A patient assessment should be completed before the evaluation is performed. This includes an 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 patient's representative and a review of the patient's medical record, if available. A pertinent history includes:

• Previous cardiovascular surgeries
• Current medications or therapies
• Results of other relevant diagnostic procedures (e.g., operative notes, revisions/fistulograms, currents status of dialysis)
• Review of prior examinations to ensure that the evaluation duplicates prior imaging and Doppler parameters.
• Verify that the requested procedure correlates with the patient's clinical presentation

Perform a limited or focused physical exam, including observation and localization of any signs or symptoms of access dysfunction.

• Determine access patency by the presence of a palpable thrill as well as the strength and consistency of thrill throughout the access (Note: prominent pulsatility is abnormal).
• Provide a visual inspection of the limb and access site noting scars, areas of redness, ecchymosis, swelling, dilatation, and presence of collateral vessels.