Assessment of Edema

[gospodarich]

I have been a nurse for over 20 years. I learned that edema is either pitting or non pitting and only the pitting edema is graded +1-+4. Also, I learned that the pitting relates to how deep of an indentation is made. I am looking for a website or book that gives this specific information so I can re-educate my colleauges. Can anyone give me that information? My institution does not a set policy on how to assess edema and it is confusing when we do not all do the same type of assessment and reporting.

[GingerSue]

This is from Jarvis Physical Examination & Health Assessment,

In the Chapter "Peripheral Vascular System and Lymphatic System"

If pitting edema is present, grade it on the following scale:

1+ Mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg looks swollen
4+ Very deep pitting, indentation lasts a long time, leg is very swollen

This scale is subjective and qualitative. The amount of pressure used is arbitrary, as is the judgment of the depth and rate of pitting. Clinicians need a standard quantified scale in order to ensure consistent clinical measurements and management. Many classify the edema by measuring the depth of the pitting in centimeters (1+ = 1 cm, 2+ = 2 cm, etc.) (Welsh, Arxouman, and Holm, 1996).

Some measure with a millimeter scale, others by an increase in weight, still others try to quantify the rate of time the pitting remains after release of pressure. Check with your institution to determine a consistently used scale.

[nlion87]

Edema Staging :

Stage
Pit Recovery Time

Stage 1
< 20 sec

Stage 2
20-40 sec

Stage 3
40-60 sec

Stage 4
> 60 sec

Edema classification scale: 1+ for each 20 seconds of pit recovery time

[ShanYS]

Pitted edema is tested by pressing & holding your finger into the swollen tissue over a bony area for 5 seconds. If there is an indentation left behind when you remove your finger it is pitted edema.

To classify the pitted edema you measure the depth of pitting & compare the measurement to the following scale;

+1 = 2mm of pitting

+2 = 4mm of pitting

+3 = 6mm of pitting

+4 = 8mm of pitting

[RNKel, ASN, RN]

And as you can see, it isn't done consistently at all anywhere... LOL

[RNCEN]

ShanYS said:

Pitted edema is tested by pressing & holding your finger into the swollen tissue over a bony area for 5 seconds. If there is an indentation left behind when you remove your finger it is pitted edema.

To classify the pitted edema you measure the depth of pitting & compare the measurement to the following scale;

+1 = 2mm of pitting

+2 = 4mm of pitting

+3 = 6mm of pitting

+4 = 8mm of pitting

This is what we were taught, and how we assess while on the clinical floor.