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What is external compression?
when you apply a mechanical force to outside of body to decrease pressure and edema
What is the accumulation of excess fluids in the spaces between the cells of tissues (interstitial space)?
What are some possible problems of fluid balance?
- vascular insufficiency
- deep vein thrombosis
What are some ways to prevent or relieve edema?
- external compression
- masage (retrograde, lymphatic manipulation)
- ted hose
What are some causes of edema?
- inadequate/obstructive blood vessels (removal of lymph nodes, natural collapse of lymp vessels)
- leg ulcers
- venous stasis (from increased capillary pressure and venous obstruction
- organ failure (heart, liver, kidney)
- varicose veins
- post-op phlebitis
- chronic and acute venous insufficiency
- inproperly fitting casts
What causes localized edema?
venous/lymphatic obstruction or increased vascular permeability (from trauma) or trauma and infection
usually limited to one part of body but can be bilateral
What causes generalized edema?
systemic process occuring with chronic illnesses such as advanced cardiac problems, kidney failure, or liver disease
both LE usually involved with groin and abdominal areas but can be whole body
What type of edema do PTs deal with?
What is pitting edema?
push for 5 seconds over bony prominences..if stays in its pitting
What is an intermittent compression unit?
pneumatic unit designed to apply external pressure to an edematous body part. it moves interstitual fluid to sites of normal lymphatic or venous drainage. pressure should be higher distally
What is it called when you massage one area into the lymph return, then the next and the next?
empty the bucket
What type of intermittent compression unit fills up separate chambers?
What are some indications for external compression?
- post-mastectomy lymphedema
- venous insufficiency
- traumatic edema
What are some contraindications?
- pts with arterial insufficiency have increased peripheral resistance (compression will increase resistance)
- infection at tx site
- edema in patients with cardiac dysfunction, kidney dysfunction, liver dysfunction
- obstructed lymphatic channels
What are the parameters for UEs?
What are the parameters for LEs?
What should you document after treatment?
- circumference/appearance pre/post
- home instructions
When should you measure for support garments?
first thing in morning or right after tx