Cardiovascular png

Published on September 23rd, 2010 | by Lewis Potter

Peripheral vascular examination – OSCE Guide

Peripheral vascular examination frequently appears in OSCEs. You’ll be expected to pick up the relevant clinical signs using your examination skills. This peripheral vascular examination OSCE guide provides a clear concise, step by step approach to examining the peripheral vasculature system, with an included video demonstration.

Introduction

Wash hands

Introduce yourself
Explain what you would like to examine
Gain consent
Place patient in a supine position
Ask if patient has any pain anywhere before you begin!

General Inspection

Comfortable at rest?
Look around bedside for treatments or adjunctsmobility aids, o2, cigarettes, medications
Obvious scars
Cyanosis / Pallor

Hands
Inspection

Temperaturecoldness may indicate poor peripheral vascular supply
Colour - cyanosis
Capillary Refillshould be < 2 seconds
Tar Staining - smoker
Tendon Xanthomahypercholesterolemia
Gangrene - necrosis secondary to inadequate limb perfusion

Palpation

Radial Pulse -good volume?
Radial-Radial Delaymay indicate aortic coarctation
Brachial Pulse
BP in both arms - significant difference may indicate aortic aneurysm

Abdomen
Inspection

Scars - midline laparotomy (emergency AAA repair) or transverse incision for elective AAA repair
Obvious pulsations – aortic aneurysm

Masses

Palpation

Palpate the aorta - expansile mass suggestive of aneurysm

Auscultation

Aortic Bruits - indicates turbulent flow – aneurysm

Legs
Inspection

Compare right to left:
Scars - may see evidence of previous bypass surgery
Dressings - ulcers / skin infections – chronic PVD
Discolouration - haemosiderin staining / cellulitis
Pallor – poor vascular perfusion
Missing hair or toes
Ulcers look between toes and lift feet up
Muscle wasting
Dry Skin
Ask patient to wiggle their toes - gross motor assessment

Palpation

Work distal to proximal;
Temperaturecompare left to right
Capillary refill-  <2 seconds is normal
Swelling - oedema
Pulsesposterior tibial, dorsalis pedis, popliteal, femoral
Sensationsoft touch

Auscultation

Femoral

To complete the examination

Thank patient
Wash Hands
Summarise Findings

.

Say you would…
Do a full cardiovascular examination
Perform a ABPI test
Perform Burgers Test

Tags:


About the Author

Doctor. Gadget Fanatic. Internet Junkie.



Back to Top ↑