Print

Print


Steve,
I'm not sure I can go along with your analysis but I'm going to think on it some more before I comment.

Carolyn M Semrow, RVS


"A master, in the art of living, draws no sharp distinction 
between his work and his play, his labor and his leisure, 
his mind and his body, his education and his recreation. 
He hardly knows which is which. He simply pursues his 
vision of excellence through whatever he is doing and leaves 
others to determine if he is working or playing. To himself 
he always seems to be doing both." 
Francois-René Chateaubriand  (1768-1848)





The HTML graphics in this message


>________________________________
> From: Steven Knight <[log in to unmask]>
>To: [log in to unmask] 
>Sent: Tuesday, October 23, 2012 9:03 AM
>Subject: Re: eliciting venous reflux
>  
>
>We discussed this at our chapter meeting on Saturday and I had a similar circumstance today with a patient with DVT. I didn’t want to use auto inflator. In cases of gross insufficiency the veins become maximally dilated with little or no capacitance for regurgitant flow. You cannot put more water into a bucket that is already full to the brim. Ergo you will have trouble showing reverse flow.
>I’m not saying that is what happened in your case but if you suspect that in the future you might try DECREASING hydrostatic pressure (have patient lay in moderate footdownberg) so that you can squeeze enough volume out of the veins to allow space for them to refill with retrograde flow.
> 
>Eager for others to chime in on this.
> 
>From:UVM Flownet [mailto:[log in to unmask]] On Behalf Of Karen Burns
>Sent: Tuesday, October 23, 2012 9:40 AM
>To: [log in to unmask]
>Subject: Re: eliciting venous reflux
> 
>Hi Steve
>We normally use a rapid cuff inflator, but didn't on this case. Do you think that makes a big difference?
>
>Sent from my iPhone
>
>On Oct 23, 2012, at 6:32 AM, Steven Knight <[log in to unmask]> wrote:
>Karen, do you use a rapid cuff inflator doing your studies or do you squeeze the leg manually?
>>~S
>> 
>>From:UVM Flownet [mailto:[log in to unmask]] On Behalf Of Karen Burns
>>Sent: Monday, October 22, 2012 10:28 PM
>>To: [log in to unmask]
>>Subject: eliciting venous reflux
>> 
>>I saw a patient today with very large veins, >8mm GSV( at the ankle), with multiple ropey tributaries but was not able to elicit reflux in the standing position.  She had an ulcer at the medial malleolus, hemosiderinstaining in the gaitor area and edematous ankles.  The perforator at the ulcer was incompetent. I am having a very difficult time believing that this patient does not have an incompetent GSV.  Have any of you ever seen this before?  Could this patient have reflux even though I couldn't demonstrate it?  
>>Karen 
>>
>>
>>
>> 
>>
>>________________________________
>>
>>To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html
>To unsubscribe or search other topics on UVM Flownet link to: http://list.uvm.edu/archives/uvmflownet.html 
>
>   

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html