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Raynaud's Cold Stimulation Test

Norm of Raynaud's Cold Stimulation Test

Within 15 minutes, digital temperature returns to prebath temperature. Recovery time >20 minutes indicates Raynaud's syndrome.

 

Usage of Raynaud's Cold Stimulation Test

Detection of Raynaud's syndrome after occlusive disease of the peripheral arteries is ruled out.

 

Description of Raynaud's Cold Stimulation Test

This test records digital temperature changes after submersion of the digits in an ice-water bath. Raynaud's syndrome is an idiopathic, vasospastic disorder of small cutaneous arteries and arterioles of the extremities characterized by intense paroxysmal bilateral pallor and cyanosis of the fingers or toes with or without local gangrene. The attacks may occur in response to exposure of the affected extremities to cold temperature. Idiopathic or primary occurrence of this syndrome is referred to as “Raynaud's disease.” “Raynaud's phenomenon” is the term used when accompanied by paresthesia and caused by underlying disease processes such as connective tissue disorders.

 

Professional Considerations of Raynaud's Cold Stimulation Test

Consent form NOT required.

Risks
Increased infection in open wounds on fingers.
Contraindications
Gangrenous digits, or open or infected wounds on the hands.

 

Preparation

  1. All jewelry should be removed from the fingers and wrists.

 

Procedure

  1. Digital temperatures are measured by thermistors attached to each digit.
  2. The hands are then submerged in an ice-water bath for 20 seconds.
  3. Serial temperature recordings are taken beginning immediately after the hands are removed from the bath and continue every 5 minutes for 20 minutes.

 

Postprocedure Care

  1. None.

 

Client and Family Teaching

  1. Avoid exposing the hands to extreme cold.
  2. Smoking greatly increases difficulties in clients with peripheral circulatory problems.

 

Factors That Affect Results

  1. Excessively cold or warm ambient temperature can alter the physiologic response.

 

Other Data

  1. Laser Doppler flowmetry is being studied for its usefulness as an adjunctive diagnostic tool for Raynaud's conditions.