Ankle pulses are not sufficient to detect impaired arterial circulation in patients with leg ulcers.
Much debate has taken place on the use of Doppler ultrasound in the community setting. A sequential study of patients attending a community ulcer clinic was undertaken to identify community nurses' ability to detect arterial disease by palpation of pedal pulses and to compare these figures with the recording of a resting pressure index. A total of 462 patients (553 limbs) were studied; 167 (31%) had no detectable pulses at the ankle. Of the 93 limbs with a reduced resting pressure index (< 0.9), 37% had detectable pulses. Of the 440 with a normal resting index (> or = 0.9), 25% had no detectable ankle pulses. A number of risk factors were identified. Palpation of pedal pulses alone by community nurses is a poor prediction of arterial disease and should be accompanied by the recording of a resting pressure index.
Moffatt
C
C
O'Hare
L
L
D000368:Aged; D000842:Ankle / Q000098:blood supply*; D003152:Community Health Nursing; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000451:nursing* / Q000503:physiopathology; D008297:Male; D009730:Nursing Assessment / Q000592:standards*; D015403:Nursing Evaluation Research; D010173:Palpation; D011237:Predictive Value of Tests; D011674:Pulse