Training activity information
Details
Identify, analyse and interpret the anatomy and haemodynamics of normal and incompetent flow at the sapheno-femoral junction and sapheno-popliteal junction using:
- Doppler spectrum
- Colour spectral
- B mode
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
- Troubleshooting
- Physiology, histology and pathology of the lower limb venous junctions
- Impact of incompetent valves on Doppler spectrum, colour spectral and B mode
- Effects on patients (vasovagal syncope)
- Artifact causes and corrections
- Limitations and pitfalls
- Consequences of misdiagnosis
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 expected normal and abnormal haemodynamic characteristics (Doppler spectrum, colour flow patterns) at the sapheno-femoral and sapheno-popliteal junctions?
- What criteria will you use to diagnose valvular incompetence using Doppler ultrasound?
- What preparatory steps will you take to review the anatomy and haemodynamics of these superficial venous junctions prior to undertaking this activity?
- How will you ensure you are augmenting flow correctly and interpreting the Doppler signals accurately?
In action
- What techniques are you using to augment flow at these superficial venous junctions?
- What are the characteristics of the spectral Doppler signals you are observing at rest and whilst augmenting flow at both junctions? Are you noting any retrograde flow?
- How long is any reflux lasting during flow augmentation, and how are you measuring this duration?
- Are you adapting your Spectral Doppler range gate size to optimise the spectral Doppler signal at these superficial junctions?
- How are you differentiating normal transient flow changes from significant venous reflux?
On action
- Describe the B-mode appearances and the Colour and Spectral Doppler findings associated with normal and incompetent flow at both the sapheno-femoral and sapheno-popliteal junctions.
- What haemodynamic characteristics did you observe in cases of incompetence?
- How effectively did you use Doppler spectrum, Colour Doppler, and B-mode to identify, analyse, and interpret the anatomy and haemodynamics of these superficial venous junctions?
- How confident were you in differentiating between normal and incompetent flow patterns based on Doppler findings?
- Were there any specific aspects of interpretation that you found challenging?
- How effective was the technique you used to augment flow, is there any aspect of flow augmentation you need to work on going forwards?
- What aspects of interpreting Doppler findings for superficial venous incompetence will you review further?
- Are there any Doppler techniques you want to practice more in this context?
- How will you ensure accurate interpretation in future assessments?
Beyond action
- Consider your initial interpretations of normal and refluxing flow at these junctions.
- How has your ability to differentiate subtle degrees of incompetence developed through further experience?
- Can you recall instances where your understanding of normal and abnormal superficial venous haemodynamics influenced your interpretation of a more complex venous study?
- How has your experience drafting reports for these examinations influenced the way in which you carry out your assessment of venous insufficiency?
- How have discussions with experienced sonographers or vascular specialists helped you refine your criteria for identifying and grading superficial venous incompetence since you completed this DTA?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 6 |
Outcome
Analyse and interpret ultrasound images with reference to haemodynamics whilst performing a range of scans. |