![]() ![]() Monophasic which occurs when the flow of blood is no longer pulsatile.Īll three types of blood flow occur in healthy subjects. Triphasic which occurs in arteries and is the result of the combination of ventricular systole, elasticity of the blood vessels and the backflow caused by the closing of the semilunar valves īiphasic which occurs in more distal blood vessels as the result of ventricular systole and the elasticity of the blood vessels Three patterns of blood flow, producing characteristic audio outputs from the Doppler ultrasound machine, are commonly associated with vascular assessment : The ultrasound waves are reflected by the blood cells back to the probe and Doppler ultrasound machine, which produces an audible output. The Doppler probe is placed over the pulse sites, with acoustic gel applied, and angled so that the emitted ultrasound waves are projected obliquely into the oncoming blood flow. Two main pulse sites are commonly used by podiatrists during vascular assessment, the posterior tibial and dorsalis pedis arteries. ![]() Doppler ultrasound investigation is particularly effective in the calculation of ankle brachial pressure indices and the assessment of blood pressures in the toe, and has become a valuable tool in PAD detection for patients with diabetes as the non-invasive nature of Doppler ultrasound investigation poses minimal risk to the patient whilst providing accurate diagnostic capability. As a component of a multimodal approach to vascular assessment it has been used routinely by podiatrists since its validation as a clinical screening tool in the 1980s for both the detection of peripheral arterial disease (PAD), and to categorise the risk of a patient developing complications such as ulceration, gangrene and amputation. Assessment of the arterial perfusion of the lower limb using hand held Doppler ultrasound machines is practical, painless and effective. Originally developed by Christian Doppler in the 19th Century, Doppler waveform has now become a portable and easily usable method of establishing pulse wave-form and systolic blood pressures. However, the results raise an issue regarding professional development of practitioners who might have been expected to have enhanced their skills of Doppler ultrasound sound identification since professional registration. The results of this relatively small study suggest that both student and HCPC registered podiatrists are in general able to identify the nature of blood flow based on the output of handheld Doppler ultrasound units. No significant difference was found in their ability to identify Doppler ultrasound recordings of monophasic, biphasic or triphasic blood flow (p > 0.050). ResultsĬhi-squared analysis found that there was no statistically significant difference between the overall abilities of student podiatrists and HCPC registered podiatrists to identify correctly Doppler ultrasound recordings (p = 0.285). ![]() Chi-squared analysis of the results was undertaken. Fifteen Doppler recordings of the blood flow in the posterior tibial artery, five each of monophasic, biphasic and triphasic blood flow, were used to compare the interpretation abilities of 30 undergraduate podiatry students and 30 HCPC registered podiatrists. MethodĪ prospective single blind comparative study design was utilised. ![]() This study compared the abilities of student and Health and Care Professions Council (HCPC) registered podiatrists to identify correctly Doppler ultrasound outputs. They are practical, painless and effective as a screening tool, and the available general evidence would suggest that interpretation by practitioners is reliable. Hand held Doppler ultrasound machines are routinely used by podiatrists to assess the arterial perfusion of the lower limb. ![]()
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