Ankle-Brachial Pressure Index Procedure Key Points
- Equipment Needed
- Manual BP cuff-make certain correct size for both arms and ankles
- Doppler and gel
- Have patient resting in bed for at least 10 minutes prior to obtaining measurements.
- Obtain manual brachial systolic blood pressures in each arm using the Doppler.
- Apply manual blood pressure cuff to the ankle above the patient’s malleolus.
- Obtain manual systolic blood pressures for the dorsalis pedis and posterior tibial pulses on both feet using the Doppler.
- Record all measurements in Health Link (see other side of this sheet).
- Be suspicious of arterial pressures
- Be suspicious of ankle pressures >300 mmHg, calcific sclerosis (common with diabetics, chronic renal failure, and hyperparathyroidism) produces falsely elevated ankle pressures.
- 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
- Where to Document Assessment Values
- Complex Monitoring Flow sheet
- Add Group
- Ankle Brachial Index or ABI
- 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.
- Health Link will calculate the ABI values once all assessment values are entered.
- 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
- Where Physicians can view a Report and Compare Values
- Chart Review
- 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)
- Ankle Brachial Index
- All the data will flow to one location. Multiple results can be shown over time.