Clinical Application Note - Using A Hand Held Doppler to Assist with PICC Placement 603406-1.pdf
ADVANCED POCKET DOPPLERS
CLINICAL APPLICATION NOTES
NOTE 5 Using A Hand Held Doppler To Assist With PICC Placement
HOW TO USE THIS APPLICATION NOTE
DOPPLEX® EQUIPMENT REQUIRED Select the most appropriate Dopplex® Pocket unit to perform the examination. For
suggestion of suitable Dopplex® equipment, refer to Figure 1.
PROCEDURE Peripherally Inserted Central Catheters (PICCs) are placed via cannulation of one of the patient’s antecubital fossa
veins. Follow the procedure in Figure 3.
LOCATING VEINS Figure 4 suggests the ideal probe position for locating veins.
Bi-directional Doppler, Super
Dopplex® II or Maxi Dopplex® with VP8 probe.
Veins generate low velocity Doppler signals which
can be described as sounding like ‘wind’; arteries
generate pulsatile multi-phasic signals.
Adequate skin preparation should always be performed prior to venipuncture. The person placing the PICC should always
wear appropriate clothing to provide personal protection, to create and maintain a sterile environment, e.g. sterile gloves,
The area surrounding the site should be draped to ensure that a sterile environment is created and maintained.
NOTE - Always clean the probe tip with an alcohol impregnated wipe or a damp cloth impregnated with a mild detergent
before and after use. Remove excess gel before storing the probe.
Diagnostic Products Division
Lightly apply the tourniquet above the antecubital fossa.
● Apply gel to area under investigation
Hold the probe at an angle of between 450 and 600 to the
vessel under examination
Slowly sweep the probe across the area to locate the vein
Use the clinical marker to mark either side of the vein
Place the PICC in accordance with the PICC
manufacturer’s instructions or local guidelines
It is important to be able to differentiate between the sounds generated by the Arteries and Veins. Arteries generate high frequency
multi-phasic sounds, whereas veins usually generate low velocity monophasic signals. If using a Bi-directional Doppler, vessel type
can be confirmed by the information displayed on the bar graph. See examples below.
Normal Dopplex® Display of an Artery
Normal Dopplex® Display of a Vein
The bar graph display should always be coincident with the sounds.
References: Gabriel J, PICCs: How Doppler ultrasound can extend their use. Nursing Times, volume 95 No. 6:1999
Our thanks go to Mrs Janice Gabriel Senior Onocology Nurse specialist / Manager for helping with the compilation of this application note.
• 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
Huntleigh Healthcare Limited
Diagnostic Products Division
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Vascular Assist with Doppler,
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