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Carolyn,

We haven't done the digital temperature measurements before, but you are correct, there is an exam protocol that involves digital temps (but you have to have that equipment which we don't at the moment).

 Matt

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From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Carolyn Kokoski
Sent: Monday, January 11, 2010 12:34
To: [log in to unmask]
Subject: Re: cold immersion studiies

Matt,

     What about taking temps on the digits.  I seem to recalll that as part of the exam.  I do not have any equipment that I can take an accurate digital temp with and am wondering the accuracy without them.   Please correct me if I am wrong about the temps but like I said it has been several years.  Thanks Carolyn

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Date: Mon, 11 Jan 2010 12:25:03 -0500
From: [log in to unmask]
Subject: Re: cold immersion studiies
To: [log in to unmask]
Carolyn,

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 there's a notable decrease in PPG waveforms/pressures that don't normalize in 5 minutes, it's suggestive of Raynaud's.  Depending on your setup, it may be easiest to just record PPG waveforms at 1 minute increments.  I also have the patient's wear exam gloves for the cold immersion, so their hands aren't sopping wet.


Matt

-----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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