In hospitalized patients with significant lower extremity edema, how can you integrate bedside POCUS findings with clinical assessment to guide the decision to start empiric anticoagulation for suspected DVT before formal imaging?

Great question! Especially if the significant lower extremity edema is asymmetric, it sounds like your clinical suspicion would be quite high. When you order a "duplex" study, the sonographer is using 2D ultrasound (aka B mode... white dots on black screen) + Doppler ultrasound (color and spectral). The sonographer compresses essentially the width of the probe, all the way from the common femoral vein until lost in the adductor canal, and picks up again as proximally as possible in the popliteal fossa, then carries down the venous system.

When we talk about POCUS protocols, we are discussing 2D compression-only ultrasound. The main variance in POCUS protocols is based on the number of sites you compress. Initial studies were of 2-point proto...