October 2012


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Bill Johnson <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Sat, 6 Oct 2012 20:51:49 -0700
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Bill Johnson, Port Townsend, WA

I agree with Calli opsis, although I think that is a flower? (I
always agree with flowers). I learned to do "blind" TCD back in the
eighties. My teacher, Colleen Douville, was not only patient with me,
and, I admit I knew nothing about the Circle of Willis and its
importance, but also about intracranial circulation and how much it
was dependent on those carotids I did know something about, in spite
of that, she taught me. I am grateful.

I did know strokes could be the result of extracranial disease, most
frequently due to carotid stenosis, but my eyes were opened wide about
intracranial sources. The learning curve is steep, and very much
dependent on our skill and how often we do this exam. But, I submit,
it is worth the effort.

I would also suggest, if you want to learn more about TCD, consider
the following link; http://www.pvicme.com/transDoppler.htm

DIsclaimer, I worked for PVI for 10 years, and still as consultant,
but not an active employee. I am in awe of the program Colleen and
Keith Fugioka have put together. They are superb instructors.

On 10/6/12, Calli opsis <[log in to unmask]> wrote:
> Frequency of performing the exam is definitely one keey component to being
> good at these, but also having sufficient training to know what you are
> looking for when things are not normal is important too. In hospitals with
> dedicated neuro units, transcranial imaging is more popular. Many
> transcranial Dopplers are performed on inpatients for vasospasm but
> recently imaging for sickle cell for outpatients has been increasing.
> On Fri, Oct 5, 2012 at 3:55 PM, Matthew Smith
> <[log in to unmask]>wrote:
>> i agree, it takes a while for most techs to scan enough TCDs to be
>> comfortable with them, typically not your easiest patients to scan and
>> requires some oversight from someone with experience to show them the
>> ropes/anatomy. very tiny window, very subtle movements to get what you
>> need
>> for color imaging studies.
>> matt
>> On Thu, Oct 4, 2012 at 11:53 AM, Cynthia Mitchell
>> <[log in to unmask]>wrote:
>>> Our IV neuro docs do coiling for aneurysms and we do do daily TCD's to
>>> check for vasospasm. Sometimes we have none our we may have 5 .The
>>> learning
>>> curve is different for everyone but doing them frequently of the key. We
>>> have invested alot in training but techs that rarely do them never got
>>> to
>>> their comfort level. I understand that at Jefferson neuro they do them
>>> twice per day.
>>> On Oct 4, 2012 1:45 PM, "Nancy Williams"
>>> <[log in to unmask]>
>>> wrote:
>>>> Are there a lot of vascular labs doing TCD's? What's the learning curve
>>>> for
>>>> training an experienced RVT/RDMS to do TCD's? I was not aware there was
>>>> a
>>>> demand for these exams? Is there?

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