| Autor: |
Theophanous RG; Department of Emergency Medicine, Duke University School of Medicine; rebecca.theophanous@duke.edu., Chow VW; Department of Anesthesiology, Dartmouth-Hitchcock Medical Center., Convissar DL; Department of Anesthesiology, Massachusetts General Hospital., Haskins SC; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery; Department of Anesthesiology, Weill-Cornell Medical College., Jones RA; Department of Emergency Medicine, MetroHealth Medical Center/Case Western Reserve University., P Kalagara HK; Department of Anesthesiology, Mayo Clinic., Bronshteyn YS; Department of Anesthesiology, Duke University School of Medicine. |
| Abstrakt: |
Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed in radiology and vascular labs, point-of-care ultrasound (POCUS) is becoming more common in the acute care setting. Providers appropriately trained in focused POCUS can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. This paper describes a simplified yet validated approach to POCUS by describing a three-zone protocol for lower extremity DVT POCUS image acquisition. The protocol explains the steps in obtaining vascular images at six compression points in the lower extremity. Beginning at the level of the proximal thigh and moving distally to the popliteal space, the protocol guides the user through each of the compression points in a stepwise manner: from the common femoral vein to the femoral and deep femoral vein bifurcation, and, finally, to the popliteal vein. Further, a visual aid is provided that may assist providers during real-time image acquisition. The goal in presenting this protocol is to help make proximal lower extremity DVT exams more accessible and efficient for POCUS users at the patient's bedside. |
