We have found that patients who spasm, will spasm with cold water minus the ice. We use 3 minutes in cold water immersion. Our protocol is the same as below, with the addition of baseline temps on all digits, then temps on all digits every 5 minutes along with the PPG's until normal or 20 min.
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
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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