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Ruth,
The ICAVL standards state: standing or sitting. I doubt that we will change, at least not at this point. We were scanning everyone standing up all the time. I am going to make a controversial statement. For those unfamiliar with a thorough venous insufficiency examination and for those labs who do not have beds/carts that at least meet the 45 degree reverse trendelenberg, standing the patient is the best way. But also standing the patient causes the sonographer a lot of discomfort unless they have a “tall venous stand” and you may encounter sonographers that take some shortcuts when their arms and shoulders start cramping.
Society for Vascular Ultrasound has a venous insufficiency guideline on their website and they make the recommendations of a reverse trendelenberg of 15-20 degrees or standing.
The American College of Phlebology recommends unofficially standing the patient during the exam. So there is variation. I still support how we perform the venous insufficiency exam because as of this date, continued QA has proven we rarely miss reflux or any sign of phlebitis. (98.5% agreement on subsequent follow-up exams)
Claudia A. Benge, RDCS, RDMS, RVT, RVS
Technical Services Director
Decatur Vein Clinic
317 218 2823
-----Original Message-----
From: UVM Flownet
[mailto:[log in to unmask]] On Behalf Of
Myers, Ruth
Sent: Thursday,
January 31, 2008 11:02 AM
To: [log in to unmask]
Subject: Re: Venous insufficiency
Claudia- with the new ICAVl standards that state that the patient must be done standing for reflux studies, will you change your protocol ( or did I mis-read the standards?)
-----Original Message-----
From: Benge, Claudia [mailto:[log in to unmask]]
Sent: Thursday, January 31, 2008 9:27 AM
To: [log in to unmask]
Subject: Re: Venous insufficiency