Procedure of Performing Ankle Brachial Pressure Index

Procedure of Performing Ankle Brachial Pressure proponentDescriptionI accompanied the District Nursing Team on placement to a Doppler Clinic for patients referred by their GPs to be assessed for compression bandages. I was talked through with(predicate) the map of performing Ankle Brachial Pressure Index (ABPI), which demand the following equipments Hand-held Doppler ultrasound machine 8 MHz test (5 MHz investigate if required for large or oedematous limbs) ultrasound transducer mousse sphygmomanometer and knock and cling film/vapour-permeable film dressing or equivalent.I was then asked to carry out the task with a nonher nurse. I process my hands, put on my gloves and apron. I raised the bed to my level so I could reach him. Seeking her consent, I asked the patient to remove all tight articles of clothing, which may cause pressure on the inception vessels proximal to the site where the consanguinity pressure is being measured.I measured the brachial systolic line of wo rk pressure by selecting a sphygmomanometer cuff of an hold size and wrapped it around the patients upper arm just in a higher place the elbow. I palpated the brachial pulse and applied ultrasound gel. I travel the Doppler probe at 45 degrees to the direction of the blood flow (towards the heart) and alter the position to locate the best signal. The Doppler emitted an audible signal and inflated the sphygmomanometer cuff until the signal disappeared. I then deflated the cuff slowly and put down the pressure at which the signal returned. I repeated this procedure development the patients other arm. I continued this procedure in measuring the mortise-and-tenon joint joint systolic pressure by palpating the posterior tibial artery and that of all the anterior tibial or peroneal artery. I then utilise the higher of these two readings to calculate the ABPI using the following equationABPI = highest ankle systolic pressure/highest brachial systolic pressure. I then save and exp lained the results to the patients. I thanked the patient for her cooperation.FeelingsDue to the fact that I had never realised a Doppler observation before, I felt extremely anxious and uneasy. These spiritings were make greater as I became to a greater extent aware of being judged not only by my mentor and other nurses notwithstanding overly by the patients most of whom came with their spouses. I felt the pressure more as at that place were other patients waiting to be seen and fetching up too untold time may delay them. In spite of these, I carry on and completed the task.EvaluationThroughout this procedure I really punishing and do sure no interruptions took place as I mickle miss the sphygmomanometer sounds. I actually couldnt get the first sphygmomanometer sounds on my first attempt so I explained to the patient and gained permission again to take the recording to which she agreed, I felt self-conscious and nervous as I had missed the first sphygmomanometer sounds but very pleased when I did manage to get the recording a second time. I feel I have gained a learning skill. The more Doppler recordings I took made me soon realised that no two patients were the same. I also acquire that different factors can affect blood pressure, from the patient rushing in late for his appointment which can lead to elevated blood pressure. It has also given me a lot of confidence in myself as I improved my communication skills.AnalysisAn ABPI is a simple non-invasive method of identifying arterial insufficiency within a limb. It compares the ankle and brachial systolic blood pressures. A slight drop in the blood pressure in the legs can be an indicator of peripheral vascular disease. Peripheral vascular disease refers to blockage of arteries. Basically, as compared to the arms, low blood pressure in the lower part of legs can be an indicator of a in effect(p) health. In the management of leg ulcers, the ABPI forms a fundamental part of the assessment. holy a ssessment is necessary to determine the correct aetiology of the ulcer and head off those patients with arterial disease for whom compression is dangerous (Stacey et al, 2002).In normal circumstances, the blood pressure in the lower leg area is a snack more than that at the elbow. Where an ABPI is greater than 0.9, it is supposed to be normal and holds no risk of peripheral vascular disease. If the ABPI value is more than 1.3, it is an indicator of puckish peripheral vascular disease. If the patient is unable to lie flat, the legs will be elevated to the level of the heart. By elevating the legs, the hydrostatic pressure to the legs is reduced.In direct to prevent cross-infection the Doppler probe should be cleaned twice with an alcohol impregnated wipe antecedent to its use (Kibria et al, 2002). It should be noted that the ABPI should not be undertaken in isolation, but should be used in conjunction with a holistic assessment, and a medical and clinical examination of the limb .ConclusionThere is controversy round the circumstances in which an ABPI should not be performed, so more look for is required. It has been suggested that an ABPI should not be performed if the patient has a suspected deep stain thrombosis, because there is a risk of emboli or the patient has cellulitis or because the procedure would be too painful or the patient has severe ischaemia or because there is a risk of further tissue damage. work on PlanAs an inexperienced learner, I hope to read more about Doppler and ABPI. I believe having an underpinning knowledge in the procedure for taking Doppler blood pressure helps to understand the theory behind the practice. I manoeuver to do more at any given opportunity in terms of, patient anxiety anomalous positioning of the patient incorrect size of sphygmomanometer cuff putting excessive pressure on the blood vessel during the procedure releasing the sphygmomanometer cuff from the patient too quickly prolonging inflation of the sphyg momanometer cuff or repeated inflation and moving the Doppler probe during the procedure.