[KungFuFtr]

Hi
The day before our clinical we must do prep work. This consists of typing out the pt's disease, pathogenesis, etiology, manifestations and list all drugs and procedures that we'll anticipate doing.
For the last part of my prep, I must print out instructions on using a doppler ultrasound.
My nursing books do not have that procedure. Does anyone have a link that shows the steps? I can't just type out the steps. I must print from an online source or xerox them from a book.

If you could referr me to a link i'd be gratefull!

[adidasgirl0699]

I don't know if either of these will help, but good luck!


http://www.nlm.nih.gov/medlineplus/e...is%20performed

http://www.centrus.com.br/DiplomaFMF...chapter_01.htm

[Daytonite]

It would be so nice if you had the brand name of the Doppler device you will be using, so you could search for the product instructions or specification on the Internet! I think I know what you are going to be using. . .basically, a microphone that will pick up the pulse in someone's foot to evaluate the presence of the person's pulse. We had one on all our medical units to assess patients with PVD.

If you scroll down slightly to the heading for "Doppler" you will find an explanation of how Doppler works.
http://www.analog.com/library/analogDialogue/archives/33-05/ultrasound/index.html

This is what the article says:
"2. Doppler -- The best analogy to medical Doppler ultrasound is color Doppler weather radar. As the name suggests, Doppler modes detect the velocity of an object in motion by tracking the frequency shift of the return signal. These principles are applied in examining blood or other fluids flowing within the body. It is accomplished by transmitting a continuous wave into the body and producing a fast Fourier transform (FFT) of the return. The computational process will determine the frequency components of the signals from the body and their relationship as a function of fluid velocity. One bin will contain the fundamental transmitted frequency while other bins contain the Doppler shifted frequencies. 4´ oversampling is often employed.

3. Venous and arterial modes -- They employ Doppler in conjunction with the gray-scale mode. First the image of a vein or artery will be found The operator will dial in a small cursor window around it. The Doppler is then engaged within the cursor area. The transmitted signal's Doppler frequency shift will be measured as discussed above. Audio will also be used with the cursor image. Venous flow produces a rushing sound (like a waterfall), while the thump of a pulse will indicate arterial flow. At the same time, blood velocity will be displayed on a digital readout. The sinus rhythm will be displayed as an X-Y plot on the screen. The velocity and rhythm displays are obtained by processing the audio signal from the Doppler shifts."

You should look onlinie or in the facility's procedure manual for a procedure on how to dopple a peripheral pulse.

[Daytonite]

Here is the procedure exactly as it appears on page 307 of Portable RN: The All-in-One Nursing Reference, third edition, published by Lippincott Williams & Wilkins:

"More sensitive than palpation for determining pulse rate, the Doppler ultrasound blood flow detector is especially useful when a pulse is faint or weak. Unlike palpation, which detects expansion and retraction of the arterial walls, this instrument detects the motion of the red blood cells (RBCs).

• Apply a small amount of coupling or transmission gel (not water-soluble lubricant) to the ultrasound probe.
• Position the probe on the skin directly over the selected artery.
• When using a Doppler ultrasound blood flow detector model with a speaker, turn the instrument on. Moving counterclockwise, set the volume control to the lowest setting. If your model doesn't have a speaker, plug in the earphones and slowly raise the volume. The Doppler ultrasound stethoscope is basically a stethoscope fitted with an audio unit, a volume control, and a transducer, which amplifies the movement of RBCs.
• To obtain the best signals with either device, tilt the probe 45 degrees from the artery and apply gel between the skin and the probe. Slowly move the probe in a circular motion to locate the center of the artery and the Doppler signal--a hissing noise at the heartbeat [this is called the bruit].
• Avoid moving the probe rapidly because it distorts the signal.
• Count the signals for 60 seconds to determine the pulse rate.
• After you've measured the pulse rate, clean the probe with a soft cloth soaked in antiseptic solution or soapy water. Don't immerse the probe or bump it against a hard surface.

Documentation: Record the location and quality of the pulse, the pulse rate, and the time of the measurement."

FYI: We often marked patient's skin at the pulse point where you could hear the bruit with a clear "X" that could be seen by all.

Hope this is what you were looking for.