Arterial Pressure Index

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TRAUMA TUESDAY POD- ARTERIAL PRESSURE INDEX

INDICATIONS

  • Severe extremity injury with...

  • Proximity of injury to vascular structures

  • Major single nerve deficit

  • Reduced pulses

  • Posterior knee or anterior elbow dislocation

  • Hypotension or moderate blood loss at scene

  • Concern for vascular injury

CONTRAINDICATIONS

  • Unable to place BP Cuff around ankle or arm due to injury

EQUIPMENT

  • Manual BP Cuff

  • Handheld Doppler Instrument

  • Ultrasound Gel

PROCEDURE

  1. Measure systolic pressure in injured extremity distal to the injury (may measure radial, ulnar, brachial, dorsalis pedis, posterior tibial)

  2. Measure systolic pressure in uninjured brachial artery

  3. Perform Calculation: Injured extremity SBP/ Uninjured brachial SBP

INTERPRETATION

  • API >0.9: Vascular injury very unlikely, CT angio unnecessary

  • API <0.9: Possible vascular injury, CT angio is indicated

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