Is non-pitting edema graded 1-4?

  1. 0
    When charting edema I have always charted pitting or non-pitting. I thought only pitting edema was graded on a scale 1+-4+ and non-pitting edema was simply charted as non-pitting (along with any other charcteristics). Am I right? My new clinical instructor says that non-pitting would also be graded 1-4 but I can't find proof of that.
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  3. 7 Comments so far...

  4. 1
    You Are correct because the 1-4 is grading how many seconds it takes for the indention that you made to go away. Right ?
    smstar1996 likes this.
  5. 1
    I have always understood non-pitting edema to be graded as "Non-pitting". I have graded it a "1" before when I could make a slight indention in the patient's foot. I've done a lot of assessments. To my knowledge there is only 1 "1-4" scale for edema. Let me know if you find out otherwise.
    smstar1996 likes this.
  6. 6
    Try this:
    Also I could find no reference to grading non-pitting edema. We always measured extremities to assess the degree of swelling, and the nature of the skin, taut, shiny, weeping etc. I have never heard of grading non pitting either. If anyone has please share.

    ASSESSMENT OF PITTING EDEMA

    2mm or less = 1 + Edema

    • Slight pitting
    • No visible distortion
    • Disappears rapidly


    2-4mm = 2 + Edema

    • Disappears rapidly
    • Somewhat deeper pit
    • No readably detectable
      distortion
    • Disappears in 10-15 seconds (2-4 mm indent)



    4-6mm = 3 + Edema

    • Pit is noticeably deep
    • May last more than 1
      minute
    • Dependent extremity looks
      fuller and swollen (4-6mm)



    6-8mm = 4 + Edema

    • Dependent extremity looks fuller and swollen (4-6mm)
    • Pit is very deep
    • Lasts as long as 2-5
      minutes
    • Dependent extremity is
      grossly distorted (6-8mm)




    Assessment Chart for Pitting Edema adapted from the Guelph General Hospital Congestive Heart Failure Pathway
    Last edit by Ruthiegal on Mar 7, '09 : Reason: more info.
  7. 0
    Oops okay
  8. 0
    I was taught that the 1-4 grade refers to the amount of edema and that is is described as either pitting or non-pitting.
  9. 0
    Table 1: Grading of Pitting Edema

    Method 1: Depth and Duration
    +1 = Mild edema (0"-1/4" indentation), disappears rapidly
    +2 = Moderate Pitting (1/4"-1/2" indentation), disappears in 10-15 seconds
    +3 = Severe Pitting (1/2" - 1" indentation), disappears in 1-2 minutes
    +4 = Severe Pitting (>1" indentation), may be present after 5 minutes


    Resources
    American College of Sports Medicine. (2006). Exercise Guidelines.

    Certo, C. (2001). Cardiopulmonary Physical Therapy Journal, 12(2), 39-45.

    Kindermann, M., Meyer, T., Kindermann, W., & Nickenig, G. (2003). Exercise training in heart failure. Herz, 28(2), 153-165.
  10. 0
    Its not graded. When you see one it is mostly associated with DVTs and you can document it as a non-pitting edema and measure circumference of limb involve if its unilateral and compare it with non affected limb to gauge the amount of fluid accumulation.

    Omar, RN-BC


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