I am in agreement that TCD is a great technology and should be performed in more is also a very interesting exam with MANY applications.  I am also in agreement that Colleen is a great teacher.  There are opportunities for all to learn from her and other experts in the field of TCD and TCI...especially if you are feeling the desire to expand your horizons in vascular ultrasound. 
The Transcranial Doppler and Imaging Course, a collaboration between the Pacific Vascular Institute for Continuing Medical Education and the Swedish Neuroscience Institute is co-directed by Colleen Douville and Keith Fujioka with many other expert faculty, including Donalee Davis, Dr. David Newell, Dr. Arthur Lam, Dr. Todd Czartoski, Meryl Harley, Krislynn Barnhart, Joshua Renz, and Elimie (Mimi) Johnson.  You will have a chance to hear great lectures covering the fundamentals of TCD and TCI, the capabilities of this technology, and the various applications, as well as get hands-on training from Colleen, Keith and the other technologist faculty.  If you feel the need to expand your horizons in vascular ultrasound technology or would just like an update on the current use of TCD and TCI, please plan to join us next year.  

This course is held in March and September in Seattle, WA, providing 21 CME for techs, sonographers, and physicians.  Our next course is tentatively planned for the last week in March...I will update you when the dates are confirmed.

Ridge B. Johnson, BSc., RVT
Director of Education, PVICME
cell: (206) 234-9932
[log in to unmask]

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Karen Limone
Sent: Monday, October 08, 2012 5:42 AM
To: [log in to unmask]
Subject: Re: TCD's

It would be interesting to see just how many of us out there doing TCD, Colleen Douville is responsible for.  Great teacher. 

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Bill Johnson
Sent: Saturday, October 06, 2012 11:52 PM
To: [log in to unmask]
Subject: Re: TCD's

Bill Johnson, Port Townsend, WA

I agree with Calli opsis, although I think that is a flower?  (I always agree with flowers).  I learned to do "blind" TCD back in the eighties.
My teacher, Colleen Douville, was not only patient with me, and, I admit I knew nothing about the Circle of Willis and its importance, but also about intracranial circulation and how much it was dependent on those carotids I did know something about, in spite of that, she taught me. I am grateful.

I did know strokes could be the result of extracranial disease, most frequently due to carotid stenosis, but my eyes were opened wide about intracranial sources.  The learning curve is steep, and very much dependent on our skill and how often we do this exam.  But, I submit, it is worth the effort.

I would also suggest, if you want to learn more about TCD, consider the following link;

DIsclaimer, I worked for PVI for 10 years, and still as consultant, but not an active employee.  I am in awe of the program Colleen and Keith Fugioka have put together.  They are superb instructors.

On 10/6/12, Calli opsis <[log in to unmask]> wrote:
> Frequency of performing the exam is definitely one keey component to 
> being good at these, but also having sufficient training to know what 
> you are looking for when things are not normal is important too.  In 
> hospitals with dedicated neuro units, transcranial imaging is more 
> popular.  Many transcranial Dopplers are performed on inpatients for 
> vasospasm but recently imaging for sickle cell for outpatients has
been increasing.
> On Fri, Oct 5, 2012 at 3:55 PM, Matthew Smith
> <[log in to unmask]>wrote:
>> i agree, it takes a while for most techs to scan enough TCDs  to be 
>> comfortable with them, typically not your easiest patients to scan 
>> and requires some oversight from someone with experience to show them

>> the ropes/anatomy. very tiny window, very subtle movements to get 
>> what you need for color imaging studies.
>> matt
>>  On Thu, Oct 4, 2012 at 11:53 AM, Cynthia Mitchell
>> <[log in to unmask]>wrote:
>>> Our IV neuro docs do coiling for aneurysms and we do do daily TCD's 
>>> to check for vasospasm. Sometimes we have none our we may have 5 
>>> .The learning curve is different for everyone but doing them 
>>> frequently of the key. We have invested alot in training but techs 
>>> that rarely do them never got to their comfort level. I understand 
>>> that at Jefferson neuro they do them twice per day.
>>>  On Oct 4, 2012 1:45 PM, "Nancy Williams"
>>> <[log in to unmask]>
>>> wrote:
>>>> Are there a lot of vascular labs doing TCD's? What's the learning 
>>>> curve for training an experienced RVT/RDMS to do TCD's? I was not 
>>>> aware there was a demand for these exams? Is there?

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