Clinical Application Note - Screening for the Absence of an Acute DVT Using PPG 603405-1.pdf
ADVANCED POCKET DOPPLERS
CLINICAL APPLICATION NOTES
NOTE 4 Screening For The Absence Of An Acute DVT Using PPG
HOW TO USE THIS APPLICATION NOTE
PATIENT SYMPTOMS Verify that your patient’s symptoms
correspond to one or more of those listed in Figure 1.
DOPPLEX® EQUIPMENT REQUIRED Select the most
appropriate Dopplex® Pocket unit to perform the examination.
For suggestion of suitable Dopplex® equipment, refer to Figure 2.
PROCEDURE Connect your Rheo Dopplex® II to the Printa II
Package or Reporter Software Package (and a computer), and
begin your examination, refer to Figure 3.
EXAMINATION RESULTS Taking careful note of your Rheo
overleaf and compare your examination results with those
NOTES Refer to Figure 6 overleaf for general notes relating
to this form of examination for venous incompetence.
It is ESSENTIAL
SENSOR POSITION Figure 4 suggests position for sensor and
correct position of patient.
SWELLING OF LEG
REDDENING OF SKIN
Remove footware and stockings.
Place foot on insulated mat.
Adjust height to minimise weight on feet.
Obese patients should be reclined to
reduce venous compression.
Fit sensor 10cm above the
(use length of blue cable).
Ensure patient is stable, i.e., pulse rate normal
Undertake exercise routine
Dopplex® Printa II or Dopplex® Reporter
Diagnostic Products Division
If the Refill Time (RT) is greater than 20 seconds, then the presence
of a DVT is highly unlikely. (See Figure 6 below)
If the refill time is less than 21seconds, then DVT or venous insufficiency
may be present.
The patient should then be referred for further investigation, i.e., Duplex
scanning or venography.
DECISION MAKING FLOWCHART FOR DVT SCREENING
i.e. Duplex scanning
Do not compress limb
if DVT is suspected
Flowchart is for guidance only
The above procedure is only valid for clinically suspected acute lower limb DVT’s. The PPG technique is not sensitive enough to
detect a floating, non-occluding thrombosis. A distal (below knee) thrombosis may not be detected.
References: Tan Y, Da Silva AF, Digital photoplethysmography in the diagnosis of suspected lower limb DVT. Euro Journ of Vasc and Endovasc Surg. 1999 18:1, p71-79
Our thanks go to Dr. Mo Aslam, Dept of Surgery. Hammersmith Hospital, London, UK
• Library of Sounds Audio Cassette
• Assessment & Treatment of Leg
• Vascular Investigations Video
• Assessment of the Diabetic Foot
• ABPI & TBPI guides.
NOTE 1 • Arterial Investigation Of The
NOTE 2 • Venous Investigation Of The
Lower Limb Using Doppler
NOTE 3 • Venous Investigation Of The
Lower Limb Using PPG
NOTE 4 • Screening For The Absence Of
An Acute DVT Using PPG
NOTE 5 • Using A Hand Held Doppler To
Assist With PICC Placement
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Diagnostic Products Division
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