The ankle brachial index is a ratio of the blood pressure in the ankle to the arm.Knowing theABI can be used as an indicator of PAD.The same thing can happen to the peripheral arteries in the body.They may become stiff due to cholesterol problems.A difference between the blood pressure in the legs and arms may be indicative of a disease.This disease can cause more serious problems such as stroke and heart failure.
Step 1: Ask the patient to lie down.
Lying face-up is considered to be in the supine position.If your patient is lying on a flat surface, his arms and legs should be at heart level.Give the patient at least 10 minutes of rest.Resting will allow the heart and brachial pulse to level out and help with his blood pressure.Your patient's arms should be exposed.The sleeves should be rolled out of the way.
Step 2: Take a look at the brachial arteries.
The pulse site can be found using your index and middle finger.If you use your thumb, it could make finding your patient's pulse more difficult.The middle part of the elbow bend is where the brachial pulse is usually felt.
Step 3: The patient has a blood pressure cuff on.
The brachial pulse site should be two inches above the cuff.If you want to avoid inaccurate readings, make sure the cuff is loose enough that it won't slip down the arm.If possible, use a blood pressure cuff that is two-thirds the length of the patient's arm.
Step 4: The arm's blood pressure can be found by inflating the cuff.
The stethoscope should be placed on the brachial pulse to take the blood pressure reading.If your patient's pulse is no longer audible, close the valve of the hand-pump and use it to inflate the cuff to about 20mmHg above regular blood pressure.The maximum pressure created by the left ventricle is called systolic pressure.The minimum amount of pressure created when the ventricles fill with blood is called diastolic pressure.
Step 5: Remove the cuff.
Release the pressure slowly at a rate of 2 to 3mmHg by opening the valve and monitoring the manometer.The point at which the pulsating sound returns and the diastolic blood pressure are the same.The value of the systolic blood pressure will be used to calculate theABI.
Step 6: Ask your patient to lie down.
The goal is to keep his arms and legs elevated so as to get the most accurate blood pressure reading.The patient has a blood pressure cuff.
Step 7: Wrap the blood pressure cuff around the patient.
The malleolus is two inches above the ankle.The cuff should not be wrapped tightly.Attach two fingers to check its tightness.It is too tight if you can't insert two fingers.Make sure you have the right cuff for your patient.The cuff should be slightly larger than the leg.
Step 8: The pedis arteries are located in the dorsalis.
Right near where the foot meets the ankle is the location of theDP artery.Spread the gel on the foot.Use a probe to find the strongest point.When you find the spot where the pulse is loudest, move the probe around.A whooshing sound is what you should hear.
Step 9: The blood pressure of the arteries should be recorded.
Until the whooshing sound from the Doppler is gone, inflate the blood pressure cuff to 20mmHg.Take note when the whooshing sound returns.This is the ankle's blood pressure.
Step 10: Take a look at the posterior tibial arteries.
You should take the blood pressure of the pedis and arteries.The back side of the calf is where the PT is located.Put the gel on the area and use the probe to find the strongest pulse.
Step 11: The blood pressure of the arteries should be recorded.
You did the same thing to find the DP arteries.After finishing, record the pressure and then switch the cuff to the right leg.The blood pressure of the pedis and arteries on the right leg is recorded.
Step 12: The ankle has higher blood pressure.
You can compare the left and right ankle readings.The highest ankle number will be used to calculate theABI.
Step 13: You can divide it.
Each leg will be calculated individually.Divide the left ankle arteries values by the brachial arteries value to get the highest value.The results from the right ankle should be repeated.The left ankle has a blood pressure of 120 and the arm has 100.120/100 is 1.10.
Step 14: You should record and interpret the result.
The ankle brachial index is usually 1.0 to 1.4.The closer the patient's ABI is to 1, the better the result.The arm blood pressure should be as close to the ankle as possible.Severe peripheral arterial disease is suggested by anABI of less than 0.4.There is a chance that the patient may develop gangrene.A mild to moderate peripheral artery disease is indicated by anABI of 0.41-90.Normal vessels are indicated by anABI of 0.91-1.30Pain may be caused by a value between 0.9 and 0.99.Blood pressure can be artificially raised by non-compressible and severely calcified vessels.This state may be caused by long standing diabetes or chronic kidney disease.