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If there is any question at all about the reflux, we stand them up.  We
have the bed adjusted to the max and often the reflux is long ond
unmistakable.  I see no need to stand these patients when you have
already proved your point beyond any doubt.  The only thing to be gained
is shoulder pain.  I agree, if it's not clear, we have to do more.
Perhaps it's a matter of just how much your bed will adjust.  

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Don
Ridgway
Sent: Thursday, January 31, 2008 11:57 AM
To: [log in to unmask]
Subject: Re: Venous insufficiency

I would think you would want to do the standing exam if you DO find
reflux in the supine RevTrend patient. As I understand it, there must be
a minimum velocity and/or pressure gradient for competent valves to work
well, sometimes achievable only with the patient really vertical. So to
confirm truly incompetent valves you would need to stand them up. 




Don Ridgway
Grossmont Hospital
Grossmont College




-----Original Message-----
From: UVM Flownet on behalf of LORI LEVY
Sent: Thu 1/31/2008 8:23 AM
To: [log in to unmask]
Subject: Re: Venous insufficiency
 
 We do the exam in reverse trendelenburg and then repeat it with the
patient standing only if we don't find reflux.  We have good luck with
this and the docs are happy.  
I looked at the standards.  Does ICAVL require the entire exam be done
with the patient standing?

_

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