/clinical/,/clinical/references/,/clinical/references/ed-resources/,/clinical/references/ed-resources/ankle-brachial-pressure/,

/clinical/references/ed-resources/ankle-brachial-pressure/

201410300

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100

UWHC,

Patient Care,

Clinical Hub,References,Emergency Department Resources

Ankle Brachial Pressure

Ankle Brachial Pressure - Clinical Hub, References, Emergency Department Resources

Focus

Ankle-Brachial Pressure Index Procedure Key Points

Dorsalis Pedis

Dorsalis Pedis

Posterior Tibial

Posterior Tibial

  1. Equipment Needed
    1. Manual BP cuff-make certain correct size for both arms and ankles
    2. Doppler and gel
  2. Procedure
    1. Have patient resting in bed for at least 10 minutes prior to obtaining measurements.
    2. Obtain manual brachial systolic blood pressures in each arm using the Doppler.
    3. Apply manual blood pressure cuff to the ankle above the patient’s malleolus.
    4. Obtain manual systolic blood pressures for the dorsalis pedis and posterior tibial pulses on both feet using the Doppler.
    5. Record all measurements in Health Link (see other side of this sheet).
  3. Troubleshooting
    1. Be suspicious of arterial pressures
    2. Be suspicious of ankle pressures >300 mmHg, calcific sclerosis (common with diabetics, chronic renal failure, and hyperparathyroidism) produces falsely elevated ankle pressures.
    3. It is common for ABI values to vary by 0.10 or less between observers and observation. A change of >0.15 should be evaluated for clinical significance. Notify the MD and the patient should go to the vascular lab for formal ABI studies.

Ankle Brachial Index Procedure Documentation 

  1. Where to Document Assessment Values
    1. Complex Monitoring Flow sheet
    2. Add Group
    3. Ankle Brachial Index or ABI
    4. Document all pressure assessments. If unable to obtain a measurement, you must enter a value of “0” or the ABI value will not auto calculate.
    5. Health Link will calculate the ABI values once all assessment values are entered.
    6. Interpretation values are listed in the details box of the ABI 
      >1.30 Non-compressible
      1.00-1.29 Normal
      0.91-0.99 Borderline (equivocal)
      0.41-0.90 Mild-to-moderate PAD
      0.00-0.40 Severe PAD
  2. Where Physicians can view a Report and Compare Values
    1. Chart Review
    2. Select encounters. Hold down Ctrl key if the MD wants to select multiple encounters (for example, he wants to compare the hospital ABI values with the clinic values)
    3. Flowsheet
    4. Ankle Brachial Index
    5. All the data will flow to one location. Multiple results can be shown over time.

Ankle Brachial Index