Back Module: S-V-S3

Advanced Practice - Venous

Module information

Module details

Title
Advanced Practice - Venous
Type
Specialist
Module code
S-V-S3
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

This module provides the trainee with the knowledge, understanding and practical skills to safely and confidently accept referrals, perform a full diagnostic scan and descriptive report of lower limb venous disease and understand its importance in the patient treatment pathway.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1,9 Training activities

Triage incoming referrals for:

  • DVT
  • Deep venous insufficiency
  • Superficial venous insufficiency
 Type ETA Action View
# 2 Learning outcome 2,4,9 Training activities

Perform optimised ultrasound scans to identify an above knee DVT

 Type ETA Action View
# 3 Learning outcome 2,4,9 Training activities

Perform optimised ultrasound scans to identify a below knee DVT

 Type ETA Action View
# 4 Learning outcome 5,8,9 Training activities

Analyse and interpret ultrasound scans to diagnose a DVT

 Type ETA Action View
# 5 Learning outcome 3,4,9,10 Training activities

Perform optimised ultrasound scans to identify incompetence of the greater saphenous and short saphenous veins and any associated branches including perforators

 Type ETA Action View
# 6 Learning outcome 3,4,9,10 Training activities

Perform optimised ultrasound scans to identify deep venous insufficiency

 Type ETA Action View
# 7 Learning outcome 5,8,9 Training activities

Analyse and interpret the results of the lower limb venous scans, including:

  • Superficial venous incompetence
  • Deep venous incompetence
 Type ETA Action View
# 8 Learning outcome 6 Training activities

Produce descriptive clinical reports for the following:

  • Chronic DVT
  • Acute DVT
  • Deep venous insufficiency
  • Superficial venous insufficiency
  • Superficial vein map
 Type ETA Action View
# 9 Learning outcome 3,9 Training activities

Assess the suitability of veins for use as a bypass graft

 Type ETA Action View
# 10 Learning outcome 7,8 Training activities

Communicate findings of venous scans to:

  • The multidisciplinary team
  • A patient
 Type ETA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform full ultrasound assessment of the leg deep veins from the CFV to ankle including calf veins, gastrocnemius and soleal veins.
  • Perform a primary venous insufficiency scan.
  • Identify and assess the thigh and calf perforators for patency and competence.

Observed Clinical Event Titles

  • Explain results of a scan to a patient.
  • Discuss treatment options with a patient or colleague.

Learning outcomes

# Learning outcome
1

Review and triage referrals for lower limb venous disease.
2

Assess lower limb venous thrombosis using ultrasound.
3

Assess venous insufficiency using ultrasound.
4

Apply ultrasound physics to correctly optimise an ultrasound scan of the lower limb veins.
5

Analyse and interpret ultrasound findings for venous disease of the lower limbwith reference to haemodynamics.
6

Produce an interpretive clinical report of the lower limb vein ultrasound findings.
7

Identify and communicate the scan results to patients and the multidisciplinary team.
8

Summarise the treatment pathways for lower limb venous disease.
9

Appraise the impact of research evidence on national guidelines.
10

Apply ultrasound scanning techniques to assess patients with complex pathophysiology.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Attend a foam sclerotherapy treatment clinic.
  2. Attend a radiofrequency ablation or similar alternative treatment session.
  3. Attend a venous surgical procedure.
  4. Attend a vascular consultant outpatient clinic which includes venous disease patients.
  5. Attend a venous ulcer clinic.
  6. Attend a clinic for patients with DVT.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Differentiate between the range of venous disease and critically appraise the clinical consequences and treatment options.
  2. Critically evaluate the expected co-morbidity associated with venous disease and explain the health and safety risks during the investigation and how they are managed.
  3. Analyse and interpret peripheral venous ultrasound images and associated spectral data.
  4. Critically evaluate the need to convey complex scientific information relating to venous disease to inform multidisciplinary teams of the diagnostic results, conclusions and consequences.
  5. Critically appraise evidence-based guidelines relating to venous disease investigation and management.

Indicative content

Venous Anatomy

  • Venous anatomical variants relevant to ultrasound scanning

Venous Diseases

  • Venous ulcers and differentiation with ultrasound
    • Venous
    • Arterial
  • Swollen leg causes and differentiation with ultrasound
    • Oedema
    • Lymphodoema
    • Venous
    • Cellulitis
    • Congestive heart failure
    • Arterial
    • DVT
    • PTS

Venous Incompetence

Current treatments and patient management
  • Medical
  • Endovascular
  • Surgical
  • Emerging treatments
    • (e.g. MOCA)
  • Pathways guidelines and recommendations
Ultrasound scanning-venous incompetence
  • Role of ultrasound in diagnosis
  • Protocol recommendations
  • Primary and recurrent veins
  • Limitations and technical challenges
  • Reporting recommendations
  • Vein assessment for various endovascular treatments

Venous Thrombosis

  • DVT symptoms and diagnosis
  • Acute and chronic DVT
  • Superficial thrombophlebitis
  • Pathways guidelines and recommendations
Current treatments and patient management
  • Medical
  • Endovascular
  • Surgical
  • Emerging treatments
    • Iliac vein stents and venous surveillance
Ultrasound scanning – DVT
  • Protocol recommendations
  • Role of ultrasound in diagnosis
  • Limitations and technical challenges
  • Reporting recommendations
PTS
  • Symptoms and diagnosis
  • Role of ultrasound in diagnosis
Alternative diagnostic modalities for DVT and incompetence
  • Venography CT and MR
  • Photoplethysmography PPG
Other Findings and Differential Diagnosis
  • Baker’s cyst
  • Pseudoaneurysm
  • Muscle tears
  • Haematoma
  • Abscess
  • Haemangioma
Vein Mapping for Bypass Grafts
  • Mapping protocol recommendations

AV Malformations

A-V Fistulas for Haemodialysis Access
  • Fistula types
  • Mapping protocol recommendations
RSI and Safe Scanning
  • Guidelines and recommendations from professional bodies
  • Protocols for safe scanning

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS1-2-22 Specialty title Vascular Science [2022] Action View
Specialty code SPS1-2-23 Specialty title Vascular Science [2023] Action View
Specialty code SPS1-2-24 Specialty title Vascular Science [2024] Action View
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