Is non-pitting edema graded 1-4?

[smstar1996]

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.

[Magsulfate, BSN, RN]

You Are correct because the 1-4 is grading how many seconds it takes for the indention that you made to go away. Right ? :)

[John20]

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.

[Ruthiegal]

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

[Magsulfate, BSN, RN]

Oops okay :)

[Valerie Salva, BSN, RN]

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.

[RNKel, ASN, RN]

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.

[Omar, RN-BC]

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