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
St. Joseph Medical Center
610 378-2802
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From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Carolyn
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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