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  • ABI Worksheet: Patient Name: Patient ID: Date

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    zaqqi ubaidillah
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    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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    ABI_Worksheet

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    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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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    52 views2 pages

    ABI Worksheet: Patient Name: Patient ID: Date

    Uploaded by

    zaqqi ubaidillah
    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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    © All Rights Reserved
    Download as PDF, TXT or read online from 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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