Swelling
In medical screenings the issue of ‘swelling’ is initially assessed by way of a visual evaluation. In cases of concern, the extent of the swelling will be gauged with either a circumference measurement or volumetry.
Visual evaluation
Screening
In the screening, the doctor initially assesses and documents the extent of the swelling by way of a visual evaluation according to prescribed evaluation criteria. Should the doctor detect a ‘light to distinct swelling’ or a ‘massive, bulging swelling, shiny skin’, the exact size of the swelling will be measured in supplementary tests undertaken by a physiotherapist or occupational therapist. The therapist will select for this one of the two test types (circumference measurement or volumetry).
Documentation example:
Circumference measurement
Supplementary testing (1)
Required material: Measuring tape
Procedure: When taking the measurement, it is important to ensure a consistent tautness of the measuring tape and its exact placement at the four defined points of measurement. The measurements are always taken for both the left and right hands. The values for left and right, along with the difference between the two sides are documented (in cm, to one decimal point ).
Documentation example:
Volumetry
Supplementary testing (2)
Required material: Volumeter container, overflow container, graduated measuring cylinder, water, towel
Preparation: The approx. 25cm tall volumeter is placed in an overflow container and filled to the rim with water. The patient removes any jewellery from his/her hands and arms.
Procedure: The patient stands and places his/her hand in the volumeter until the interdigital space between the ring and middle finger lies on the horizontal bar. The hand should be held vertically and should not touch the walls of the container. The hand remains in position until water stops flowing over the top of the volumeter. The expelled water is collected in the overflow container and then transferred to and measured in the graduated measuring cylinder.
Note: Both hands are measured, first the unimpaired hand and then the afflicted one. The measured values for left and right hands as well as the difference between them is documented (any difference above 10ml should be noted).
Documentation example:
