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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? _ To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html This electronic message may contain information that is confidential or legally privileged. It is intended only for the use of the individual(s) and entity named as recipients in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from any computer. Do not deliver, distribute, or copy this message, and do not disclose its contents or take any action in reliance on the information it contains. To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html