Page 286 - Libro 2

266
PART 4 — PERIPHERAL VENOUS
A platform device used for evaluation of patients in the standing position.
cannot be performed is a reverse Trendelenburg position.
The following order is recommended to optimize the standing examination:
1. Most symptomatic or affected thigh
2. Least symptomatic or affected thigh
3. Most symptomatic or affected calf or saphe-
nous vein
4. Least symptomatic or affected calf or saphe-
nous vein
Episodes of fainting or ill conditions most like-
ly would occur after a thigh examination. Follow- ing the previous order, the thighs are examined first and the patient can then rest and recover if necessary. Veins in the calf, knee, and lower thigh can be examined in a less stressful sitting position (Fig. 17-13).
The patient rotates the knee outward during GSV examination of the great saphenous vein. The SSV can be examined with the patient facing the tech- nologist, sideways, or with his or her back toward the technologist.
Technologist position must be addressed. Ergono- metrics are paramount to a technologist’s long-term professional health. The torso should be erect and not forcefully twisted because attention changes between instrument and patient. Elbows should be close to the body. One hand deals with instrument controls while the other handles the transducer. One foot controls compression/decompression maneuvers if using an automated cuff system. Po- sitioning the patient on a platform minimizes arm extension as the veins are examined from groin to ankle. Height of the technologist’s stool is accom- modated to optimize body positioning differences among groin, thigh, knee, or calf examinations (Fig. 17-14).
EQUIPMENT
High-resolution duplex ultrasound with transducer frequencies ranging from 3.5 to 7.5 MHz and 7.5 to 17.0 MHz are recommended for deep and superficial venous testing, respectively. Linear transducers are ideal for extremity venous applications.
Figure 17-13 Proper patient and technologist position for a sitting CVVI examination.
Figure 17-12