![]() The cuff is slowly released until the Doppler device picks up the arterial sound again (the systolic pressure) The cuff is pumped up 20 mmHg past the point where the Doppler sound disappears.Alternatively the cuff can be placed on the forearm and the ulnar or radial arteries are assessed (the cuff has to be distal to the injury!). ![]() The ipsilateral brachial artery is detected with a Doppler device until the brachial artery is clearly heard.The patient is placed supine with the cuff placed on the injured upper extremity.The procedure is performed as follows for an injured upper extremity:.also known as DPI (Doppler Pressure Index) or Arterial Brachial Index or Ankle Brachial Index (ABI) – despite the last name, the same procedure can be performed for upper extremity injuries.Hypotension or moderate blood loss at the scene.Posterior knee or anterior elbow dislocation.sciatic, femoral, median, ulna or radial) Proximity of injury to vascular structures.Signs of limb ischemia/ compartment syndrome (the 6 Ps).Pulses and APIs may be difficult to assess in the obese, shocked, hypothermic or those with pre-existing peripheral vascular disease.Angiography can be performed only if the patient is hemodynamically stable.Cold, pale and pulseless distal extremity or a rapidly expanding hematoma suggests arterial compromise - look for ‘hard signs’and ‘soft signs’.arterial injury due to associated fracture) stab or gunshot) or severe blunt trauma (e.g. complete transections with hemorrhage or occlusion.complete wall defects with pseudoaneurysms or hemorrhage.flaps, disruptions, or subintimal/intramural hematomas) There are 5 major types of arterial injury: They may be threatening due to exsanguination, result in multi-organ failure due to near exsanguination or be limb threatening due to ischemia and associated injuries.Extremity arterial injuries may be the result of blunt or penetrating trauma. ![]()
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