Thanks for the info Lisa!!

Sent from my iPhone

On Apr 23, 2020, at 7:03 PM, Marlowe, Lisa (GE Healthcare) <[log in to unmask]> wrote:


<image2.jpeg>
I just watched this free webinar on WRMSDs yesterday, and I’ll post the link below for anyone who wants to watch it. You can take a test at the end and get 1 CME as well if you’d like. There are actually 10 free CME webinars on the site, and you can get up to 5 CMEs from them in a 12 month period. This is from GE but you don’t have to be a GE customer to access them or to get the CMEs. If you are a GE customer and received CMEs for the install training on your machine, you can still get these CMEs in addition to that.

http://www.clinical-conversations.com/


~Lisa

 

Lisa Marlowe, BS, RDMS, RVT

POCUS Team Lead, SE US

GE Healthcare

 

+1 941 724 2322

HelpDesk 800 682 5327

LinkedInTwitter


FOR A QUICKER RESPONSE, PLEASE TEXT ME AT 941-724-2322


On Apr 23, 2020, at 9:27 PM, Carolyn Semrow <[log in to unmask]> wrote:


I'm surprised that the data doesn't already exist. I seriously injured my back while performing a bedside exam that was in 1994. In 2000 I was considered totally disabled all because of the 1 where it was impossible to use proper body mechanics. While several years later I was able to return to work after work hardening it was with the understanding that I only performed exams in my lab where I could practice good ergonomics. 
We should be studying ways to prevent injuries using different scanning techniques, patients positions and scanning tables and chairs designed for peripheral vascular access. 
The way to change the system is reporting ojt injuries. When the cost of these injuries impacts the bottom line, charges will be made. Suffering in silence does nothing. 

Carolyn 
"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)


On Thursday, April 23, 2020, 07:28:03 PM CDT, Bill Schroedter <[log in to unmask]> wrote:


While I cannot disagree, Carolyn, the real goal would be a way to generate data, which could prove beneficial to possibly demonstrate direct causal relationship.   

Bill

 

From: UVM Flownet <[log in to unmask]> On Behalf Of Carolyn Semrow
Sent: Thursday, April 23, 2020 4:19 PM
To: [log in to unmask]
Subject: Re: Limited Protocols

 

While I agree with the premise of withholding accreditation when the workload is above a specific threshold, US health care is profit not outcome based & accreditation is optional not mandatory. Therefore, the corporation when faced with choosing between profit or accreditation will without exception chose profit. 

I would suggest that during this period of reduced tests and testing times that you use it to work on body mechanics. If you start practicing it now, even if it requires you to modify how you perform the test, by the time things return to normal you will accustom to using ergonomic procedures. 

 

Carolyn 

"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)

 

 

On Thursday, April 23, 2020, 08:16:35 AM CDT, Bill Schroedter <[log in to unmask]> wrote:

 

 

That’s good to hear Kim.

 

I have been saying for years that as part of an accreditation process, the accrediting body should track sonographer workloads and the #’s of WRMSD. If facilities have WRMSD’s above a given threshold, accreditation should be withheld until corrective measures are put into place.  Also very importantly (maybe more important going forward), this would be incredibly useful data to have and could certainly positively impact our profession.  Acceptable workloads could be recommended and/or established based on data, not reimbursement.

Stay safe everybody.

Bill

PS – Do good!

 

 

William B Schroedter, BS, RVT, RPhS, FSVU

4120 Woodmere Park Blvd

Suite 8B

Venice, Florida  34293

www.qualityvascular.com

www.virtualveincenter.com

 

 

From: UVM Flownet <[log in to unmask]> On Behalf Of Kim Weaver
Sent: Wednesday, April 22, 2020 9:40 PM
To: [log in to unmask]
Subject: Re: Limited Protocols

 

Hi Joan, 

 

I have been working about 50% since mid March. My IT band issues have lessened dramatically. I’ve had issues with it at least 6 years and I knew it had to be work-related! 

 

Best regards, 

Kim Weaver, BS, RDMS, RVT

 

 

 

On Apr 22, 2020, at 7:07 PM, Joan Baker <[log in to unmask]> wrote:



It would be nice to hear from those whose protocols have changed are you doing more patients in the time that has been freed up as a result of the shorter scanning time? Those who have been furloughed have you got less pain and discomfort? Those with reduced   length of studies have you noticed a change in your pain or discomfort .

 

 

Sent from Mail for Windows 10

 

From: Bill Schroedter
Sent: Thursday, April 9, 2020 6:51 AM
To: [log in to unmask]
Subject: Re: Limited Protocols

 

Also, please go to the SVU website which recently released a “position” statement which was cited in the IAC release mentioned below. It only makes sense to limit potential exposure. They reference a risk stratification for US exam performance.

 

While I would still strongly support the phrase I have lived by for all these many years “Do what’s right for the patient” still applies, we equally have a duty to protect the sonographer.

Seems to me that the studies that should be performed in a timely fashion are:

  1. DVT studies would qualify as urgent. Arguably, we could perhaps suggest a certain score in the Wells clinical prediction rule in order to even justify the performance so we are not ruling out DVT in a leg with cellulitis. And based on the patient, an abbreviated exam would seem to be acceptable in many instances. 
  2. Acutely symptomatic carotid studies
  3. Perhaps arterial studies for patients with limb-threatening ischemia or clinical signs of embolization but certainly not for claudication.

Other than that, it would seem the risk-benefit is questionable. I would also argue that often the decision to abbreviate the exam would be made at the time of patient encounter which would require an experienced sonographer to make that judgment. As Jeremey suggests in his post, we also find that many of the ordering physicians seem to have ceased ordering non-urgent or follow-up exams anyway.

 

What everyone else think?

Bill

 

From: UVM Flownet <[log in to unmask]> On Behalf Of jeremy orlikoski
Sent: Wednesday, April 8, 2020 7:23 PM
To: [log in to unmask]
Subject: Re: Limited Protocols

 

Hmm. Interesting. 

 

We have not ever been given the option to shorten the exam time. 

 

I wish you luck with finding a good protocol. Also stay safe and thank you for working through this pandemic. :-)

 

 

Jeremy Orlikoski

 

On Apr 8, 2020, at 6:04 PM, Matthew Weigelt <[log in to unmask]> wrote:



The new IAC statement below is supportive of shortening exams  at this time.  Our volume of exams are down significantly but we typically have a 40-50 pts in our hospital that are under suspicion for COVID and 8-10 that are positive. We are looking at shortening the staff exposure time by reducing some images but it isn't easy figuring out what is safe to cut. 

 

 "Accredited IAC Vascular Testing facilities may implement limited testing protocols for use during the COVID-19 pandemic as directed by the Medical and Technical Director(s). These protocols should be adapted to patient and facility-specific factors including availability of personnel and equipment. These limited protocols may not include all elements of the IAC Vascular Testing Standards. For example, a laboratory may abbreviate its venous duplex testing protocols specifically for scanning patients who are known or suspected of being COVID-19 positive. "

 

 

 

Sent from my Verizon, Samsung Galaxy smartphone

 

 

 

-------- Original message --------

From: jeremy orlikoski <[log in to unmask]>

Date: 4/8/20 5:37 PM (GMT-05:00)

Subject: Re: Limited Protocols

 

Limited Protocols?

 

Sorry. I have not heard of anyone using limited protocols. I can’t imagine why you would shorten the protocol anyway. Here in Texas we actually have very limited patients in the hospital or clinic needing vascular exams. All the internist and PCP have backed off on ordering exams. Most healthcare systems in Austin are sending most of the vascular lab staff home early or having them not come in at all. Every patient that does get a study receives a full diagnostic exams. 

Jeremy Orlikoski

 

On Apr 8, 2020, at 3:49 PM, Matthew Weigelt <[log in to unmask]> wrote:



Can any of you share your limited protocols that are being used during the pandemic?

 

Venous exams and Carotid exams specifically.

 

Thank you!

Chris

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