FAYETTEVILLE, Ark.
— New is a relative term. Peripheral arterial disease isn’t new to health care professionals
employed in vascular-related specialties — those that deal with the health of
the body’s blood vessels — but many in general nursing practice don’t know
about the simple test that can detect the disease and prevent pain and
suffering as well as progression to life-threatening conditions.
That’s why
Glenda Lawson, University of Arkansas clinical associate professor of nursing,
has spent years educating the public and nurses, both in the field and as part
of the curricula of the UA’s Eleanor Mann School of Nursing, about peripheral
arterial disease and the ankle-brachial index. She advocates that the index, a
diagnostic tool that requires a nurse to compare blood pressure levels taken at
the ankle and the arm, be included in the routine practice of taking a
patient’s vital signs.
A reading that
is lower at the ankle than one taken at the arm indicates a possible blocked
artery, and the patient should be referred immediately for further testing.
Lawson became
the first nationally certified vascular nurse in Arkansas in 1997. Over the
next 10 years, she published articles about peripheral arterial disease,
received a $6,000 grant to conduct research in screening for the disease and
presented this research during the 2005 Oxford Round Table Research Conference
in England.
Most recently, Lawson
was named the winner of the 2007 Jeanne E. Doyle Award, the highest honor given
by the Society for Vascular Nursing, an international association dedicated to
promoting excellence in the compassionate and comprehensive management of
people with vascular disease. The society focuses on providing high quality
education, fostering clinical expertise and supporting nursing research.
Lawson will be
recognized at the society’s annual convention in Baltimore on June 8.
“The college is
extremely proud that Dr. Lawson is being honored for her work concerning
peripheral arterial disease,” said Reed Greenwood, dean of the College of Education
and Health Professions. “Her efforts to bring attention to this insidious
disease will improve the lives of thousands of patients who could otherwise
face severe pain and debilitation. Many fledgling nurses will take this
knowledge into the medical community with the result that the disease may be
seen less and less often.”
The
ankle-brachial index is still new to the typical medical-surgical nurse and many
nurses who work in physicians’ offices and community health clinics, Lawson
said, but by routinely performing this test they could detect the disease much
earlier than it is commonly found and head off more serious problems. It
requires the same instruments used to take blood pressure readings in the arm plus
the addition of a hand-held ultrasonic Doppler that works on the foot where a
stethoscope would not be able to achieve an accurate reading.
“I’ve done it
for years because I know the significance,” Lawson said. “I travel regularly to
senior citizen centers in Northwest Arkansas and to the Jones Center for
Families in Springdale to screen older adults and educate them about the
disease. I’ve been to the Wal-Mart distribution center in Bentonville to screen
truck drivers. After an article I wrote was published in the Journal of
Vascular Nursing and an announcement made locally, I heard from former
faculty members of the College of Education and Health Professions who wanted
me to take their ankle-brachial index.”
Peripheral
arterial disease results from narrowing of blood vessels caused by buildup of
plaque and is most commonly seen in the legs. Older people commonly dismiss the
pain they feel while walking as something associated with arthritis, diabetes
or just part of aging. That’s a dangerous assumption that Lawson is hoping her
efforts will prevent.
People with
untreated peripheral arterial disease face increased risk of stroke or heart
attack, and diagnosing it in the early stages can help in preventing these
vascular diseases associated with aging that can be fatal. Smoking, diabetes,
obesity, family history and a sedentary lifestyle are primary risk factors for
peripheral arterial disease.
Public awareness
is growing, Lawson said. Now, a handful of nurses in the state have earned the
national vascular certification, and the public may occasionally notice peripheral
arterial disease screenings offered in community settings and see advertisements
on television or in magazines about the disease. Lawson also educates faculty
at other nursing schools in the state so that new nurses coming out of those
schools can perform the diagnostic test.
“The pain can
lead a person to become home-bound, then chair-bound, with the result that
their quality of life diminishes greatly,” Lawson said. “I have found people
who could have lost a foot or a leg if they had not had the test done. When
oxygenated blood can’t reach the lower extremities because of a blockage, the
loss of circulation can result in gangrene and eventually amputation.”
Lawson will soon
take to the road again to dispense free medical care on a medical mission trip
to Guatemala. She’ll have her pocket Doppler with her.