04-06: Volumetric Measurements & Intermittent Compression Flashcards
Types of Swelling (3)
Joint Swelling, Lymphedema, Ansarca
Joint Swelling
- Blood and joint fluid in the capsule
- Feels like a water balloon
- Common to ankle sprains
Lymphedema
- Lymph accumulates in subcutaneous tissue
- Lymph node excision, radiation therapy, trauma
- Common in women with masectomy
- Usually need compression bandage after treatment
Ansarca
Extreme generalized edema
What moves lymph (5)
- Muscle activity
- AROM, PROM
- Elevation
- Respiration
- Contraction of vessels
Pitting Edema
Impression is left when pressure is applied to edematous area
Measuring Girth
Locate bony landmark, then measure couple of inches above (every two inches)
Ascites
Edema marked by excess serous fluid in peritoneal cavity - causes distention
Edema treatments (4)
- Elevation
- Compression
- WB Exercises - cocontract muscles; compression helps with edema
- Cryotherapy - constricts blood vessels
Compression treatments (4)
- Ace Wrap
- Lymphedema wrapping
- Compression garments
- Intermittent Compression
Ace wrap
- Apply with Figure 8 wrap (less of tourniquet effect)
- Wrap distal to proximal
- Frequent re-wrap (comes loose)
Compression wraps
- Custom: Typically measure pt at full edema to get right size
- Pre-fabricated sizes
Intermittent Compression Indications
- Lymphedema
- Traumatic Edema
- Chronic Edema (immobility)
- Venous Stasis Ulcers
- Amputations
- Edema from renal/arterial insufficiency
- Post-surgical edema
Intermittent Compression Contraindications
- DVT
- Superficial infections
- CHF
- Acute pulmonary edema
- Displaced fractures
Purpose of Intermittent Compression
- Control and reduce accumulation of lymph in body tissues
- Assist return of body fluid towards heart
IC Parameters
- Less than diastolic pressure
- 30-60 mmHg (upper extremity)
- 40-80 mmHg (lower extremity)
IC On-off sequence
30 seconds on, 30 seconds off
IC Treatment time
20-30 minutes
IC procedure
- Check BP
- Check for skin breakdown
- Measure girth of extremity, compare with other LE
- Elevate LE, wrap in cuff
- Connect tubing, turn on units, set parameters
- Leave off time to 0 until sleeve inflates (after inflation, set time to 30 sec
- Off time - encourage patient to move extremity
- Re-measure girth
- Wrap extremity in elastic or lymphedema wrap
IC Cryotherapy
Cold water circulates through sleeve; 10-25˚ C
