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Venous Procedure > venous week 7 > Flashcards

venous week 7 Flashcards

1
Q

What is accreditation?

A

Process that ensures high quality vascular testing.

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2
Q

How often must an institution be re-accredited?

A

Must get re-accredited every 3 years.

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3
Q

In some states Medicare and third party insurers now require patients to get their exams done at accredited labs for what?

A

Reimbursement.

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4
Q

What are the types of accreditation?

A
  • Extracranial cerebrovascular (Carotid duplex)
  • Intracranial cerebrovascular (Transcranial Doppler)
  • Peripheral arterial (LE and UE arterial exams)
  • Peripheral venous (LE and UE venous exams)
  • Visceral vascular (Abdominal)
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5
Q

What are the 3 guidelines and protocols that labs must follow in order to achieve accreditation according to IAC?

A
  1. Techniques used (position, equipment, optimization of equipment, ect.)
  2. Documentations (how exams are documented)
  3. Protocols for each exam.
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6
Q

What is the accreditation process?

A
  • Submit accreditation application
  • Once submitted all necessary material, it is then peer reviewed by the board of directors.
  • Accreditation is either granted, denied, delayed, or a visit is required.
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7
Q

What must an accreditation application include in order to be considered?

A
  • Must include details on all aspects of daily lab operations.
  • Must include case studies
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8
Q

Once an accreditation application has been submitted, who is it reviewed by?

A

Board of directors.

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9
Q

What does “accreditation granted” signify?

A

Accreditation is approved and given to the institution.

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10
Q

What does “accreditation delay” signify?

A

There is a delay in accreditation for further review.

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11
Q

What does “accreditation-require visit” signify?

A

IAC comes out to the actual lab to observe.

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12
Q

What does “accreditation denied” signify?

A

Per IAC website, no accreditation is immediately denied a site visit or delay is first received.

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13
Q

What does IAC stand for?

A

Inter-societal Accreditation Commission.

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14
Q

Why are protocols in a lab beneficial?

A
  • Help maintain quality assurance in a lab.
  • Help with a cohesion for follow up exams.
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15
Q

Are the protocols the same for each lab?

A

No, they vary from one another.

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16
Q

What is the IAC protocol for the LE venous duplex?

A

-Transverse grayscale image with and without compressions must include at a minimum:

CFV, SFJ, Prox. Mid. Distal FV, POPV, PTV, PERV, additional images to document areas of suspected thrombus and any additional images (if required by lab protocol)

-Spectral doppler waveforms demostrating spontaneous, phasic and augmental flow inslcuidng a minimum:

RT & LT CFV, POPV, any additional waveforms if required by lab protocol.

(For unilateral exams, both the RT&LT CFV waveforms are required)

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17
Q

What is considered fully compressibile?

A

*normal compressibility*

The near and far walls fully touch and the vein is completely compressed.

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18
Q

What does partial compressability mean?

A

The vein only compresses partially down.

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19
Q

What does non-compressible mean?

A

The vein doesn’t compress at all.

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20
Q

What does it mean if the vein is partially and non-compressible?

A

There is a precense of a DVT.

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21
Q

What are the characterisitics of a normal venous doppler waveform signal?

A
  • Spontaneous
  • Phasic
  • Augmentable
  • Competency
  • Non-Pulsatile
22
Q

Where should spontaneous “automatic” venous signal be heard at?

A

It should be heard at all sites except for the calf.

23
Q

What kind of flow should you hear when the doppler is sampled inside the vein?

A

Automatic flow.

24
Q

What does phasicity mean?

A

Venous doppler signal should vary with respirations.

25
Q

How is normal phasicity seen?

A
  • No signal or reduced signal with inspiration.
  • Signal should return or augment with expiration.
  • Sounds familiar to waves/ocean.
26
Q

What does reduced phasicity/non-phasic indicate?

A

Presence of thrombus and/or extrinsic compression to the vein.

27
Q

What are the characterisitic of reduced phasicity/non-phasic?

A
  • Flow doesn’t change with respiration
28
Q

What is reduced phasicity/non-phasic also known as?

A

Continuous flow.

29
Q

What does augmentation mean?

A

Increase in venous flow with distal compression.

30
Q

What is an example of augmentation?

A

Valsalva maneuver.

31
Q

What is the valsalva maneuver?

A

a technique where you have the patient hold their breath and “push”

32
Q

This is what a normal augmentation looks like:

A
33
Q

This is what an abnormal augmentation looks like:

A
34
Q

Should normal venous flow be pulsatile?

A

No.

35
Q

When is pulsatility seen in venous flow?

A
  • venous hypertension
  • congestive heart failure
36
Q

What do you do if a doppler demostrates pulsatility?

A

Suggest a hypervolemic state.

37
Q

Why is it important to know how to interpret the results from a a venous duplex exam?

A
  1. To be able to verbally give a preliminary report to the DR.
  2. To be able to formulate a written or typed out preliminary report for the patients chart.
38
Q

What are the two parts to a good intrepration?

A
  1. Findings/analysis
  2. Impression
39
Q

What are the findings/analysis you should have?

A
  1. Compressibility
  2. Doppler waveform analysis
  3. Any incident findings.
40
Q

What is the impression you should have as your intrepretation?

A
  1. Overall summary of your findings.

EX: No evidence of acute DVT or venous obstruction in the right LE.

41
Q

What should you state in your analysis?

A
  1. State the compressibility
  2. State which veins and the extent of the abnormalities.
  3. State Doppler waveform analysis and in which veins
42
Q

What are the type of things you should include in the impression?

A
  1. State the presence or absence of thrombus
  2. State age of thrombus if present
  3. State the location of the thrombus
43
Q

What should you put in the comments in a report?

A
  • Any limitations:
    • If any area was not visualized.
      • State what veins were not assessed ad the reason.
44
Q

what does “+” mean in the legend?

A

Means “present” or “normal”

45
Q

what does “-”

A

means “reduced”

46
Q

What does “Ø” mean?

A

means “absent” or “not present”

47
Q

What does T mean?

A

Totally occlusive

48
Q

What does P mean?

A

Partially occlusive

49
Q

Why are follow-up exams used?

A

to check for:

  1. Progression
  2. Recanalization
  3. Resolution
  4. No change
50
Q

Whats piece of information is very important for you to document?

A

Always document that the preliminary report was given to pager # or Dr, and if the results were relayed.

Venous Procedure (5 decks)

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