Detailed Skill Performance Evaluation: Peripheral Vascular Examination

Directions: You will have 10 minutes to complete the skill. All critical (C) steps and 80% of the noncritical steps
must be performed (if possible) or verbalized. Special tests (S) will be performed if requested by examiner.
Start: End:
Performed Verbalized
Washes hands and dons appropriate personal protective equipment. C
Introduces self to patient using first and last names. Y/N
Notes general appearance and vital signs. Y/N
Inspection
Arms: from fingertips to shoulders
1. Assess size, symmetry, and note any swelling Y/N Y/N
2. Note color of skin and nail beds Y/N Y/N
3. Inspect the venous pattern for prominent veins Y/N Y/N
Legs: from groin to toes (Anterior, lateral, and posterior.)
1. Assess size, symmetry, and note any swelling Y/N Y/N
2. Note color of skin and nail beds Y/N Y/N
3. Note the distribution of hair on the lower legs, feet and toes Y/N Y/N
4. Inspect the leg for varicosities (Ask patient to stand for this.) Y/N Y/N
5. Note any pigmentation, rashes, scars, or ulcers (Include toes and soles of feet.) Y/N Y/N
Palpation
Arms
1. Palpate radial and brachial pulses (Pulses are graded 0 to 3+.) Y/N Y/N
2. Palpate epitrochlear nodes (With elbow flexed 90º, palpate 3 cm from medial epicondyle
Y/N Y/N
between biceps and triceps muscles.)
3. Assess capillary refill (Press down on nail so it blanches, then let go and observe time it
Y/N Y/N
takes to “pink up.”)
Legs (Don gloves for femoral pulse and inguinal nodes.)
1. Palpate femoral, popliteal, dorsalis pedis, and posterior tibial pulses Y/N Y/N
2. Palpate superficial inguinal nodes Y/N Y/N
3. Note temperature of legs and feet (Use backs of fingers and compare bilaterally.) Y/N Y/N
4. Look for edema, comparing sides for prominence of veins, tendons, and bones Y/N Y/N
5. If edema is present, assess for pitting edema (Press with thumb for at least 5 seconds
S Y/N
over dorsal feet, behind each medial malleolus, and over shins.)
6. Assess capillary refill (Press down on nail so it blanches, then let go and observe time it
Y/N Y/N
takes to pinken.)
Special Maneuvers
1. Allen test: competency of radial and ulnar arteries (Ask patient to make a tight fist while
compressing ulnar and radial arteries. Patient opens hand and one arterial compression is S Y/N
released. Repeat test with release of the opposite artery.)
2. Assessment of arterial insufficiency of lower extremities (Raise both legs to ~60º until
foot pallor develops, usually within a minute. Patient then sits up and dangles feet. Note S Y/N
return of pinkness in ~10 seconds and filling of veins of feet and ankles in ~15 seconds.)
Adequate exposure was maintained for all inspection steps. C
Adequate draping was maintained for all steps. C
Evaluation: #Y = #C =
min. = 30/37 min. = 3
Needs remediation?
Comments on quality of performance:
Y/N

Developed by Albany Medical College, Center for Physician Assistant Studies | Bickley: Bates’ Guide to Physical Examination
and History Taking, Twelfth Edition. Copyright © 2017 Wolters Kluwer Health