Upper Extremity Venous Protocol
Scan through and verify patent venous system before augmenting
Structure
Scan Plane
Internal Jugular
Vein
Transverse
Dual Screen
Sagittal
Innominate with
Internal Jugular
and subclavian
bifurcation
Sagittal
Sagittal
Subclavian Vein
Central
Subclavian Vein
Mid
Subclavian Vein
Peripheral
Axillary Vein
Brachial Vein
Bascilic Vein
Cephalic Vein
Radial Vein
Ulnar Vein
Sagittal
Sagittal
Transverse
Dual Screen
Sagittal
Transverse
Dual Screen
Sagittal
Transverse
Dual Screen
Sagittal
Transverse
Dual Screen
Sagittal
Transverse
Dual Screen
Sagittal
Transverse
Dual Screen
Sagittal
Label-Identify RT & LT
Appropriately
IJV
W/COMP
IJV
IJV
INN, IJV, SUB
INN, IJV, SUB
INN
SUB VEIN CENTRAL
SUB VEIN CENTRAL
SUB VEIN CENTRAL
W/AUG
SUB VEIN MID
SUB VEIN MID
SUB VEIN MID W/AUG
SUB VEIN PERIF
SUB VEIN PERIF
SUB VEIN PERIF W/AUG
AXL V
W/COMP
AXL V
AXL V W/AUG
BRACH V
W/COMP
BRACH V
BRACH V W/AUG
BASC V
W/COMP
BASC V
BASC V W/AUG
CEPH V
W/COMP
CEPH V
CEPH V W/AUG
RAD V
W/COMP
RAD V
RAD V W/AUG
ULN V
W/COMP
ULN V
ULN V W/AUG
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Images Stored
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler
Gray Scale Inn, IJV & Subclavian bif- without
compression
Color Doppler Inn, IJV & Subclavian Bif
Color & Spectral Doppler with Valsalva
Gray Scale Subclavian Vein Central
Color Doppler Subclavian Vein Central
Color & Spectral Doppler with augmentation
or Valsalva
Gray Scale Subclavian Vein Mid
Color Doppler Subclavian Vein Mid
Color & Spectral Doppler with augmentation
Gray Scale Subclavian Vein Peripheral
Color Doppler Subclavian Vein Peripheral
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler with augmentation
Gray Scale- without compression
Gray Scale-with compression
Color Doppler
Color & Spectral Doppler w/augmentation
Upper Extremity Venous Protocol
Anatomy/Image Correlation
Artery
Vein
Artery
Vein with
Compression
Tips
Vein with Doppler

Patient set-up
 Very important for ease of completing the examination for the sonographer and patient
 Using the arm attachment on bed for the patient to rest the arm being evaluated
 If an arm attachment is not available use a food tray table to rest the arm being evaluated
 Have the patient (with rail raised) move over to side of bed to give the arm a place to rest
 If scanning the left arm, turn the patient completely around, for easy access

Have the patient turn their neck slightly when evaluating vessels in this area
 Turning the neck to the side too much may make visualization of the vessels difficult

Do not remove bandages unless you have e asked permission first
 Patients may have a PICC line-do not remove the bandage

Some clinical sites that do not document the cephalic, radial or ulna unless noted on the order or there
is swelling or redness is in that area
Spectral Doppler
 No angle correct is used
 Gate should be placed in center of vessel
 Utilize large gate (SV length)
Thrombus Present (Blood Clot)
 Do not augment peripheral to the location of the thrombus
 Document thrombus with Color & Spectral Doppler
 Document exact location of thrombus
Paired Veins
 Veins may be duplicated
 Note if thrombus is evident in one or both veins complete documentation is required
 If no evidence of thrombus document only one with augmentation
Labs

D-dimer – if increased may indicate thrombus formation
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