Clip 1: Compression of femoral vein and artery at the level of the saphenous vein. Hyperechoic clot is seen within the femoral artery and acts to brace open the femoral artery walls that do not compress at all with pressure.
Clip 2: Color doppler shows no flow in femoral artery.
A middle aged patient is rolled into the resuscitation bay screaming about excruciating left leg pain. It’s acute in onset, and on physical exam the left leg is not swollen, but is cool to the touch, with a difficult to palpate dorsalis pedis pulse.
POCUS shows that when enough pressure is applied to the femoral vein at level of the saphenous junction, the femoral artery, with hyperechoic clot inside, does not compress at all (clip 1 above). When color doppler is applied to both femoral artery and vein, there is no arterial flow (clip 2 above).
The patient was immediately started on a heparin infusion. All before the triage note was written. Superb work to all involved.