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ABI Worksheet: Patient Name: Patient ID: Date

This document is an ABI worksheet used to assess a patient's risk for peripheral artery disease. It includes fields to record the patient's name, ID, date and relevant medical history. It then has sections to record blood pressure readings in both arms and ankles to calculate the ankle-brachial index on both sides. Waveform readings are also taken from various leg arteries. The ABI is used to indicate the severity of any vascular disease, with values below 0.9 suggesting increased risk.

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zaqqi ubaidillah
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404 views

ABI Worksheet: Patient Name: Patient ID: Date

This document is an ABI worksheet used to assess a patient's risk for peripheral artery disease. It includes fields to record the patient's name, ID, date and relevant medical history. It then has sections to record blood pressure readings in both arms and ankles to calculate the ankle-brachial index on both sides. Waveform readings are also taken from various leg arteries. The ABI is used to indicate the severity of any vascular disease, with values below 0.9 suggesting increased risk.

Uploaded by

zaqqi ubaidillah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ABI Worksheet

INDICATIONS SYMPTOMS
Patient Name: ❏ Heart Disease ❏ Ulceration / Gangrene
❏ Tobacco Use ❏ Resting Hip / Leg Pain
❏ Stroke ❏ Numbness / Tingling
Patient ID: ❏ Vascular Surgery ❏ Claudication
❏ Hypertension ❏ Other: ____________
❏ Diabetes
Date: ❏ Other: ____________

RIGHT ARM LEFT ARM

Systolic Pressure Systolic Pressure

RIGHT ANKLE LEFT ANKLE

Posterior Tibial (PT) Posterior Tibial (PT)

Dorsalis Pedis (DP) Dorsalis Pedis (DP)

RIGHT ABI
Higher of Right Ankle Pressures

Higher of either Arm Pressures


= *Ankle Brachial Index Interpretation
1 or above: Normal
LEFT ABI 0.9 – 1.0: Minimal Vascular Disease
Higher of Left Ankle Pressures 0.5 – 0.9: Moderate Vascular Disease

Higher of either Arm Pressures


= 0.0 – 0.5: Severe Vascular Disease

*Reference: Rumwell C., McPharlin, M: Vascular Technology; An Illustrated Review.


Davies Publishing, Inc., Pasadena, CA, 2000.
Right Brachial Waveform: Left Brachial Waveform:

Right Posterior Tibial Waveform: Left Posterior Tibial Waveform:

Right Dorsalis Pedis Waveform: Left Dorsalis Pedis Waveform:

Right Anterior Tibial Waveform: Left Anterior Tibial Waveform:

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