Port Townsend, WA
I for one am getting lazy, I think. I was very happy when I began doing compressions for pseudoaneruysms. Wow, not only are we doing noninvasive diagnostics, we can do noninvasive intervention!
I have not been called on to do a compression for over five years now, and frankly, I do not miss them. I do appreciate Dr. Szarnicki's position although I have never seen an allergic reaction nor do I know the incidence. I do know the potential problem of thrombosing the artery, but have never seen an example of that either, though I know it has happened, and the artery should be evaluated prior and post injection. I also know the compressions can be extremely uncomfortable for the patient, even with pain meds aboard, and an effort should be made to push enough but not overly so.
And, Homans' sign is still used, and probably will be for some time, entrenched in the medical culture as it is, well past my retirement. At least you know the referring physician saw the patient's leg...
From: UVM Flownet on behalf of Robert J. Szarnicki,MD
Sent: Thu 4/16/2009 2:14 PM
To: [log in to unmask]
Subject: Re: Pseudo compressions
I would like to take issue with Paul Ramirez' statement that "Homen's sign" is archaic. If clinicians did not look for it, there would be far less DVT diagnosed. The ultrasound is for confirmation only. Also, pseudoaneurysm may be time consuming and not "fun" for the tech, but it works in a large majority of patients without having to inject a foreign substance to which a patient might allergic. Are we getting lazy or what?
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