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Carolyn,   
 
When we have issues such as you outline, we often go to Rob Daigle's
Techniques in Noninvasive Vascular Diagnosis. It is easy to find the
information you are looking for, tells you how to perform, pitfalls to watch
out for, tips and tricks, and outlines diagnostic criteria. you can check
out www.summerpublishing.com
 
OK, I will confess and tell you Rob is a friend of mine but I get nada in
royalties and the above is true. It is a go to book in our lab. 
 
Bill Schroedter
Venice, Fl.


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From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Carolyn
Kokoski
Sent: Monday, January 11, 2010 3:02 PM
To: [log in to unmask]
Subject: Re: cold immersion studiies


Barbara,  
 
     Thanks so much I am feeling so much better about performing this exam
now.. I think when you do not perform a certain exam for a length of time it
is very easy to second guess ourselves.  Everyone has been so helpful!  
                           Carolyn
 

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Date: Mon, 11 Jan 2010 12:28:17 -0700
From: [log in to unmask]
Subject: Re: cold immersion studiies
To: [log in to unmask]


Carolyn,
 
Do a base line upper arterial or lower arterial to r/o arterial disease. Do
resting PPG on all digits. Pick two of the digits with the worst symptoms
and use these for the test. Document how long ( one hand or foot at a time)
that the patient can immerse in the ice water. ( If you use gloves on the
patient, you won't have to waste time drying the hands.) Do PPG tracings
immediately after ice immersion, do PPG tracings 5 minutes after ice, 10
minutes after ice and if the waveform has not returned by 15 minutes post
ice immersion, there is indication of vasospastic disease. 
Everyone will have dampened waveforms immediately after ice immersion. Hope
this helps
 
Barbara Pizzo, BS RVT
Technical Director, Vascular, Neurologic and Non-Invasive Cardiology
Services
St. Joseph Medical Center
610 378-2802
[log in to unmask]
 
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From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Carolyn
Kokoski
Sent: Monday, January 11, 2010 10:02 AM
To: [log in to unmask]
Subject: cold immersion studiies


   I have not had to perform a cold immersion study in quite some years and
am being asked to perform one next week.  I am having a hard time recalling
the proper protocalor finding it in the manual.  The machine I have
available is a Unetixs Freedom V.  Any assistance will be greatly
appreciated.  Thank you in advance for your help. Carolyn 

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