Ankle brachial pressure index

Abstract

I was interested to read Dr Jones's response to your article in respect of ankle brachial pressure index (ABPI) (JRSM 2007;100:4-5 and 117). Sadly, I'm not surprised he doesn't know how to use a doppler. My first job after qualifying at the beginning of the 1980s was as a surgical assistant in a vascular surgical unit in Germany. There were five of us and each of us, as well as the five Senior Registrars, were equipped with our own hand-held doppler machines. Each ward, of which there were two, also had its own doppler. These were used to assess patients prior to and after their surgery. I unfortunately returned to this country in 1987 and have worked in several District General Hospitals in the Yorkshire region. It never ceases to amaze me that in each of these hospitals, all involved in vascular surgery, there is only one example of this fairly cheap, user-friendly equipment—which has a high specificity and sensitivity—which is usually guarded like the Holy Grail by the senior sister of whatever department in which it is based. I have always seen this as an expression of the abject poverty in which the public health service in this country is kept.