How to Perform Vascular Assessment in a Person with Diabetes

and a Foot Ulcer?

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§ Pedal Doppler arterial waveforms § Triphasic Doppler waveforms
Palpation of foot pulses § Ankle systolic pressure and ankle brachial index § Ankle brachial index 0.9-1.3 PAD is less likely
§ Toe systolic pressure and toe brachial index § Toe brachial index ≥ 0.75
Presence of foot
pulses does not
reliably exclude PAD Abnormal values but not severe ischemia:
No Irrespective of the
2 Is there infection or ulcer deeper than skin?
results of
bedside tests, when
Severe ischemia: the ulcer is not
§ Ankle systolic pressure <50mmHg or Yes healing within 4-6
§ Ankle brachial index < 0.5 or weeks:
§ Toe pressure <30mmHg
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CONSULTATION WITH
VASCULAR SPECIALIST

Posterior tibial artery Ankle systolic pressure Toe systolic pressure

Dorsalis pedis artery