Product Manual

Page 6 of 21
Draft 1.1
Chapter 5 – Performing Exams
ABI EXAMINATION
Overview: The ABI has become the best known and standardized test for PAD.
Fundamentally it is simply the systolic blood pressure taken with the cuff at the ankle
divided by the systolic pressure with the cuff on the upper arm. Recent reviews
1
and
reimbursement criteria require that the measurements be done with a Doppler using
both the DP and PT arteries at the foot.
A PVR waveform is also required for reimbursement.
Contraindications: Do not perform the ABI exam on someone suspected of having acute
deep vein thrombosis, and do not take an arm pressure in an arm with a shunt or
dialysis graft. The cuff should not be applied over a distal bypass or over ulcers. Any
open lesion posing suspected contamination should be covered with an impermeable
dressing.
Have the patient lie down in the supine position relaxed, head and heels supported in a
comfortably warm room. Wrap appropriate sized cuffs (usually 12 cm on the arms and
10 cm on the ankles). On the arms apply the cuffs as you would for a normal blood
pressure. On the legs, have the patient place their feet flat on the table with knees bent
as you apply the cuff above their ankle. Cuffs should fit snugly so that fingers should
slide between the cuff and limb with difficulty. The lower edge of the ankle cuff should
be about an inch above the top of the medial malleolus (ankle bone).
Setting up
On the computer desktop screen, select the simpleABI reports icon. When the screen
opens click on the File tab, then New, and then select the ABI report. Fill out the
patient information, risk factors, ICD-9 codes, etc.
1
Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart
Association. Circulation. 2012;126