BEYOND SEARCHING FOR A DVT
By Andrea Kadrou, Birmingham Children’s Hospital
Background:
This case study illustrates the critical role o f ultrasound (US) in providing comprehensive patient care by encouraging practitioners to extend their clinical investigations when necessary. The case involves a 14-year-old male with a history of 22q11.2 deletion syndrome who underwent heart surgery. During the procedure, a venous cutdown was performed—a rapid, emergency method for gaining intravenous (IV) access when less invasive options fail. The case under scores the importance of leveraging additional imaging techniques and thorough clinical e valuation to address and resolve clinical concerns effectively.
Methods:
This study emphasises the value of utilising ultrasound to contribute significantly to the multidisciplinary team’s decision-making process. By adhering to the British Medical Ultrasound Society (BMUS) guidelines, practitioners are encouraged to extend their examination protocols and review all pertinent clinical information, including surgical notes, prior to the procedure. The impor tance of the “satisfaction of search” principle is highlighted, guiding pr actitioners to not only identify the ob vious findings but to continue investigating until all potential c omplications are explored. This approach led to the identification o f a large hematoma in the right groin, an unexpected, but clinically significant finding
Conclusion:
In the evaluation of deep vein thrombosis (DVT), it is crucial for ultrasound practitioners to adopt a holistic approach—engaging in thorough patient communication, regardless of age or assumed capabilities, and maintaining an investigative mindset. This case demonstrates that what initially appears as a simple finding may reveal underlying complexities, akin to an iceberg. Once an “iceberg” is discovered, the entire scope of the issue must be examined to ensure comprehensive patient care.