simpleABI ABI Exam Procedure (NM0013)
Contents
1. The ABI Examination with simpleABI Systems Please Read the User Manual first This is a quick reference guide Contraindications Do not perform the ABI exam on someone suspected of having acute deep venous thrombosis and do not take an arm pressure in an arm with a shunt or dialysis graft Patient Preparation The patient should be relaxed in a supine position for 5 10 minutes in a warm room Explain the examination to the patient This is an ideal time to enter patient information The ABI Procedure e On the computer desktop screen select the simpleABI reports icon Fill out the patient information risk factors ICD 9 codes etc New and then select the ABI report When the screen opens click on the File tab then eWrap appropriate cuffs at each site generally 12cm cuffs on the arms and 10cm cuffs on the ankles V Arm Pressure e Connect the hose to the right arm cuff Place the Doppler probe at an angle to the skin over either the radial preferred or brachial artery Use plenty of ultrasonic gel and slowly move the probe until the best signal is obtained eInflate the cuff until you no longer hear the signal and continue for an additional 20 mmHg eSlowly bleed pressure down until the signal returns and note that return pressure This is the systolic pressure Then rapidly deflate the cuff Enter the pressure into the respective brachial field on the report PVR Waveform Move the hose to the ankle cuff and infl2. ate to 75mmHg and then bleed to 65mmHg the green bar should be about in the center of its box Set aneroid on exam table when finished bleeding pressure to avoid affecting waveforms with your movement Press or click Right PVR button A pop up window will appear press or click Get Waveform simpleABI Reporting software will take 5 seconds of PVR waveforms and return to form If waveform is acceptable proceed to the ankle pressures You can click again on the Get Waveform box if you are not satisfied with the waveform Ankle Pressures Now take the pressures at the right ankle using the Doppler probe on the posterior tibial PT artery which is usually found just behind roughly half an inch about the diameter of a dime the ankle bone Occlude the artery in the same manner you did on the arm in the previous step noting return pressure Record return pressure in the respective field on report e Now take the pressure at the foot using the Doppler probe on the dorsalis pedis DP artery which is usually right on top of the foot To avoid occluding the arteries by pressing too hard with the probe be gentle Inflate and bleed the cuff as you did with the PT artery and arm noting return pressure Enter the systolic pressure into the respective DP field on the report When finished with the right side move to the left ankle eStart by obtaining a PVR waveform on the left ankle Then take the ankle pres
3. sures at the PT and the DP Follow by taking the left brachial arm pressure When finished save the report Helpful Hints e Hold the probe close to the end and support the probe with your hand resting on the patient so that the probe does not move as the cuff is inflated and deflated It also helps to rest your hand on the patient to keep the probe in place One of the keys to a successful exam is being able to keep the probe in place as you inflate and deflate If it moves you will not be able to hear the Doppler sounds return and you will have to repeat the inflation The Cheater will help with all these issues be sure and fill it with plenty of gel artery may be incompressible due to calcification If the ankle pressure is high above 200 mmHg or the cuff cannot obliterate the Doppler sounds this indicates that the Don t be discouraged if measuring the ABI seems slow or clumsy at first Like any procedure the ABI becomes easier to do with practice As you become more comfortable with the exam you may also change the order of above steps as fits your practice Newman Medical 1 800 267 5549 NM0O013 F
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