Applied Fundamentals of Vascular Science —
Training activity: 8

Details

Perform ultrasound scans following a set protocol to identify normal lower limb arterial anatomy for the fem-pop segment only

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 lower limb arteries 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 is your local protocol for performing femoral and popliteal arteries?
• What anatomical landmarks do you need to be confident in identifying using ultrasound for the fem-pop segment?
• What preparation will you undertake to ensure you are familiar with the normal ultrasound appearance of these arteries, including B-mode and Doppler characteristics?
  • What spectral doppler waveform characteristics do you expect to see in a normal femoral-pop scan?

In action

• Have you set up the room and patient in an appropriate way to assess the fem-pop segment?
• Are you following the steps of the set protocol in the correct order as you scan the femoral and popliteal arteries?
• How confident are you in locating and identifying the common femoral, superficial femoral, profunda femoral and popliteal arteries based on anatomical landmarks and ultrasound appearance in the fem-pop segment?
• Are there any variations in the arterial anatomy that you are noting?
• What adjustments to transducer position, angle, and pressure are you making to visualise the fem-pop segment clearly?
• What machine control settings are you adjusting to correctly identify the arteries in the fem-pop segment?
• Are you ensuring all required views and Doppler samples are being obtained as per the protocol for this segment?

On action

• Describe the process of performing the lower limb arterial scan for the fem-pop segment according to the protocol.
  • What anatomical structures) were you able to clearly visualise?
  • Were there any difficulties encountered during the scan?
• How well were you able to follow the set protocol for this specific arterial segment?
  • How confident were you in identifying the normal anatomy using ultrasound?
  • Were there any specific techniques that you found effective for visualising these vessels?
• Are there any steps in the protocol that you need to review?
  • What techniques for visualising the femoral and popliteal arteries will you remember for future scans?
• How confident do you feel identifying the arteries in the fem-pop segment during a more complex/diseased scan?

Beyond action

• Reflect on your initial experiences performing these lower limb arterial scans.
  • How has your understanding of potential anatomical variations, abnormalities or challenges in this segment developed since performing this DTA?
  • What steps have you taken to aid this development?
• How have experiences with patients presenting with arterial disease in the fem-pop segment enhanced your understanding of normal anatomy in this region?
• In what ways has developing skill in this focused scan contributed to your ability to perform more comprehensive lower limb arterial assessments later in your training?
• What are you areas of focus to further develop your ability in scanning the fem-pop segment going forward?

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.