Case Study 1: Physical Examination - Vascular
Mr Bearay now undergoes a vascular examination by inspecting the health and viability of the skin and tissues of the foot.
This is done by:
- palpating pulses
- checking skin temperature
- checking blood flow in the feet using Doppler ultrasound equipment then comparing this to blood flow in the brachial artery (ABI)
- checking tissue perfusion by measuring toe pressure indices (TPI)
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Lloyd: physical examination includes assessment of vascular status by inspecting the health and viability of the skin and the tissues of the foot, palpating the pulses and checking skin temperature. A more specialised assessment of blood flow is performed using the Doppler ultrasound equipment to compare blood flow in the brachial artery to the blood flow in the arteries of the foot. This allows us to determine an ankle brachial index. An index of 1.0 or near to 1.0 suggests there there is adequate/healthy flow to the foot.
Lloyd: more information can be gathered regarding blood flow into the tissues or the tissue perfusion by measuring toe pressure indices or TPI. We use photoplethysmography to do this. This technique uses a light source reflected from the tissue to indicate the strength of tissue perfusion.
