ABPI (May 2004)
Respondent sequence number
ABPI Section Comment
Arm tested
Arm comment
Brachial cuff size used
Large adult used, poor thigh cuff fit
Ankle(s) tested
Ankle comment
Ankle cuff size used
Brachial SBP 1 (mm Hg)
Brachial SBP 2 (mm Hg)
Mean Brachial SBP (mm Hg)
Left Posterior Tibial SBP 1 (mm Hg)
Left Posterior Tibial SBP 2 (mm Hg)
Left Mean Posterior Tibial SBP (mm Hg)
Left ABPI
Right Posterior Tibial SBP 1 (mm Hg)
Right Posterior Tibial SBP 2 (mm Hg)
Right Mean Posterior Tibial SBP (mm Hg)
Right ABPI
Left PT pulse detected?
Right PT pulse detected?
Left ankle SBP > 255 mm Hg?
Right ankle SBP > 255 mm Hg?