Circulatory Assessment

Circulatory assessment is performed in addition to heart / cardiac auscultation.   

Inspection of the following should occur:

• • Oedema to lower limbs. 

  • Ask candidate if they notice any swelling of the ankles at the end of the day or following prolonged periods of sitting/standing/walking.

  • Evidence of peripheral vascular disease:

    • lack of or faint peripheral pulses 

      • • Upper limb:   radial, brachial (if required) 

        • Lower limb:  dorsalis pedis, posterior tibial 

        • Grading:  0non-palpable; 1+barely detectable; 2+ slightly diminished; 3+ normal

        • Palpation should occur for 15seconds

    • abnormal skin colour (pale, red, grey, blue)

    • cool skin temperature

    • leg ulcers / wounds that won't heal

  • Shortness of breath on exertion (i.e. changing position, walking)

  • Presence of varicose veins / spider veins