Swipe om te navigeren naar een ander artikel
The authors declare that they have no competing interests.
CAP, RS, SH, JP, NR, SJ and WW administered and carried out the collection of Doppler ultrasound recordings from patients and interpretation data from participants. MY and SO guided the research design, supervised the research and provided interdependent validation of the recordings and results. IB guided the interpretation of the results, undertook the data analysis and produced the final manuscript. All authors read and approved the final manuscript.
Hand held Doppler ultrasound machines are routinely used by podiatrists to assess the arterial perfusion of the lower limb. They are practical, painless and effective as a screening tool, and the available general evidence would suggest that interpretation by practitioners is reliable. This study compared the abilities of student and Health and Care Professions Council (HCPC) registered podiatrists to identify correctly Doppler ultrasound outputs.
A prospective single blind comparative study design was utilised. Fifteen Doppler recordings of the blood flow in the posterior tibial artery, five each of monophasic, biphasic and triphasic blood flow, were used to compare the interpretation abilities of 30 undergraduate podiatry students and 30 HCPC registered podiatrists. Chi-squared analysis of the results was undertaken.
Chi-squared analysis found that there was no statistically significant difference between the overall abilities of student podiatrists and HCPC registered podiatrists to identify correctly Doppler ultrasound recordings (p = 0.285). No significant difference was found in their ability to identify Doppler ultrasound recordings of monophasic, biphasic or triphasic blood flow (p > 0.050).
The results of this relatively small study suggest that both student and HCPC registered podiatrists are in general able to identify the nature of blood flow based on the output of handheld Doppler ultrasound units. However, the results raise an issue regarding professional development of practitioners who might have been expected to have enhanced their skills of Doppler ultrasound sound identification since professional registration.
Stubbings N: Using non-invasive methods to perform vascular assessment. Nurs Stand. 1996, 10 (45): 49-50. PubMed
Vowden K, Vowden P: Hand-held Doppler Ultrasound: the assessment of lower limb arterial and venous disease. 2004, Cardiff: Huntleigh Healthcare
Singh N, Armstrong DG, Lipsky B: Preventing foot ulcers in patients with Diabetes. Ame Med Assoc. 2005, 293 (2): 217-218. 10.1001/jama.293.2.217. CrossRef
Lythgoe AG, Barlow A: Clinical Experience with Doppler Audio Sound. Br J Podiatr. 2007, 10 (1): 20-23.
Burrow G: Examination and diagnosis in clinical management. Neale’s Disorders of the Foot. Edited by: Frowen P, O’Donnell M, Lorimer DL, Burrow G. 2010, Edinburgh: Churchill Livingston Elsevier, 1-17. 8
Eagle M: Doppler ultrasound – basics revisited. Br J Nurs. 2006, 15: 11-Tissue viability supplement CrossRef
Tweedie J: Pulse palpation and Doppler Assessment in Podiatric Practice. Podiatry Now. 2002, 3: 294-298.
Vowden KR, Goulding V, Vowden P: Hand held Doppler assessment for Peripheral arterial disease. J Wound Care. 1996, 5 (3): 125-128. PubMed
Mowatt G, Houston G, Hernandez R, de Verteuil R, Fraser C, Culthbertson B, Vale C: Systematic review of the clinical effectiveness and cost effectiveness of oesophageal doppler monitoring in critically ill and high risk surgical patients. Health Technol Assess. 2009, 13 (7): 1-95. CrossRef
Caruana MF, Bradbury AW, Adom DJ: The Validity, Reliability, Reproducibility and extended utility of ABPI in current vascular surgical practice. Eur J Endovasc Surg. 2005, 29: 443-451. 10.1016/j.ejvs.2005.01.015. CrossRef
Kaiser V, Kester AM, Staffers HE, Kitslaar PM, Knoltneurus JA: The influence of experience on the reproducibility of the Ankle-brachial systolic pressure ratio in peripheral arterial occlusive disease. Eur J Vasc Surg. 1999, 18: 25-29. 10.1053/ejvs.1999.0843. CrossRef
Department of Health: The NHS Improvement Plan: Putting People at the Heart of Public Services. 2004, Norwich: Her Majesty’s Stationery Office
- A comparison of the Doppler ultrasound interpretation by student and registered podiatrists
Chloe Alexa Potter
- BioMed Central