the only thing i would add to Matts comments is leave the ppg sensor on under the gloves when you immerse the hands, it allows immediate documentation of the vasospasm if present.


To handle yourself, use your head. To handle others, use your heart.

On Mon, Jan 11, 2010 at 11:25 AM, Smith, Matthew G. <[log in to unmask]> wrote:


Perform a complete bilateral upper extremity study first (to rule out arterial stenosis, (segmental pressures, Doppler and PVRs)).† This should include PPG waveforms and resting pressures of the affected digits (or every digit if you wish).† Next, the patient immerses their hands in ice water for 5 minutes (if they can tolerate it that long) and PPG waveforms/digital pressures are taken at 1 minute intervals, for 5 minutes.† If thereís a notable decrease in PPG waveforms/pressures that donít normalize in 5 minutes, itís suggestive of Raynaudís.† Depending on your setup, it may be easiest to just record PPG waveforms at 1 minute increments.† I also have the patientís wear exam gloves for the cold immersion, so their hands arenít sopping wet.


-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Carolyn Kokoski
Sent: Monday, January 11, 2010 10:02
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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