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November 2002

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Subject:
From:
"Hodge, Megan D." <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Date:
Thu, 7 Nov 2002 09:05:29 -0600
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  When I worked in the Echo lab as their procedure nurse, we would use the
automated BP machine during stress tests.  There were some circumstances
like AV grafts, IV location, known subclavian disease that the arm BP were
not accurate, we tried to use the ankles, but I got such wide ranging BPs
from one sequence to the next that I wasn't sure if they were accurate. Then
I was worried that there was tibial artery disease and this was not a
reflection of their true BP and that the physician would start treating the
patient for a hypotensive situation  that I stopped using it on the ankles.


> -----Original Message-----
> From: Andy Wallace [SMTP:[log in to unmask]]
> Sent: Thursday, November 07, 2002 8:44 AM
> To:   [log in to unmask]
> Subject:      Re: Screening device for PVD?
>
> I now have accurate information concerning this
> screening device.  It is called "Vasocor Vascular
> Diagnostic Center"  They use the Framingham study to
> predict risk of CHD, PVD, and Stroke.  They use
> plethysmography to evaluate arterial compliance which
> they have studies on showing this correlates with
> Athersclerotic burden.  I'm sure this is where the
> person who asked me to investigate this got the
> plethysmography from. The next part is what caught my
> eye.  They are doing Ankle Brachial Indices. However,
> they are using automated BP technology.  I'm
> comfortable with the nursing units using this
> technology for brachial pressures.  I've not heard of
> anyone using the automated BP technology for ankle
> pressures.  I certainly have concerns especially in
> those patients who do have significant disease and
> faint pulses. Does anyone have any experience with
> this equipment or have referrals from a primary care
> MD who uses this equipment.  Do you get too many false
> positives, false negatives??  Thank you again in
> advance for your feedback.
> Andy Wallace RVT, RDCS, RDMS
> Manitowoc, WI
>
>
> --- Andy Wallace <[log in to unmask]> wrote:
> > A sales person got to one of our networks Family
> > Practice physicians and sold him on the idea of a
> > screening device for PVD.  It sounds like the device
> > uses a pneumoplethysmograph in some way.  I'm not
> > sure
> > of what criteria this equipment or perhaps the
> > physician uses to define PVD.  This is supposed to
> > be
> > simple enough to use that CNAs or LPNs with very
> > little training can use it accurately.  I don't
> > believe he is looking to charge for the service only
> > to use as a "possibly" more accurate method than his
> > fingers on distal pulses.  Our vascular surgeon
> > feels
> > this device will over call PVD and we'll end up with
> > a
> > lot of normal segmental pressures on asymptomatic
> > patients.  I've not heard of any "screening" device
> > like this and am looking to see what others
> > experience
> > has been with something like this.  My experience
> > and
> > knowledge tells me the simplest and most accurate
> > method of screening for PVD is ABIs.  Has anyone had
> > any experience with a device of this type?  If not
> > this type, any other simple device that can
> > accurately
> > be used in a Family Practice setting?  I looking to
> > help them provide this service accurately.  I
> > certainly have strong feelings about this but I'm
> > not
> > the one in control of this environment.  I can only
> > try and have a positive impact.  Thank You in
> > advance
> > for any information you might have.
> >
> > Andy Wallace RVT, RDMS, RDCS
> > Manitowoc, WI
> >
> >
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