Ankle–brachial pressure index grossly overestimate the ABI (by approximately 0.3). A Doppler ultrasound blood flow detector, commonly called Doppler wand or Doppler probe, and a sphygmomanometer (blood pressure cuff) are usually needed. The blood pressure cuff is inflated proximal to the artery in question. Measured by the Doppler wand, the inflation continues until the pulse in the artery ceases. The blood pressure cuff is then slowly deflated. When the artery's pulse is re-detected through the Doppler probe the pressure in the cuff at that moment indicates the systolic pressure of that artery. The higher systolic reading of the left and right arm brachial
Brachial plexus manipulation can cause the baby's shoulder to stretch, which can damage the brachial plexus to varying degrees. This type of injury is referred to as shoulder dystocia. Shoulder dystocia can cause obstetric brachial plexus palsy (OBPP), which is the actual injury to the brachial plexus. The incidence of OBPP in the United States is 1.5 per 1000 births, while it is lower in the United Kingdom and the Republic of Ireland (0.42 per 1000 births). While there are no known risk factors for OBPP, if a newborn does have shoulder dystocia it increases their risk for OBPP 100-fold. Nerve damage