Doppler – Ultrasonic Auscultation 

Purpose: 

To obtain distal pulses or auscultate blood pressure that may not otherwise be heard with a conventional stethoscope. 

Equipment: 

• Doppler 

• Water-based lubricant 

• Headphones 

• Tissue or soft cloth for cleaning 

Procedure: 

1. Indications for Use: 

• The Doppler may be utilized to document the presence of distal pulses that are otherwise not palpable. 

• The Doppler may be utilized to auscultate a blood pressure that cannot be heard with a conventional stethoscope. 

• The Doppler is used only by a licensed nurse. 

2. Preparation: 

• Retrieve the Doppler from the carrying case. 

• Ensure that the probe and headphones are attached. 

3. Application: 

• Apply a small amount of water-based lubricant to the suspected location of the pulse. 

4. Operation: 

• Place headphones on. 

• Turn the Doppler on. 

• Place the tip of the probe carefully onto the conductive lubricant and contact the skin. 

• Adjust the volume to a comfortable level. 

• Move the tip of the probe within the lubricant on the surface of the skin until the pulse is located. Note the pulse or blood pressure. 

5. Post-Use: 

• Turn off the Doppler. 

• Remove the headphones and take the probe off the skin. 

• Wipe the skin clean of any lubricant. 

• Cleanse the tip of the probe with soap and water, and pat dry with a tissue. Do not cleanse with alcohol. 

• Return the Doppler to the carrying case. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the use of the Doppler, including the resident’s response and any observations, in their medical record. 

• Note any abnormalities or difficulties encountered during the procedure. 

• Regularly review and update techniques for Doppler use according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper Doppler use procedures to ensure resident safety and accuracy. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.