A patient assessment must be performed before the exam. This includes assessment of the patient’s ability to tolerate the procedure and an evaluation of any contraindications to the procedure. The sonographer or examiner should obtain a complete, pertinent history by interview of the patient or their representative and a review of the patient’s medical record, when available.

A pertinent history includes:

• Relevant risk factors including previous deep venous thrombosis (DVT) or superficial venous thrombosis (SVT)
• Upper extremity trauma
• Extremity immobilization
• Recent major surgery
• Prolonged bed rest
• History of cancer
• Family history of DVT
• Pregnancy
• IV drug abuse
• Congestive heart failure (CHF) or other similar cardiac history
• Current medications and/or therapies (including central venous or subclavian catheters)
• Results of other relevant diagnostic procedures
• Verify that the requested procedure correlates with patient’s clinical presentation.

Complete a limited or focused physical exam, including observation and localization of any signs or symptoms of peripheral venous disease:

• Pregnancy
• Swelling
• Pain/tenderness
• Discoloration (including hands and digits)
• Ulceration
• Shortness of breath
• Cyanosis if superior vena cava is affected