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Introduction

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Certain patients in the intensive care unit (ICU) are at risk for arterial insufficiency due to arterial injury (ie, aortic or other vascular dissection) or vascular surgery. Portable Doppler evaluation may also be used as an adjunct to standard blood pressure measurement or pulse detection.

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Definitions and Terms

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  • Doppler ultrasound: The use of an ultrasound probe and speaker to applied over a vessel to detect flow beneath the probe

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Techniques

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  • The tip of the ultrasound probe is lubricated with ultrasonic gel and applied to the skin over vessels in the extremity to detect flow in arteries of interest, such as the dorsalis pedis (Figure 53-1) and posterior tibial (Figure 53-2) arteries.

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Figure 53-1.
Graphic Jump Location

Doppler examination of dorsalis pedis pulse.

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Figure 53-2.
Graphic Jump Location

Doppler examination of posterior tibial pulse.

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Clinical Pearls and Pitfalls

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  • If arterial sounds are absent over suspect arteries, the probe should be applied to arteries with pulsatile flow elsewhere on the patient, or the operator may apply the probe to one of his own arteries to verify correct functioning of the device.

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Suggested Reading

Campbell WB, Fletcher EL, Hands LJ. Assessment of the distal lower limb arteries: a comparison of arteriography and Doppler ultrasound. Ann R Coll Surg Engl. 1986;68:37–39.  [PubMed: 3511835]

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