A patient assessment must be performed before the evaluation. This includes an assessment of the patient's ability to tolerate the procedure, an evaluation of any contraindications to the procedure, and a physical assessment of arms, hands, and fingers. The sonographer or examiner should obtain a complete, pertinent history and review the patient's medical record, if available.

A pertinent history includes:

• Previous vascular/cardiovascular surgeries
• Current medications or therapies
• Risk factors for arterial disease:
  • Diabetes,
  • Hypertension
  • Hyperlipidemia
  • Coronary artery disease
  • Age
  • Smoking history
• Connective Tissue Disease such as Scleroderma, Systemic Lupus Erythematosus, and CREST syndrome.
• History of Raynaud’s Syndrome
• Prior cannulation of the radial artery
• Prior trauma to the extremity
• Results of previous vascular studies
• Physical assessment of arms, hands, and fingers for symptoms of upper extremity arterial disease

A complete assessment should guide the sonographer to:

• Verify that the procedure ordered correlates with the patient’s clinical presentation.
• Perform adjunctive procedures according to the laboratory-specific protocol: auscultation of bruits and/or palpation of pulses.