Edema, Emergency Medicine

Laura J. Macnow Reviewed 06/2017
 


Basics

Description

  • Clinically apparent accumulation of extravascular fluid due to a derangement in the balance of oncotic and hydrostatic forces:

    • Increase in venous/capillary hydrostatic pressure

    • Decreas...

Diagnosis

Signs and Symptoms

  • Weight gain of several kilograms

  • Discomfort in the affected areas

  • Swelling

  • Tenderness

  • Pitting edema:

    • Increased venous hydrostatic pressure or decreased oncotic pressure

  • Nonpittin...

Treatment

Initial Stabilization/Therapy

See “ED Treatment.” 

Ed Treatment/Procedures

  • Treatment should be directed toward the underlying cause.

  • Diuretics are usually indicated in cases of generalized edema...

Follow-Up

Disposition

Admission Criteria

  • Base the decision to admit the patient on the underlying etiology.

  • Concomitant cardiovascular or pulmonary compromise

  • Inability to ambulate without adequate home s...

Pearls and Pitfalls

  • Classify edema as generalized vs. localized, pitting vs. nonpitting.

  • Pitting edema is caused by “protein-poor” extravasated fluid (by increased hydrostatic pressure or decreased onc...

Additional Reading

  • Braunwald  E, Loscalzo  J. Edema. In: Longo  DL, Fauci  AS, Kasper  DL, et al., eds. Harrison's Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.

  • Ely  JW, ...

Codes

ICD9

  • 782.3 Edema

  • 992.7 Heat edema

  • 995.1 Angioneurotic edema, not elsewhere classified

ICD10

  • R60.9 Edema, unspecified

  • T67.7XXA Heat edema, initial encounter

  • T78.3XXA Angioneurotic edema, initial encount...

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