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Deteriorating Patient
Deteriorating Patient




  • Look for swelling of the lower limbs; apply pressure to the anterior aspect of the tibia for fifteen seconds and then release to assess for pitting oedema.
    • Causes of Oedema

    • Pitting

    • Fluid overload - excessive IV fluids, renal failure, heart failure
    • Right ventricular failure
    • Venous pathology - thrombosis / insufficiency
    • Dependency (the effect of gravity)
    • Hypoalbuminaemia - malnutrition, malabsorption, nephrotic syndrome, liver (synthetic) failure
    • Non-Pitting

    • Impaired lymphatic drainage
    • Pretibial myxoedema (hypothyroidism)
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