RD2 Competency Assessment Form

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Name:

Ward:

Date:

Hospital/Department: Having completed this assessment, users will be able to demonstrate competency with the equipment to ensure correct application. Performance Criteria

Attained

Deferred Date

Signature of Assessor

State the clinical applications for the Rheo Dopplex Demonstrate how to connect the Rheo to the Dopplex Printa (if applicable) Demonstrate how to connect the Rheo to the Dopplex Reporter software package running on a PC* Show how to record a Doppler waveform on the Printa or Reporter package* Show how to increase and decrease the height of the waveform Explain how to change the battery Demonstrate how to connect the VPPG sensor to the Rheo Demonstrate how to correctly prepare the patient for a VPPG test Show how to attach the VPPG sensors Demonstrate how to undertake a VPPG test Explain the RT and VP values calculated by the Rheo Explain the shape of the curves obtained and their relevance to venous disease Explain the clinical parameters when screening for the absence of DVT Demonstrate the use of the tourniquet at the three positions Explain how to use the flowchart and how to diagnose different levels of venous disease (ie. Superficial or deep) * where applicable depending on customer requirements / intended mode of use Signature of Assessor:

Date:

Signature of Participant:

Date:

LIT 726447-A

Re-assessment Date:

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