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the Almighty Yankee Dollar

On Sun, Oct 28, 2012 at 8:42 PM, Patty <[log in to unmask]> wrote:

Thats so sad. I take pride and am passionate about my studies, how they look and I treat every study as a potentional ICAVL audit. How do techs sleep at night knowing they did not complete a protocol and possibly missed a DVT?

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Doug Marcum wrote:

Patty
Unfortunately and realistically, accreditation can mean to some facilities that all the paperwork was submitted correctly and the studies sent in were inclusive of everything necessary. Unless the ENTIRE department is held accountable (including the interpreting physicians) accreditation is a formality that easily can digress back to substandard quickly :(



Doug Marcum
RDMS,RDCS,RVT(APS),RPhS
Advanced Ultrasound Consultants
Global Vein Solutions

On Oct 28, 2012, at 7:12 PM, Denise Levy <[log in to unmask]> wrote:

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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