Question

Mrs. Marconi is a 68 year-old retired woman who volunteers 3 days per week at the hospital. A group of nursing students from the local college were holding a health fair and invited her to participate. One station was set up to check the ankle-branchial index (ABI) on the participants. Mrs. Marconi asked the students to explain what an ABI is and why she needs this test.

1. How would you answer this question?

2. Describe how the test id done when should someone be referred for further testing after having the ABI checked?

Answer 1

1)the student answer the question like,

The ankle brachial index(ABI)is the easy method to identify the peripheral vascular diseases as early as possible. It is the method in which compare the difference between systolic blood pressure of ankle and pressure of arm, and find a ratio that is check the flow of blood through the blood vessels.

You are 68 years old that near to 70 years and you are more vulnerable to getting peripheral vascular diseases and it is best to check whether you have a chance to get this disease .Early diagnosis is better to treat problems. Aging is one of the reason for occurring of peripheral vascular diseases .

2)Ankle brachial index

In this method check the systolic blood pressure from both brachial artery and both dorsalis pedis and posterior tibial. In this procedure patient lie on supine position and it take 10 to 15 minutes. Blood pressure is measured by using handheld Doppler and blood pressure cuff also put on the ankle. The pressure from the right arm is take first and then right leg, left leg and at last left arm.

:measuring the brachial pressure

The patient is lie on supine position, the hand is in position at the heart level. Place the cuff on the arm and place gel on the anticubital area where the brachial pulse feel.position the transducer at high intensity and inflate the cuff above 20 mmofhg of expected systolic pressure. At that time the transducer image will disappear then slowly deflate and measure the pressure when transducer image reappears. This is the brachial pressure. Documents the value.

Measurement of ankle pressure

For measuring ankle pressure place the cuff proximal to the malleolus. The dorsalis pedis is lie lateral to the Malleolus to dorsum of foot and by using handheld Doppler probe and ultrasound gel focus the signal of the dorsalis pedis and check blood pressure as take from the brachial pressure.

The posterior tibial artery lie posterior to the medial malliollus and trace the signal using hand held Doppler probe and measure the pressure and document it.

Calculating the result

The ABI is calculated by the highest pressure of both arteries in ankles devided by highest pressure of both brachial artery.

Right ABI=highest pressure of right foot/highest pressure of both brachial artery

Interpretation of result

Normal value =1.0 to 1.4

Value above the 1.4is indicate non compressible calcified arteries.

0.9 to 1.0 is acceptable

Less than 0.9 is diagnosis of peripheral vascular diseases

Less than 0.5 is indicate severe peripheral vascular diseases

Referral and follow up

If the value is less than 0.9 should refer to the vascular specialist or vascular surgeon for treatment of the condition .