certainly 
yield 2 mm dilation, and 2.5 mm is the diameter goal-- are tourniquets really 
needed since it seems anyone with a detectable vein most likely will meet the 
criteria og 2.5 mm? Is torniquet use problematic due to vasospasms? 
Literature suggests pre and post tourniquet numbers get more patients to 
fistulas who may otherwise not meet the 2.5 criteria but data on post fistula 
outcomes for torniquet 2.5's are not apparent. What patients are not able to 
dilate, at least somwhere along the basilic or cephalic? Also, specific torniquet 
protocols for use in venous mappings have escaped my research-- there are 
plenty established for venipunture use but not for extended times that occur 
during mappings. Potential patient injuries as a result of extended times on 
elastic tourniqets pose some hospital acquired injury risks that have to be 
considered--our PI department insisted I provide policy and procedure 
references before implementing torniquet use and I have yet to locate any 
referenced material on the subject. Comments?

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