Talk about money loss. I can't tell you how many patients would appear in
the ER from another facility prior excluding the calf. The patient and
referring MD not satisfied with no DVT found. We are second referral and
the patient is admitted to treat a PE and calf clot. So the radiologist and
the other local hospital looses out for the DVT admission and the patient
gets to live another day.
Many an orthopedic surgeon who has lost a patient to PE and symptoms
started in the calf.
Do you sense how passionate many technologist are about finding DVT in the
LEG and the lower extremity does not end just below the knee.
I know most radiologist insist the entire Upper extremity is done
subclavian to the wrist.

Denise Levy

cell 408-391-0837
Saratoga, CA
Ultrasound Professional Credentials
Transcranial Doppler
Skype denisevascular12

On Sat, Oct 27, 2012 at 7:26 PM, Bill Johnson <[log in to unmask]>wrote:

> Bill from the Northwest.
> "Why we scan the entire leg"?  "...possible time saved and training
> spent."?  I would answer "how much is a life worth?  Would your new
> supervisor like us to save a dollar and miss a potentially life ending
> clot?  Would she want us to take that risk on her, or her mother or her
> daughter, son or husband?
> I do believe the best "argument" to an administrative type is the
> importance of following the standards we have fought to uphold.  There are
> more than enough reasons to support them.
> I cannot and refuse to support "when other facilities in the area scan
> only to the knee and stop."  Ask your supervisor if these "other
> facilities" are accredited, and, regardless, would she want your facility
> held to a lesser, potentially life threatening standard?  I know you do not
> want that.  If you supervisor understands the issues of potential lawsuits
> for substandard care would not ask you to limit your exams.  I wonder if
> your new supervisor is from the Radiology department.  Radiologists can
> quote chapter and verse as to why nothing venous happens below the knee.
> And they certainly have no compulsion to spend money or any resources on
> noninvasive technology.  That is not where the money is.  I hope this does
> not offend anyone, it is just my opinion.  I refuse not to rant, when
> patient care is an issue.
> Patricia, please contact me offline; [log in to unmask] Your issue
> is important to me.  It is about caring for patients.  I will do all in my
> limited power to help.
> On Sat, Oct 27, 2012 at 7:41 AM, Patricia Rudibaugh <
> [log in to unmask]> wrote:
>> The new supervisor of our Vascular Lab asked me why we scan the
>> entire leg in a Venous Duplex scan when evaluating for DVT when other
>> facilities in the area scan only to the knee and stop.  The lab follows
>> ICAVL, SCU and our Medical Directors guidelines/protocols, however,
>> she is looking at the possible time saved and training spent.  Any
>> explainations out there? I have never heard of scanning only to the
>> knee, but I am new to Vascular since 2009. Is there something I am
>> missing???  Thanks in advance for your explainations...
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