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I always tell my patients when fighting with these cords that one day these will be wireless...but then I wonder how long after that they get stolen?!

Kim Higgins, BS, RDMS, RVT
________________________________
From: UVM Flownet [[log in to unmask]] On Behalf Of Nancy Hohn [[log in to unmask]]
Sent: Tuesday, November 05, 2013 9:37 AM
To: [log in to unmask]
Subject: Re: wireless transducers

I did see this at a Siemens meeting in Nebraska.  Mostly the unit was developed for sterile situations, picc lines, biopsies, etc.  My first question was, ďHow long until I lose that little transducer?Ē  They were thinking, it beeps when you get too far away.
Iím sure like many firsts, it will get better in time.  Nice to know the technology is advancing.

Have a great day!
Nancy Hohn, BS, RVT, RDCS
Cardiovascular Sonographer
Nebraska Heart Hospital
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Bill Schroedter
Sent: Tuesday, November 05, 2013 7:52 AM
To: [log in to unmask]
Subject: Re: wireless transducers

Hi Paul,

Wireless transducers have been talked about for more than a decade.  When I was at an ultrasound meeting in Australia earlier this year, I played with a wireless system by Siemens/Acuson in the exhibit hall.  I have not seen it here in the states.  The entire instrument was in the transducer and it wirelessly transmitted the data to a monitor that had to be placed within about 15í of the transducer.  I am not certain what it weighed but not much and was fairly easily maneuvered.  The data was also stored and could be manipulated after.  There were basic controls on transducer - a couple of multi-function buttons (4 as I remember) and a wheel similar to an I-Pod.  I only looked at my arm and have no idea how good it was clinically.  It would seem to be pretty slick for answering  specific question in the ICU or ED where moving even a small system is difficult.  Certainly, doing a complete exam would be very tough, but then I donít like the smaller portable systems for all day use because of limited user interface which however I admit are improving dramatically.  But clearly, the technology is on the way.

Bill


William B Schroedter, BS, RVT, RPhS, FSVU
Technical Director
Quality Vascular Imaging, Inc
Venice, Florida
(941) 408-8855
www.qualityvascular.com<http://www.qualityvascular.com>
www.compressionsocks.pro<http://www.compressionsocks.pro>



From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Paul English
Sent: Tuesday, November 05, 2013 8:06 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Heatic vein flow and wireless transducers

Thanks for all the input.  I have been doing ultrasound for 35 years and I learn (or relearn HELLO OLí AGE!!) terminology and information on a continual basis.  One example is the term cryptorchidism.  I had scanned for undescended testicles both in nuclear medicine and ultrasound and that was the only reference I had ever heard until I came across the term preparing a CME presentation on genitourinary imaging.  So when this article surfaced about triphasicity of the normal hepatic venous flow.  So I contacted my good friend who is a vascular clinical instructor for the local sonography program and she had never come across this as well but one of her teaching colleagues had heard of it but had pretty much the same opinion as Iíve seen reflected here.  I knew my FLOWNET buddies could put it in perspective.  Thanks to all and keep Ďem coming.

Now about those wireless transducers???

Paul English RT(N), CNMT, RDMS, RVT

From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of EILEEN SELPH
Sent: Monday, November 04, 2013 4:38 PM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Heatic vein flow and wireless transducers

Words have definitions and connotations.  To me, triphasic connotes that which is related to a normal peripheral arterial signal and I would hesitate to use this term to describe the hepatic vein despite the actual definition of triphasic.  Perhaps it is also important to consider the the manner in which the receiver of the specific word of the technologist will perceive its meaning and weigh the possibility for confusion.

Now that we all have worms, let's go fishing!   Thank you, Steve.

E. Selph,RDMS,RVT
Consensus



________________________________
Date: Mon, 4 Nov 2013 15:25:26 -0500
From: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Heatic vein flow and wireless transducers
To: [log in to unmask]<mailto:[log in to unmask]>
Paul, do you hear that? Thatís the sound of a can of worms opening Ė great topic!

Ö.and  a controversial one. Some of our waveform nomenclature comes from different points in the evolution of cardiovascular testing. Different disciplines have brought terminology into the mix. Our  vascular testing language is a hodgepodge of inter-specialty jargon.

This isnít an answer to your question, more of a justification for both answers being correct.

Personally, I feel that when blood changes velocity abruptly (slows, then speeds again with or without changing direction as in your hepatic vein example) it is a new phase because flow has been influenced by a momentary change in a pressure gradient. A pressure wave reflection, the delayed arrival of a collateral flow, the residual pressure in a Windkessel can all come to bear on waveform morphology. For these reasons I think flow should be described as unidirectional or bidirectional, regardless of how many phases you think it has. I believe itís possible to have unidirectional biphasic (or multiphasic) flow.
There, I said it. Gauntlet tossed.

And remember:  We donít hear a waveform, we look at it. We hear a signal (a lack of making these distinct can further complicates things).

~S

Steve Knight BSc RVT RDCS
Senior Vascular Technologist
[log in to unmask]<mailto:[log in to unmask]>

Beth Israel Deaconess Medical Center
CardioVascular Institute
Division of Vascular and Endovascular Surgery

110 Francis Street
Boston, MA 02215

(617) 632-9962 Phone
(617) 632-7977 Fax
www.bidmc.org<http://www.bidmc.org>

[cid:[log in to unmask]]

From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Paul English
Sent: Sunday, November 03, 2013 3:03 PM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Heatic vein flow and wireless transducers

I've got two questions for all of my learned colleagues out there.  Ever since I started in non-invasive vascular testing I've used the term triphasic to refer to arterial waveforms like this..

[cid:[log in to unmask]]

Recently I came across this article http://www.slredultrasound.com/Filesandpictures/Guidelines10.pdf where they refer to the normal hepatic venous flow as triphasic
[cid:[log in to unmask]]

C, Longitudinal color and spectral Doppler images of a normal triphasic hepatic vein. Notice the 2 antegrade waves during systole (solid arrow) and diastole (dashed arrow), as well as the 2 retrograde waves after both systole (arrow head) and diastole (open arrow)

The descriptions make sense but this is a new concept to my coworkers and I.

The second topic is about the use of wireless transducers.  A colleague of mine is the vascular clinical instructor for the ultrasound program in our area.  One of her students is preparing a paper on sonographer MSK RSI.  The student's proposal is to investigate the current usage of wireless transducers and/or voice controlled equipment.  I remember several years ago Philips introducing some technology along these lines but I've not heard much about it since.  Does anyone out there use this technology, how is it working, and has it been in use long enough to see if it has the potential to reduce RSI?  Joan Baker, since you are the maven of sonographer RSI have you encountered this technology?

Paul English RT(N), CNMT, RDMS, RVT
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