I have to agree that the word "finding" is the magic bullet . However, most providers do not know what accelerated and turbulent velocities mean, or non compressible filled lumen. Most PCP's will directly ask "what does that mean" should I send them to the ER or what do I do. I have been in places were we describe the "findings" but this is not a just reality, when the readers do not read until the end of the day. Vicarious situation I know, nontheless, without a direct reading, we have made a diagnosis. If not ,vascular would follow suit like echo and general, where they put RIGHT FLANK ULTRASOUND and nothing else. This is universal in most labs in my area. As far as techsheets and prelim's, the calculations are right on them, there is no getting around that, especially in the face of an emergent referral. A critical ICA narrowing sends a patient to surgery, or the ER on our call to the PCP, not the readers...diagnosis made.
just my thoughts
> Date: Mon, 14 Apr 2008 21:24:53 -0700 > From: [log in to unmask] > Subject: Re: Prelim Vs Diagnosis > To: [log in to unmask] > > If I do a venous study in the ER and tell the doc that "the femoral and popliteal vein lumens are filled and incompressible," that's a finding (magic word). That's how it's phrased on the preliminary report that we leave. The doc can probably figure it out from there. Our carotid preliminary report form is a little more complicated, but contrives to keep it in the nature of "findings" rather than calling percent stenosis. Findings are just the observations: BP is 138/88, temperature is 99.3, heart rate is 85 bpm, velocities are accelerated and turbulent, vein lumen is filled, all findings. > > We had to work this out with the lawyers so that we could report something without interpreting, as there was very strong demand for preliminary reports. It seems to work. The doc is given the findings, the doc decides the significance. > > > Don Ridgway > Grossmont Hospital > Grossmont College > > > > > > > > -----Original Message----- > From: UVM Flownet on behalf of JASON ROBERTS > Sent: Mon 4/14/2008 3:56 PM > To: [log in to unmask] > Subject: Re: Prelim Vs Diagnosis > > > I have given this statement some thought, however, describing and diagnosing are not that far in comparison, at least in my area, and with my vascular director. In the face of emergent studies or after hour studies an immediate impression is given to PCP or ER doctor by the sonographer, is this not a diagnosis? The reading physician or on-call surgeon is not contacted and the study is not read until the next day. I know this some how falls under preliminary impression, however, this is clearly a diagnosis since the patient will be released following a negative finding. This may not be the case in radiology suites where radiologist directly read post study and then contact the referring physician in the face of a positive or critical findings. But most of us know this is not the case, mostly we are practicing technologist's, no necessarily describologist's :) > > One other issue,my fiancee who is also in vascular is required to educate the patient post positive findings, utilizing pamphlets and clinical findings. > > > What says the masses out there, on the emergent preliminary findings.> > Jason > > > > Date: Mon, 14 Apr 2008 12:11:50 -0400 > > > From: [log in to unmask]> Subject: Re: carotid plaque interpretation> To: [log in to unmask]> > Jason: Again, it's the interpreting physicians call. We describe > findings, not diagnose them.> > Terry Case> > Terry, is this to say all irregular plaque can be classified as > questionably ulcerated?> > Jason> > > > Quoting JASON ROBERTS <[log in to unmask]>:> > >> > Terry, is this to say all irregular plaque can be classified as > > questionably ulcerated?> >> > Jason > Date: Mon, 14 Apr 2008 09:53:46 -0400> From: [log in to unmask]> > > Subject: carotid plaque interpretation> To: > > [log in to unmask]> > It is my experience that the term > > "ulceration" is a clinical > diagnosis, not a technical finding. > > Radiologists have great difficulty > determining ulceration even > > with angio and studies have showed when > reviewing angios, they > > not only disagreed with others but even among > their own > > interpretation. Only the surgeon or pathologist can call it > an > > ulceration. As sonographers, I believe we should limit the findings > > > to ?irregular surface characteristics.? Remember you can tell the > > > interpreting physician it is a fowl, with web feet and says > > ?Quack, > Quack.? But it is up to the interpreting physician to > > call it a > duck..... and in some cases, rule out chicken, rule out > > turkey, etc > and so on.> > Terry Case> > > > > > > > > > Quoting > > "Haase, Craig K." <[log in to unmask]>:> > > yes,> > c. haase> >> > > > -----Original Message-----> > From: UVM Flownet > > [mailto:[log in to unmask]]On Behalf Of paul hrdlick> > Sent: > > Saturday, April 12, 2008 2:19 PM> > To: [log in to unmask]> > > > Subject: carotid plaque interpretation> >> >> > Does anyone use the > > term "ulceration" when describing plaque in the > > carotid? I> > > > remember yrs. ago Dr. Strandness ( an article) commented that this > > was> > inappropriate due to our 2D imaging limitations. Can we > > truly say with any> > certainty that plaque contains ulcerations?> > > >> > _____> >> > Get in touch in an instant. 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