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Assessment of Ischaemia
Absence of dorsalis pedis and posterior tibial pulses on one or both feet.
2. Ankle/brachial pressure index 0.8.
With the subject lying, using the Doppler/coupling gel, the posterior tibial/dorsalis pedis arteries are identified.
Place the sphygmomanometer cuff around the ankle above the malleoli.
Inflate the cuff, keeping the Doppler/gel where a strong pulse can be heard. Once the pulse signal disappears gradually deflate the cuff until it reappears. This will ascertain the systolic ankle pressure. This should be done in both legs. Check twice and record.
Measure the brachial systolic pressure (the higher reading), in the right area with the subject lying down.
ANKLE BRACHIAL PRESSURE INDEX (A.B.P.I.) =Ankle Systolic Pressure____________________________________ Brachial Systolic Pressure
If this is <0.8: the foot is at risk of ulceration If this is <0.5: the foot is critically ischaemic |
NB In the presence of vascular calcification, it may be impossible to compress the artery which can cause the ABPI to be falsely elevated. If there are other clinical features of ischaemia eg pallor on elevation and dependent rubor, consider referral.
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