Applied Fundamentals of Vascular Science —
Training activity: 16

Details

Perform ultrasound scans following a set protocol to identify normal and incompetent flow at the sapheno-femoral and sapheno-popliteal junctions

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Considerations

• Patient centred care and support
• Local SOPs
• National, international guidelines and standards
• Documentation and record keeping
• Use of machine controls
• Principles of Doppler ultrasound
• Selection of appropriate probes for patient/vessel
• Patient positioning and exam technique
• Anatomy of the junctions on ultrasound

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What are the key steps and considerations within the set protocol for assessing flow at the SFJ and SPJ?
• What anatomical landmarks do you need to be confident in identifying using ultrasound at these junctions?
• What preparation will you undertake to ensure you are familiar with the ultrasound techniques for assessing valvular competency?
• How will you assess to see whether the SFJ and SPJ are competent?
• What are the criteria for determining normal and incompetent venous flow at these junctions using Doppler, colour Doppler and spectral Doppler?

In action

• Are you following the steps of the set protocol for assessing flow at these superficial venous junctions?
• How confident are you in locating the SFJ and SPJ using ultrasound?
  • What anatomical landmarks are you using to ensure you are on the correct vein?
• What technique are you using to assess competence at the junctions?
• How are you positioning the Doppler sample volume to accurately assess flow at the junction during your assessment?
• What visual cues on colour Doppler are you observing that might suggest reflux (incompetent flow)?
• If there is incompetent flow at the junction, how are you grading this using spectral Doppler?

On action

• Describe the process of performing the ultrasound scans at the SFJ and SPJ according to the protocol.
  • How did you assess for normal and incompetent flow?
  • What specific ultrasound techniques did you employ?
  • What were the visual and Doppler findings associated with competent and incompetent flow?
• How well were you able to follow the set protocol for assessing these superficial venous junctions?
  • How confident were you in identifying normal and incompetent flow patterns using ultrasound and Doppler?
  • Were there any challenges augmenting flow or interpreting the flow patterns?
• Are there any specific aspects of the protocol for assessing superficial venous incompetence that you need to review?
  • What techniques for visualising flow at these junctions and eliciting reflux will you focus on in future practice?

Beyond action

• Reflect on your initial experiences assessing valvular function at these key superficial venous junctions.
  • How has your understanding of the technical challenges and the importance of patient positioning evolved?
• How have subsequent experiences, potentially including observing or performing full lower limb venous scans, broadened your perspective on the significance of competence at these junctions?
• Have you revisited your initial reflections on this DTA?
  • How has your growing understanding of venous haemodynamics influenced your approach to evaluating flow at these junctions?
• In what ways has developing proficiency in this DTA contributed to your ability to understand and potentially participate in the management of patients with varicose veins or superficial venous reflux later in your training?

Relevant learning outcomes

#	Outcome
# 1	Outcome Communicate effectively with a range of patients and other professionals.
# 2	Outcome Assess vascular anatomy using ultrasound.
# 3	Outcome Apply the principles of ultrasound safety and ergonomics whilst performing a scan.
# 5	Outcome Apply the principles of ultrasound physics to adjust and optimise an ultrasound machine to obtain quality images.
# 10	Outcome Evaluate protocols and national guidelines and their impact of vascular science practice.