Madtown Sono

DVT

Objectives

  1. Describe the steps and technique when performing a DVT ultrasound exam.
  2. Name several locations where DVTs may occur and the most/least common locations.
  3. Walk through the steps and technique when occurring a DVT exam (and locations to compress).
  4. Name several ‘fake outs’ to beware of when performing a DVT exam.

Introduction to DVT Ultrasound (presented by Sara Damewood, MD)

Evaluation:

Like what you see? Tell us! Leave us an evaluation HERE

Check your knowledge!

This is an accordion element with a series of buttons that open and close related content panels.

Name various locations where DVTs happen in the lower extremity (and which is most common)

Clots can occur in various places:

  1. Common femoral vein (1.4%)
  2. Deep femoral vein (0.8%)
  3. Femoral vein (5.5%)
  4. Popliteal vein (14.6%)

Describe how to position the patient when performing a DVT exam.

Steps:

  1. Have the patient change into shorts or a gown
  2. Position the patient in the “frog leg” position- flex leg and externally rotate.
  3. Consider placing the bed in the reverse Trendelenburg position

Name the first location to scan when evaluating for a DVT.

The first location to evaluate is the femoral vein, at the takeoff of the greater saphenous vein.

Name the second location to scan when evaluating for a DVT.

The next location to evaluate is the femoral vein (before it splits into the femoral vein and deep femoral vein).

Name the third location to scan when evaluating for a DVT.

The third location to evaluate is the split of the femoral vein (into the femoral vein and deep femoral vein).

Name the fourth location to scan when evaluating for a DVT.

The fourth location is the mid-thigh— remember that 5.5% of DVTs may occur in this area.

Name the fifth and final location to scan when evaluating for a DVT.

The fifth (and final) location is the popliteal vein. This is the most common location where DVTs occur!

Remember “pop on top.” The popliteal vein will be on top of the popliteal artery (in contrast to the rest of the leg).

Name several adjuncts you can use to supplement your DVT scan.

Two adjuncts (with Doppler!)

  1. Phasicity: measures the velocity of flow through the vein with changes in intrathoracic pressure (undulating wave form)
  2. Augmentation: measures the velocity of flow through the vein after squeezing the patient’s calf (large rush of flow seen on Doppler).

Name several "fake outs" when assessing for DVTs on ultrasound.

Several “fake outs” to beware of:

  1. Lymph nodes (especially near the groin)
  2. Baker’s cyst (looks like a “speech bubble”)