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  I agree with Tina Nack's ideas regarding cross training as stated
yesterday.
  In addition, I think that the issue of reporting masses seen
incidentially
on duplex examination is not optional.  Abnormal structures need to be
reported primarily for the care of the patient, but secondarily for the
legal
implications of documenting by image, but neglecting to report a
potentially
significant health problem.  I also think it wise for non-physicians to
avoid
the use of terms such as "Baker's cyst" unless the individual is willing
to
assume the responsibility of defending their knowledge of such
structures and
how they differ by ultrasound image from more serious problems such as
synovial sarcoma.  Even more problematic are the masses sometimes seen
during
carotid duplex examination where such structures are more likely to be
malignant than those found in the popliteal fossa.  Vascular labs should
have
specific criteria for documenting and reporting such structures when
found
for the protection of patients and techs.
   Regarding another potentially lethal problem:  Does anyone routinely
have
patients sign a release before exercising patients on the treadmill in a
non-cardiac setting?
Lee Nix