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October 20-21, 2019
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3
DVT
DVT for the Hospitalist?
- Compression of veins at bedside
- Immediate results
- Available nights and weekends
- Able to repeat the exam
- Accuracy is good
Disclosure I have no relevant financial relationships with any - - PDF document
Disclosure I have no relevant financial relationships with any - - PDF document
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
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LE DVT US: Anatomy LE DVT US: Probe
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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+
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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
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- 1. Common
Femoral Vein
- 2. Common Femoral
Vein at Greater Saphenous
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- 3. Common Femoral Vein
at Lateral Perforator
- 4. Common and Deep
Femoral Veins
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4+. (Superficial) Femoral Vein Mid Thigh
- 5. Popliteal Vein
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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]
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Summary
- Learn the anatomy
- 2 region exam (no longer 2 point)
- Compression is key
- Be mindful of pitfalls