VASCULAR LABORATORY PERSONNEL ON-CALL - EFFECT ON PATIENT-MANAGEMENT

Purpose: A prospective study was undertaken of all vascular laboratory tests performed by the ''on-call'' technologist during a 3-year time period. Methods: Technologists take call on a rotating basis. All pati ents evaluated had symptoms. History and risk factor data were collect ed at the time of patient encounter. Results: Studies were initiated f rom the emergency department 56% of the time, from inpatient examinati ons 33% of the time, and from outpatient examinations 11% of the time. Ninety percent (n = 440) of the studies obtained were venous duplex s cans (VDS). Fifty-eight percent (257 of 440) of the studies were perfo rmed on weekends. Thirty-two percent of the studies resulted in admiss ion of the patient. Of the 440 VDS obtained, 51% (224 of 440) identifi ed some type of disease. Acute deep venous thrombosis (DVT) was diagno sed in 15% (67 of 440), acute superficial venous thrombosis (SVT) in 4 % (17 of 440), acute DVT and SVT in 7% (31 of 440), chronic DVT in 4% (17 of 440), chronic SVT in 4% (16 of 440), and chronic DVT and SVT in 1% (3 of 440); 2% (9 of 440) of the DVTs were of indeterminate age. O ther diseases were identified in 22% (95 of 440), including popliteal cysts, inguinal lymphadenopathy, and soft tissue edema. Conclusions: H aving an ''on-call'' vascular technologist has allowed patients with a cute venous thrombosis to be triaged and admitted, if necessary, in a timely fashion. Those patients who have symptoms and a negative VDS re sult are able to avoid unnecessary hospitalization and treatment. The expense of this service is easily justified by the savings of unnecess ary hospital days.