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The comparison of an arm and leg DVT is not consistent. Below the knee is
more of a health risk than a brachial..

Denise Levy

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



On Sun, Oct 28, 2012 at 3:44 PM, Patty Rudibaugh <[log in to unmask]>wrote:

>  Denise,
>
> She informed me that these same ICAVL accreditated facilites also scan
> only to the the elbow... I was shocked......What the heck is going on and
> if these facilites are acrreditated like she says, how are they getting
> away with it?
>
> ------------------------------
> Date: Sat, 27 Oct 2012 22:07:31 -0700
> From: [log in to unmask]
> Subject: Re: Entire leg vs to knee venous
> To: [log in to unmask]
>
> 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
> RDMS, RVT
> 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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