How To Measure ABPI - Ankle Brachial Pressure Index Clinical Examination - Vascular OSCE - Dr Gill

[Music] hello my name is Dr Gill I've been asked a special test on you today to look at the blood pressure supplying your feet and your ankles that's the ankle break your pressure index before we go any further could I please confirm your name and date of birth salary 2nd of January in 2000 thank you so what this is going to involve is going to involve me taking the blood pressure on both of your arms and then comparing that to the blood pressure in your feet that is going to involve me having to use a Doppler probe to place on your feet so there may be a little bit of jelly there afterwards is that okay perfect so to start off I'm just going to set you up and we're going to do your blood pressure on both wrists so if you want to swing your legs back so I'm going to the first time just relax down for me I'm going to do the first time just feeling your pulse yes okay so your pulse disappeared at around about 110 so I'm now going to get the stethoscope and I'm going to do exactly the same but I'm going to go a little bit higher than that okay so now just going to listen over the brachial artery and we're going to do the same again so I'm adding an extra 30 uh millimeters of pressure there's 110 that's 140. now if I let the pressure out okay the sounds have returned and disappeared so that was for 108 to 60. so we're going to compare again on the opposite side and we've got a rough idea of where your blood pressure is now so we're going to just take the blood pressure using the stethoscope so if you relax down there for a moment okay it says 100 over 60. okay a bag on the bang on the dots right let's take that off so now we need to assess your legs so we'll put that there from around and we're going to disregard the stethoscope now I'm just going to put my hands on your feet if that's okay I'm going to try and find the pulses there so you've got a good strong pulse at both posterior tibial and over the front we've got good strong pulses at the docile spds put the blood pressure cuff just around your ankle now I won't be able to hear the um the blood pressure this time so what we're going to do instead is I'm going to take a a sonicade bit of jelly on it I'm going to have a listen to the pulse let's see if we can find your pulse foreign again and just increase at the pulse until the sound disappears and then we're going to let it out okay so the pulse is coming back about 112. that's systolic okay so that was excellent and now we're going to do the same again over the dorsalis penis okay now we'll do the same again all the way up and wait for the sound to return super now when you see the same again on the opposite side we kind of have to lift this leg up for me back down thank you put a little bit more uh jelly on the probe and we'll see if I can find this at the ankle foreign foreign so that completes our examination um so the pressures in your legs are slightly higher than the pressures in your arms so you'll have an abpi of greater than one which shows you've got good uh vessels in your legs do you have any questions for myself thank you very much take care