Vascular Ultrasound

Venous thromboembolism is a common presentation to the Emergency Department and Critical Care setting. It is estimated that two million people are diagnosed with a deep venous thrombosis (DVT) each year in the United States resulting in 600,000 hospitalizations and 200,000 deaths from pulmonary embolism. Additionally, venous thromboembolism is a common complication of hospitalization in the critical care environment owing to a patient’s immobility and comorbid disease. The diagnosis of DVT begins with appropriate clinical suspicion. Several clinical prediction tools have been developed to help determine patients at high or low risk for DVT. However, these tools used in isolation suffer from an insufficient sensitivity or specificity to exclude or identify the presence of a DVT. Ultimately imaging is necessary in making the diagnosis of a DVT. Venous ultrasound has been shown to be effective in the evaluation of DVT. Ultrasound has the advantage of being rapid, non-invasive and can be done portably. Additionally, multiple studies have demonstrated the feasibility of DVT ultrasound performed at the bedside by clinical physicians. Therefore, ultrasound is the ideal modality for the evaluation of DVT in the critical care environment when the patient’s condition or monitoring equipment preclude the patient from being transported to a specialized imaging suite.