Disclosure I have no relevant financial relationships with any - PDF document

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10/9/2019 Point of Care Ultrasound UCSF Continuing Medical Education DVT Charlie LoPresti, MD October 20-21, 2019 Disclosure I have no relevant financial relationships with any companies related to the content of this course. 1 10/9/2019

10/9/2019 Point of Care Ultrasound UCSF Continuing Medical Education DVT Charlie LoPresti, MD October 20-21, 2019 Disclosure I have no relevant financial relationships with any companies related to the content of this course. 1
10/9/2019 DVT 3 DVT for the Hospitalist? • Compression of veins at bedside • Immediate results • Available nights and weekends • Able to repeat the exam • Accuracy is good 2
10/9/2019 LE DVT US: Anatomy LE DVT US: Probe 3
10/9/2019 2 “points” = 2 Regions, 6 Clips – Proximal Thigh = From CFV to Middle/Distal SFV (5 Clips) – Popliteal Fossa = Pop Vein 3‐ 4cm above crease (1 Clip) LE DVT US: Positions 4+ 4
10/9/2019 LE DVT US: Compression technique • Compression is adequate • Doppler does not improve sensitivity and specificity but may help identify and confirm vessels • Visible Thrombus is diagnostic • Non compressible vein is diagnostic 5
10/9/2019 1. Common Femoral Vein 2. Common Femoral Vein at Greater Saphenous 6
10/9/2019 3. Common Femoral Vein at Lateral Perforator 4. Common and Deep Femoral Veins 7
10/9/2019 4+. (Superficial) Femoral Vein Mid Thigh 5. Popliteal Vein 8
10/9/2019 LE DVT US: Pitfalls • Finding vessels – Inadequate depth • False Positives – Inadequate pressure – Caught on hamstring tendon – Lymph nodes – Overcalling branch of pop artery as pop DVT View? Side? Abnormality? 04.35.14 hrs __[0006225] 9
10/9/2019 Summary • Learn the anatomy • 2 region exam (no longer 2 point) • Compression is key • Be mindful of pitfalls 10

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