Could it be some sort of overreaction by the nervous system (shutting down the capillaries but the digital arteries remaining open) in response to the trauma?

 

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Jeffrey Yarus
Sent: Tuesday, September 25, 2007 8:51 AM
To: [log in to unmask]
Subject: Re: Upper Extremily Arterial Question

 

Steve:

    The finger is not swollen.  Appears same as the other fingers.

 

Thanks,

Jeff

 


From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Steve Knight
Sent: Tuesday, September 25, 2007 10:56 AM
To: [log in to unmask]
Subject: Re: Upper Extremily Arterial Question

Jeff, is the finger in question swollen?

On 9/25/07, Jeffrey Yarus <[log in to unmask]> wrote:



-----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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--
Steve Knight BSc RVT RDCS
Specialists In Ultrasound, Inc.

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