#ortho
> **ABI** = injured SBP / uninjurged brachial SBP
> API = arterial pressure index
> API > 0.9 : unlikely to have vascular injury and can be observed/discharged
> API <0.9 : possible vascular injury
*upper limb*
- ipsilateral brachial artery detected with doppler device until brachial artery heard
- cuff pumped up 20 mmHg past point where doppler sound disappears. cuff released until doppler picks up sound again (systolic pressure)
- the pressure at which this sound occurs is recorded and the procedure is repeated for opposite uninjured upper extremity
*lower limb*
- pt supine with cuff on injured lower extremity
- ipsilateral DP or PT detected with doppler until arteyr heard
- cuff pumped 20 mmHg past where doppler sound disappears
- cuff slowly released until doppler device picks up arterial sound again (systolic pressure)
- pressure at which this sound occurs is recorded and procedure repeated on opposite uninjured extremity or brachial artery