Acute Peripheral Vascular Injuries - Guidelines for Initial Evaluation - Michigan Medicine

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A vascular surgery consult will be requested based on the below algorithm. Serial neurovascular exams hourly will be performed in the ED and charted in the medical record. An order for serial neurovascular exams will be required to initiate this process.

ABI Procedure:

  1. On the lower extremity, a manual BP cuff is placed on the calf. A hand-held Doppler is used to find either the PT or DP pulse. While listening to the Doppler, the cuff is slowly inflated. The “closing” or occlusion pressure (where the Doppler pulse signal disappears) is recorded
  2. The identical technique is used to measure the closing pressure in the arm.
  3. A comparison of ankle to brachial closing pressures is calculated (ankle/brachial) and recorded. (Normal is 1.0 or greater)

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  1. Title: Acute Peripheral Vascular Injuries - Guidelines for Initial Evaluation
  2. Author:  Michigan Medicine
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  4. License: “CC BY-NC 4.0”

Acute Peripheral Vascular Injuries - Guidelines for Initial Evaluation,  Michigan Medicine, Dept of Surgery ,  “CC BY-NC 4.0”

Last reviewed: 09 June 2021