Bedside Evaluation of Edema
| Status: | Recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/17/2019 |
| Start Date: | November 30, 2017 |
| End Date: | December 31, 2019 |
| Contact: | Richard Schreiber, MD |
| Email: | rschreiber@geisinger.edu |
| Phone: | 717 724 6414 |
A Simple Technique for Quantitative Evaluation of an Important Clinical Sign
Edema, commonly called swelling, is a common medical condition, with many causes. Clinicians
generally find edema by pressing against a patient's skin, usually on the feet or shins, and
observing how much dimpling there is in the skin. Most clinicians estimate the amount on a
scale of mild to severe, or perhaps state the amount as 1 to 4. There is little agreement
between observers, and it is hard to judge different clinicians' use of these scales. The
first part of this experiment will demonstrate this inconsistency. After clinicians are shown
a new technique for measuring edema, the second part of the study will show more accurate and
consistent measurements. This will help clinicians to measure edema better, and to
communicate their findings to other clinicians more effectively.
generally find edema by pressing against a patient's skin, usually on the feet or shins, and
observing how much dimpling there is in the skin. Most clinicians estimate the amount on a
scale of mild to severe, or perhaps state the amount as 1 to 4. There is little agreement
between observers, and it is hard to judge different clinicians' use of these scales. The
first part of this experiment will demonstrate this inconsistency. After clinicians are shown
a new technique for measuring edema, the second part of the study will show more accurate and
consistent measurements. This will help clinicians to measure edema better, and to
communicate their findings to other clinicians more effectively.
The research team will recruit as many clinicians who are conveniently available for the
study. Clinicians will include attending physicians from any specialty, residents, medical
students, physician assistants, physician assistant students, nurses, certified nurse
practitioners, and certified nurse practitioner students.
Once patients and clinicians have been recruited, the research team will maintain a list of
the patients and a grid of which clinicians are to examine which patients. Each clinician
will be given a data collection sheet, listing the patients' room numbers, and a grid for
recording results for each of the patient's affected limb(s). The first data collection sheet
(before instruction on the quantitative method) will just show a blank free text field so
that clinicians can record their results as they normally do.
After instruction in the novel quantitative technique, the clinicians will receive another
data collection sheet now indicating the intent to have the clinicians record their findings
in millimeters.
The expectation is that a minimum of 6 examiners will determine the extent of edema on at
least 38 limbs. If possible, the research will continue until approximately 100 limbs have
been examined by a total of at least 10 to 20 clinicians.
study. Clinicians will include attending physicians from any specialty, residents, medical
students, physician assistants, physician assistant students, nurses, certified nurse
practitioners, and certified nurse practitioner students.
Once patients and clinicians have been recruited, the research team will maintain a list of
the patients and a grid of which clinicians are to examine which patients. Each clinician
will be given a data collection sheet, listing the patients' room numbers, and a grid for
recording results for each of the patient's affected limb(s). The first data collection sheet
(before instruction on the quantitative method) will just show a blank free text field so
that clinicians can record their results as they normally do.
After instruction in the novel quantitative technique, the clinicians will receive another
data collection sheet now indicating the intent to have the clinicians record their findings
in millimeters.
The expectation is that a minimum of 6 examiners will determine the extent of edema on at
least 38 limbs. If possible, the research will continue until approximately 100 limbs have
been examined by a total of at least 10 to 20 clinicians.
Inclusion Criteria:
- Currently admitted patients
- Patient who can understand the purpose of the study and sign a consent form
- Patient has a measurable amount of edema
- Patient will likely be available during the time the clinicians can examine the
patient
Exclusion Criteria:
- Unable or unwilling to sign the consent form
- No measurable edema
- Currently in isolation for infection control purposes
- Patients in the Behavioral Health section of the hospital
- Maternity patients (due to availability of infant rooming-in)
- Prisoners
- Age below 18 years
- Patients with bilateral lower extremity amputation
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