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

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