I have only done this test for upper extremities.  How many of you also do cold immersion testing for toes / lower extremity symptoms?
What are your outcomes for these tests overall in terms of QA: PPV, NPV?

Let me hear from you flownetters who perform these tests, please.  I will soon be presenting some info about the value, or lack of value, in keeping these tests on the vascular lab menu and am very interested in your opinions and practices.

Patricia A. (Tish) Poe, BA RVT FSVU
Director Noninvasive Vascular Laboratory Services
University of Cincinnati Surgeons
Vascular Division
Office (513) 558-4081
Cell   (513) 460-9474

From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Pizzo, Barbara
Sent: Monday, January 11, 2010 2:28 PM
To: [log in to unmask]
Subject: Re: cold immersion studiies


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]

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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