Ankle–brachial pressure index Ankle–brachial pressure index The ankle-brachial pressure index (ABPI) or ankle-brachial index (ABI) is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to peripheral artery disease (PAD). The ABPI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure in the arm. The patient must be placed supine, without the head or any extremities dangling over the edge of the table. Measurement of ankle blood pressures in a seated position will
Brachial plexus block subjected himself to the supraclavicular block. Later that year, Georg Hirschel (18751963) described a percutaneous approach to the brachial plexus from the axilla. In 1928, Kulenkampff and Persky published their experiences with a thousand blocks without apparent major complications. They described their technique with the patient in the sitting position or in the supine position with a pillow between the shoulders. The needle was inserted above the midpoint of the clavicle where the pulse of the subclavian artery could be felt and it was directed medially toward the second or third thoracic spinous process. By the late 1940s, clinical experience