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Introduces self
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1
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Confirms name & age of patient
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1
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Explains & gains consent
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1
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Washes hands
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1
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Exposes patient fully and asks them to stand up if able
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1
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Asks if patient is in pain
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1
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General inspection around bed and patient: comfortable, amputations,
pallor, walking aids, cigarettes, GTN spray.
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1
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Inspects for venous changes (particularly in gaiter's area) with patient
standing (oedema, varicose veins, ulcers, stars, eczema, haemosiderin
deposition, thromboplebitis, lipodermatosclerosis, scars)
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1
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Describes size/depth/edge/colour/discharge of any ulcers
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1
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Palpates the course of the short saphenous, feeling for hardness and tenderness. Tests for cough impulse at saphenopopliteal junction
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1
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Palpates the course of the long saphenous, feeling for hardness and tenderness. Tests for cough impulse at saphenofemoral junction
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1
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Performs tap test on any varicose veins and listens for venous bruit
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1
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Thanks patient and offers help to redress
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1
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Washes hands
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1
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Requests additional venous tests (Trendelenberg's/Tourniquet test,
Perthes test, abdopelvic exam, duplex ultrasound, rectal examination)
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1
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Summarise appropriately with only key findings.
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1
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Offer appropriate differential diagnoses.
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Patient global score
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1
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2
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If the station asks you to take a brief history, it is important to ask questions about current symptoms of venous disease and assess its severity. Additionally, you could ask briefly about risk factors.
Venous
- Pain/heaviness/pruritus/swelling
- Changes to the skin
- Risk factors: prolonged standing, injury, pregnancy, immobility (for DVT)