Ankle Brachial Index Why it is essential to measure both arms

Example a) Example b) One Arm Both Arms

Right Arm Right Arm Left Arm Pressure Pressure Pressure 110 110 140

Right Ankle Left Ankle Right Ankle Left Ankle Pressure Pressure Pressure Pressure 105 105 105 105

105 105 Ankle Brachial Pressure: = 0.96 Ankle Brachial Pressure: = 0.75 110 140

You would INCORRECTLY compress You would NOT compress

Current guidelines specify you should measure both arm pressures and take the highest. (NICE, ESC, ACC/AHA, TASC2 and Aboyans et al*)

Otherwise: • You could misdiagnose PAD (Vowden & Vowden; 2018)** • You could apply compression to a patient with PAD which could lead to an adverse incident (Vowden & Vowden; 2018)** • You should always follow evidence based practice • Automatic systems which measure the pressure in only one arm contradict the guidelines and may miss or incorrectly classify cases of PAD. Dopplex Ability is an automatic ABI system that correctly measures systolic pressures in all four limbs. Join the conversation @huntleighdiag #correctABI #2arms

@soap1231 For more information contact 029 2048 5885 or visit www.huntleigh-diagnostics.com Huntleigh Healthcare Ltd. 35 Portmanmoor Rd. Cardiff. CF24 5HN

* NICE, CG147 (Peripheral arterial disease: diagnosis and management 2018); ESC - European Society of Cardiology (Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for , European Heart Journal, 2017); ACC/AHA - American College of Cardiology/American Heart Association (Guideline on the management of Patients with Lower Extremity Peripheral Artery Disease, Circulation, 2017); Measurement and Interpretation of the Ankle-Brachial Index (Aboyans et al, Circulation, 2012); TASC2 - Inter-Society Consensus for the Management of Peripheral Arterial Disease (Journal Of Vascular Surgery, 2007) ** Vowden P & Vowden K (The importance of accurate methodology in ABPI calculation when assessing lower limb wounds, BJCN, 2018) HUNTLEIGH ABI / 77

10 reasons why you should have the

1. Extremely easy to use and fully automatic Minimal training required 2. No need to rest patient for 15 mins Reduces total test time 3. Rapid bi-lateral ABI measurement in 3 mins Doppler based ABI typically takes 30 mins Simultaneous measurements reduces time 4. ABI can now be undertaken by healthcare support staff More cost effective measurement 5. No need to remove patient's socks or tights Maintains patient comfort and dignity 6. Easy to apply 4 cuff system Improves patient experience 7. Portable and powered by mains or rechargeable battery For home or clinical environments 8. Integral printer for documentation of results and waveforms Instant hard copy for patient notes and reimbursement 9. Automatic interpretation of ABI Reduces operator error 10. Accurate reproducible results Clinically proven by recent studies

ASK ABOUT OUR 4 WEEK TRIAL FOR YOUR PRACTICE

FULLY COMPLIANT WITH MBS ITEM 116101 Fee: $63.75 Benefit: 75% =$ 47.85 85% = $54.20

1 All Medicare Benefits Schedule (MBS) item rebates are subject to compliance with the MBS information. It is the responsibility of the user to ensure full compliance with the MBS. Visit http://www.mbsonline.gov.au for full up to date MBS information.

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] [ 77 ] 78 / HUNTLEIGH ABI Complies with International Guidelines

Automatic Ankle Brachial Index System

Automatic Ankle Brachial Index (ABI) System The Dopplex Ability has revolutionised the ABI process and provides fully automatic, easy, fast and accurate measurements. It requires minimal training and provides rapid bilateral ABI measurements in just 3 minutes. Unique patented two chamber cuff design measures systolic pressures using duo sense™ pneumatic technology based on Volume Plethysmography. warranty: 2 years on unit • Fully automatic, easy, fast and accurate measurements 2YR 1 year on warranty cuffs, battery & • Minimal training required accessories • Patients do not need to be rested for 15 minutes • Easy to apply 4 cuff system, can be applied over patients socks or tights PREMIUM PRODUCT • Automatic calculation of results • Records the highest ankle pressure in all 3 arteries • PVR Waveforms (Pulse Volume Recordings) are also generated for accurate diagnostics • Superior to other automatic systems especially in detecting low ankle pressures and ABIs, can detect an ABI from 0.29 - 1.57

Visit our website to watch the product video

Dopplex Ability - Stand Alone Unit Dopplex Ability eABI - PC Based Unit The Dopplex Ability provides an immediate printout of results A USB connects the eABI device to your PC. The DR4 from the integral printer. Its portability enables measurements software provided with the unit records the results to be made anywhere in your primary care clinic. and creates a PDF for importation into your Medical Ask about our 4 week obligation free trial software. It’s a more economical option having a lower buy price and no ongoing cost for printing paper.

Supplied with FREE $ $ DR4 software. HUNDA100PB 4995 HUNDA100 4295 (5 licenses per unit)

The Dopplex eABI is supplied with one set of standard cuffs, DR4 Software (5 Supplied with one set of standard cuffs, two rolls of paper, pack licenses for Free), pack of sleeves, 2 metre mini-USB to standard USB cable, of sleeves, mains cable and instructions for use mains power cable and training pack.

DR4 PC Connection No rest for Based on volume Printer Battery Power A/C Power 4 Cuffs Software Required patient Plethysmography Dopplex Ability ✔ ✔ ✔ ✔ ✔ ✔ Dopplex eABI ✔ ✔ ✔ ✔ ✔ ✔

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical [ 78 ] PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] HUNTLEIGH ABI / 79

Pictorial Evidence Documentation/Reporting International Guidelines (ESC, 2011) state Dopplex Reporter 4 Package enables automated ABI’s that ABI should be undertaken on patients to be undertaken and saved in a patient database. It also provides full page documentation hard-copy with suspected PAD as first line test and PVR printouts and PDF file capability for interfacing to waveforms as second line test. Electronic Patient Record Systems.

The Dopplex Ability printout provides both of $ these requirements on one unique printout to HUNDR4 995 aid the clinician in their diagnosis.

DR4 software is supplied free of charge with e-Ability. (5 licenses per unit)

Accessories Fixing plate Allows easy fixing of the unit to trolley, wall mount and couch bracket HUNVAS012 $56.00 Trolley 5 castor adjustable height trolley with tube management and integral basket for storage (requires fixing plate) HUNVAS013 $695.00 Carry Bag Lightweight, durable case holds main unit, power cable, cuffs and tubing HUNVAS015 $135.00 Sleeves Disposable sleeves to aid as infection control barrier between cuff and patient limbs Box/100 HUNACCVAS016 $56.75 Paper Standard Thermal Paper Roll HUNACCVAS017 $15.90 Paper Self Adhesive Thermal Label Paper Roll HUNACCVAS019 $22.50

For more accessories visit our website www.teammed.com.au Search for “Ability” and see the full range of spares

DOPPLER PLETHYSMOGRAPHIC OSCILLOMETRIC ABI ABI (Dopplex Ability) ABI > 1.3 ✔ ✔ 1.0 - 1.3 ✔ ✔ 0.8 - 0.99 ✔ ✔ 0.5 - 0.79 ✔ ✘ < 0.5 ✔ ✘

The Ability Doppler uses true volume Plethysmographic technology The Ability Doppler can be used to attract the Medicare Rebate for Ankle Brachial Index Assessment; item no 11610. In purchasing a Huntleigh Ability, you can have peace of mind that your unit meets all the requirements to perform a successful ABI reading and qualify for all parts of the rebate description. The Dopplex Ability test takes less than 5 minutes per patient. The Dopplex Ability is therefore not only a great clinical addition but also a commercial value-add.

MEDICARE REBATE #11610 MEASUREMENT OF ANKLE: BRACHIAL INDICES AND ARTERIAL WAVEFORM ANALYSIS, measurement of posterior tibial and dorsalis pedis (or toe) and brachial arterial pressures bilaterally using Doppler or plethysmographic techniques, the calculation of ankle (or toe) brachial systolic pressure indices and assessment of arterial waveforms for the evaluation of lower extremity arterial disease, examination, hard copy trace and report.

# All Medicare Benefits Schedule (MBS) item rebates are subject to compliance with the MBS information. It is the responsibility of the user to ensure full compliance with the MBS. Visit http://www.mbsonline.gov.au for full up to date MBS information.

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] [ 79 ] 80 / HUNTLEIGH VASCULAR DOPPLERS

Vascular Assessment Range Dopplex DMX Digital Doppler with Waveform

The Bi-Directional waveform is uniquely generated from the digital Doppler spectrum. It gives the clinician objective evidence to assist in the diagnosis of vascular disease that other Dopplers may find difficult or impossible to achieve. The algorithms optimise the presentation of waveforms and enhance the quality of sound using the unique Dynamic For more information download the Digital Noise Reduction (DDNR) system and gel filter. Doppler sound recording and product brochure from our website playback is just one of the many new features in this state-of-the-art digital Doppler unit.

The key features of the DMX are: ABI pressures confirmed • High Resolution Colour Display with waveforms • Bi-directional Waveform generated from the Digital Doppler Spectrum with Audio Scaling features • Data Storage on Micro SD Card Store waveforms and sounds for review or transfer to optional DR5 software package for printing reports and archiving. • Integrated Charging & Connectivity • High Sensitivity Interchangeable Probes • Dynamic Digital Noise Reduction

Choose from the handy ABI or ATP kit Alternatively the DMX doppler and probes can be purchased separately.

$ HUNDMX 835 (base unit only; probes not included)

The DMX Vascular doppler connects to multiple High Sensitivity Probes. See the accessories brochure on our website

EZ8 XS High Sensitivity 8MHz Widebeam Probe HUNEZ8XS Wide beam 8MHz probe allows for easy location of vessels. Easier to maintain vessel contact during inflation and deflation. $465

Dopplex® ABI 3YR Ankle Brachial Index Kit warranty The Ankle Brachial Index (ABI) kit combines a DMX Doppler, Doppler probes and cuffs to provide the wound care or vascular specialist with a system to help warranty: in the assessment of arterial disease prior to bandaging. Doppler waveforms 3 years on unit 1 year on probes & can be stored on the internal memory and reviewed at any time. Alternatively accessories the waveforms can be transferred to the DR5 software package for archiving, reviewing and printing of reports.

The ABI kit includes: See page 78 for the Automatic • DMX digital Doppler ABI system - dopplex Ability • Medical grade recharging kit • EZ8XS widebeam 8MHz Doppler probe • VP5XS Doppler probe • Trigger operated sphyg • Arm/Ankle cuffs (standard and large: latex free) • Educational CD $ • Large carry bag HUNABIKIT 1695

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical [ 80 ] PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] HUNTLEIGH VASCULAR DOPPLERS / 81

Dopplex® ATP Ankle & Toe Pressure Kit The Ankle and Toe Pressure (ATP) kit is a unique combination of the DMX Doppler, probes and accessories providing the Vascular, Diabetic or Lymphatic specialist with a system to aid the assessment of arterial disease and neuropathy. The Arterial Plethysmography (APPG) probe easily attaches to the DMX Doppler unit by simply swapping your Doppler probe with its adaptor. Arterial systolic pressure can be rapidly measured in patients with incompressible ankle arteries and can be repeated on the arms to determine the TBI. The internal pressure sensor in the adaptor provides a direct pressure reading on the Doppler display. PPG waveforms and pressures can be stored on the internal memory and reviewed at any time. Additionally the waveforms and pressures can be transferred to the DR5 software package.

ATP Kit includes: • DMX digital Doppler • Medical grade recharging kit • EZ8XS widebeam 8MHz Doppler probe 3YR • APPG probe and adaptor warranty • Toe cuffs & inflator • Arm/Ankle cuffs (standard and large: latex free) Toe Pressures and • Trigger operated sphyg warranty: • Neuropen & box of tips (includes 10g monofilament) 3 years on unit TBI made easy • Educational CD 1 year on probes & • Large carry bag accessories

$ HUNATPKIT 2495 EZ8XS Widebeam 8MHz Probe Incorporates wide beam technology. Easier location of vessels. Easier to maintain contact during inflation and deflation.

APPG Probe Arterial Plethysmography (APPG) probe easily attaches to the DMX Doppler unit by simply swapping your Doppler probe with it's adaptor.

Dopplex DR5 Reporting Software Dopplex DR5 is a unique vascular reporting software package for use in conjunction with the Dopplex DMX. It allows real time visualisation of waveforms on a PC. An unlimited number of traces can be transferred and stored for reviewing, archiving and printing. • Displays Doppler colour spectral waveforms in real time • Replay of Doppler waveforms and flow separated sounds • An integral database for patient data storage and Doppler sound files • The facility to package tests together and email them for review • Storing an unlimited number and length of traces per session • A PDF generator enables the final reports to be saved and transferred to an external EPR system • Calculate Doppler indices and flow rate

$ HUNDR5 850 www.huntleigh-diagnostics.com

Note: Dopplex DR4 is also available for display of waveforms and data from the MD200 and Dopplex Ability - see page 79

Need more information? Visit our website or call our team. We are here to look after your team.

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] [ 81 ] 82 / FOETAL DOPPLERS

NOW YOU GET TO SEE WHAT YOU ARE HEARING

PREMIUM PRODUCT

...a new dimension in sound and vision

SR2 2MHz Foetal Doppler Rate and Trace Display Doppler with fixed 2MHz waterproof probe Now you can see the benefit of visual presentation of fetal heart rate in both numeric and trace views, providing you with added clinical reassurance. • Big Numbers and Trace View Modes Watch the video explaining Viewed clearly even in bright conditions on a high definition colour display Intelligent Intermittent • Improved Performance . Visit our website Specially designed high performance probes are optimised to perform in early gestation • Improved Audio 3YR Reduced background and probe placement noise assists in quicker location of the foetal heart warranty • Enables Documentation of Intermittent Auscultation Communicates with viewing & archiving software • Record and Playback FHR Data with Audio Using internal data storage, an added aid for training (Requires an SD card, optional extra) This high sensitivity handheld Digital Doppler is intended for general purpose screening of the foetal heart at all stages of pregnancy from as early as 8-10 weeks, right through to labour. The attached probes are waterproof (IPX7) for high sensitivity FHR detection in both normal use and in water birth monitoring.

$ HUNSR2 995 Supplied complete with: gel, soft carry bag, user manual, uses 2 x AA batteries (included)

Also available SR3 3MHz Foetal Doppler The 3MHz probe is the probe of choice for many clinicians for use in early gestation (6-8 weeks). HUNSR3 $995

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical [ 82 ] PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] FOETAL DOPPLERS / 83

Sonicaid FDI Hi Bebe Doppler Doppler with foetal heart rate display Pocket sized foetal doppler The FD1 combines high sensitivity with excellent audio quality. It is easy to • Colour screen - new use and provides optimum foetal heart detection from 8-10 weeks gestation. • Compact, light and easy to use • 2MHz waterproof probe The FD1’s active noise reduction technology ensures crystal clear • Large display and clean sound audio and the high sensitivity 2MHz probe is waterproof. • High sensitivity doppler probe • 10-12 week sensitivity • Advanced real time auto-correlation foetal heart rate processing • Continuous use for up • Active noise reduction for crystal clear foetal to 6 hours • Waterproof probe suitable for use in a water birthing environment • 12 months warranty • Advanced power management with auto switch-off to conserve battery life • Long robust coiled cable enables optimum probe position in all circumstances • Large carry bag • 5 year warranty

$ 5YR $ warranty 395 895 HUNFD01 BIOBT200WP

ES-100VII foetal doppler Echo Sounder The Hadeco ES-100VII is a hand held foetal Doppler ES-101EX featuring advanced waveform LCD and speaker One-piece construction • Displays real-time foetal heart rate foetal doppler • Freeze key freezes heart rate for notation • LCD flashes to alert if heart is not stable • One-handed operation • Indicates if battery is running low • 2MHz probe • Low intensity beam • Clear sound with built-in speaker • Automatic shut-off • Freeze key freezes heart rate for notation • Advanced LCD and speaker • Large LCD for foetal heart rate • Waterproof probe • Automatic shut-off • Includes carry case, battery, conducting gel • Includes carry case, battery, and headphones conducting gel and headphones • 1 year warranty • 1 year warranty

$ $ 795 CRISM100VII 595 CRISMAP101EX

Bi-directional Doppler ES-100V3 With USB interface and Software • Bi-directional Doppler with backlit waveform LCD • Comes with 8MHz probe Ideal for the • Quality sound and speaker paperless • 30 waveform memory and USB interface • Easy key to freeze waveform practice. • Vascular Link Software Smart-V-Link for Windows with FFT analysis • Multi-probe option of 2, 4, 5, 8 & 10MHz and PPG Probe • Includes carry case, battery, conducting gel and headphones • Automatic Power Off • 12 months warranty • Also available without software $2090 CRISM100V3 + CRIDLINK

ES-100V3 without software CRISM100V3 $1495.00

2MHz Foetal Probe CRISMAP100VX2 $695.00

CRIDLINK $ Easy PDF report Smart-V-Link Software for Windows 595.00

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected] [ 83 ] 84 / HADECO VASCULAR DOPPLERS

Smartdop™ 45 with 8MHz probe Bi-directional Doppler with waveform LCD & fast printer and 2 probe ports All you need in a hand-held vascular doppler with printer. Prints high resolution waveforms in real-time as well as numerical data. • Now comes standard with 2 probe ports • Fast printer for immediate data output • Comes with 8MHz probe • Stores up to 30 patient waveforms • Various mode settings are available for optimal measurement • Multi-probe option of 2, 4, 5, 8 & 10MHz and PPG Probe • Automatic power “Off” • Optional connection to Smart-V-Link Software for data download • Built in rechargeable battery • Includes carry case, battery, conducting gel and headphones • 12 month warranty • Made in Japan

$ CRISMADOP45W 2395 Includes 2mhz foetal probe

2Mhz Foetal Probe CRISMAP100VX2 $695.00 PPG/PV Probe CRISMAPPG21 $795.00 Paper for Smartdop 45 DOPPAP900 $13.90 Smart-V-Link Software for Windows CRIDLINK $595.00

Smartdop™ 30EX Bi-directional Doppler for ABI/TBI studies with built-in cuff inflator (ABI= Ankle brachial index ) (TBI = Toe brachial index) • Doppler recorder • Full auto system with built-in cuff inflator • Stores up to 30 patient waveforms $ • Calculates and prints ABI/TBI and pressure documentation 3295 • Comes with 8MHz probe CRISMADOP30EX • Two probe combination of 2, 4, 5, 8 & 10MHz, PPG and PV Probe • Automatic power “Off” • Optional connection to Smart-V-Link Software for data download • Built in rechargeable battery • Additional cuffs and toe cuffs available • 12 month warranty • Made in Japan

Clinical Applications: – Ankle Brachial Index (ABI) – Toe Brachial Index (TBI) – Bi-directional lower extremity studies – Blood pressure segmental studies – Peripheral vascular procedures – Penile & digit systolic pressures – Toe pressures & venous reflux studies (PPG)

Paper for Smartdop 30EX DOPPAP900 $13.90 Smart-V-Link Software for Windows CRIDLINK $595.00

BP Medical (WA) | www.bpmedical.com.au Team Medical | www.teammed.com.au

medical [ 84 ] PHONE 1300 33 55 60 | [email protected] All prices are subject to 10% GST unless marked with * (GST Free) supplies PHONE 1300 22 44 50 | [email protected]