Peak Technique: Conquering the continuous wave venous Doppler
Jolinda Chrisman RN
Spencer Warren BSN, RN, CCRN
Charlotte Davis BSN, RN, CCRN

Nursing Made Incredibly Easy!
October 2012 
Volume 10  Number 5
Pages 51 - 53
  PDF Version Available!

Editor's note: Last issue, we examined how to use a bladder scanner. Join us in this issue as we take a look at how to use a venous Doppler device.A continuous wave venous Doppler is a portable, handheld ultrasound device that evaluates the patency of major veins in the arms, legs, and neck by detecting blood flow. This painless, noninvasive procedure is often referred to as a "bedside Doppler" by clinicians.Continuous wave venous Doppler devices are used by nurses in a variety of healthcare settings, such as the: * ED * medical-surgical unit * CCU * physician's office * wound care clinic * long-term care facility * home health setting.Conductive ultrasound gel is applied to the skin over the selected blood vessel. The handheld wand (transducer) is pressed into the gel against the skin, directing high-frequency sound waves over the blood vessel. These sound waves enter the tissue and bounce off the flowing blood, creating an ultrasonic echo; the transducer detects and converts these echoes into a sound wave. The repetitive sound waves are bounced off the blood cells as they course through the vessel with each heartbeat and are sent back to the transducer, filtering through two piezoelectric crystals that vibrate at 8 million cycles per second.The speed and flow of blood coursing through the vein is interpreted by the amplified ultrasound as a "whoosh" sound. The presence or absence of this repetitive sound can help clinicians measure the patency of venous blood vessels and assist with diagnosing potentially life-threatening conditions. If the blood vessel is patent, a loud, repetitive "whoosh" will be heard. If the vein is partially occluded, a faint "whoosh" sound may be heard. If the vein is completely occluded, there will be no sounds other than the continuous baseline static noise emitted from the device.You should perform a quick neurovascular check before performing the venous Doppler procedure. A basic neurovascular check includes the eight P's: * pallor * pain

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