Indications: Presence of peripheral arterial disease
1. Have patient in supine position so arms, legs and heart are at same level.
2. Use blood pressure cuff and Doppler to measure systolic BP in both arms and record.
3. Use Doppler to identify location of dorsalis pedis and/or posterior tibialis pulses, mark location bilaterally.
4. Wrap BP cuff around lower leg. Using Doppler to listen to signal, inflate cuff until signal disappears, then slowly deflate until pulse signal returns. Record pressure at which pulse is heard (systolic) by Doppler at DP and PT in both ankles.
5. To calculate the AAI divide the highest SBP from each ankle (either DP or PT) by the highest SBP reading from the upper extremities.
6. ABI = ankle / arm systolic pressure
> 1.3 = suggests noncompressible, calcified vessels
0.91-1.3 = normal
0.41-0.9 = mild to mod peripheral arterial dz (range for claudication)
<0.4 = Severe peripheral arterial dz. (range for critical leg ischemia and rest pain)

Source: http://students.washington.edu/aomega/procedures.shtml#chestTube

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