Practice development How to...Ten top tips for Doppler ABPI
How to... Ten top tips for Doppler ABPI
T
his practical guide offers tips on how to use a hand-held Doppler ultrasound for assessing peripheral arterial
disease. Leg ulcers can have an extremely deleterious effect on a patient’s well being and quality of life. One part of a comprehensive assessment
of a patient with a leg ulcer is to perform a Doppler ultrasound and examine the signals transmitted from the Doppler probe. However, this is a skilled procedure and forms only one part of the overall assessment.
WHY DOPPLER ABPI IS USEFUL When employed by clinicians as part of a vascular assessment, the Doppler assessment system uses the direction and velocity of blood flow to ascertain whether the patient’s arterial blood vessels are healthy or whether they have become diseased. The brachial and ankle systolic pressures
are measured by the clinician using a hand-held Doppler probe at the patient's brachial pulse, and the dorsalis pedis pulse on the dorsum of the foot. The ankle pressure is then divided by the brachial pressure to obtain the patient's ankle brachial pressure index (ABPI).
HOW TO USE DOPPLER ULTRASOUND TO MEASURE ABPI It must be stressed that a Doppler assessment alone does not constitute the entire assessment of a patient with a leg ulcer.
1 2 3
Preparation: The procedure should be performed by two nurses, if possible, one
of whom should be a registered nurse trained in Doppler assessment.
Explaining the procedure: Before undertaking a Doppler assessment, the patient should
receive a full explanation of the procedure so they are aware of what is involved.
Informing the patient: Patients should be told that they will need to lie as flat as possible, with one pillow under their head, for 10–20 minutes, because this removes the effect of gravity on blood flow [Fig 1]. Patients with breathing difficulties may not be able to lie entirely flat, in which case they should be asked to lie as low as is tolerable for them. Patients should be informed that they may experience some discomfort from the blood pressure cuff on the ankle and that they may stop the procedure at anytime if it is too painful.
Author: Pauline Beldon
Figure 1. The patient lies supine.
Figure 2. Cuff applied above the elbow.
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