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Nathalie:
    The injury to the finger was the end of the finger was crushed but
no bone trauma.
The pressure in the finger was taken on the finger tip. The pressure was
taken in the middle of the finger with
The cuff.  
Your idea makes sense.  

Thanks,
Jeff

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Nathalie
Garbani
Sent: Tuesday, September 25, 2007 12:28 PM
To: [log in to unmask]
Subject: Re: Upper Extremily Arterial Question

I have several questions for you. What type of trauma was it to that
finger?
Crush or laceration, etc?
Where did you take the pressure in the finger? if the trauma is really
distal, the PPG at the tip of the finger will be flat, but if you place
the digital cuff at the first metacarpal, then you are really getting
the pressure of the proximal digital artery and if the injury is more
distal, you could still have a reasonably normal pressure!
Nathalie
NSU
----- Original Message -----
From: "Jeffrey Yarus" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, September 25, 2007 10:35 AM
Subject: Re: Upper Extremily Arterial Question


>
>
> -----Original Message-----
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Bonnie
> Johnson
> Sent: Friday, September 14, 2007 12:27 AM
> To: [log in to unmask]
> Subject: UE Arterial Question
>
> We had a patient arrive for an Upper Extremity exam with a trauma to
his
> left index finger.
> The Doctor's office had an indication of Digital Cysnosis.
>
> Finger looked normal except pt complained of poor capillary refill.
He
> had no pain in the finger
> Or cold sensitivity.
>
> Exam results:  Waveforms in the Brachial, Radial and Ulnar were
> triphasic and above 1.0
>
> PPG waveform is the fingers in the left hand were normal in all finger
> EXCEPT the finger with the trauma.
> The finger in question had a flattened waveform but the pressure was
> within the range of the other fingers, 0.94.
>
> This finding did not make sense?
>
> I performed a cold stress exam in the left hand because the doctor had
> requested the test.
>
> After 4 minutes of his fingers in ice water, the waveforms in all of
the
> fingers REMAINED the same after
> Cold stress. The finger with the trauma showed a flattened waveform
> again with NO change?
>
> The reading Doctor is puzzled as I am with these findings?
>
> Any Ideas would be helpful!!
>
> Thank you,
> Jeffrey Yarus
> Cheshire Medical Center
> Vascular Lab
> Keene, NH
>
>
>
>
>
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