Evaluation of an automated ankle brachial pressure index calculator in a nurse-led leg ulcer clinic

The Dopplex Ability® is a new automated ankle brachial pressure index (ABPI) calculator, the increased use of which the authors are witnessing in clinical practice. Proposed benefits over the traditional hand-held Doppler machine and manual blood pressure (BP) sphygmomanometer include: ease of use, reduced procedure time and reduced time lying flat for patient, which may lead to more cost- effective treatment outcomes. Since it is routine practice in a number of clinical areas for two members of staff to carry out the holistic leg ulcer assessment process, an additional benefit may be the ability of a single member of staff with minimum training to use the Dopplex Ability. An evaluation of the Dopplex Ability was carried out at a busy nurse-led community leg ulcer clinic over a period of 3 months. A total of 22 patients who attended the clinic for Doppler assessment consented to participate. Participants underwent ABPI calculation using both the Dopplex Ability and the hand-held Doppler. Overall 56% of readings were marginally higher with the Dopplex Ability than with the hand-held Doppler; 9% of readings were lower and 34% were equal. ABPI readings from the Dopplex Ability equipment were on average 0.067 higher than corresponding readings taken from hand-held equipment; this difference was statistically significant (p=0.014). Differences between methods were greater in patients who had readings taken by the Dopplex Ability first than in patients who had hand-held readings taken first. The majority of patients found the Dopplex Ability to be tolerable and staff found it easy to use. The Dopplex Ability
was found to be a useful adjuvant to the hand-held Doppler.