The Bariatric Patient The World is Growing Dixie Lee Davenport,
RN, CEN, CCT-RN, PHRN EMS Outreach Manager Riverside Methodist
Hospital OhioHealth
Slide 2
Disclosure The author/speaker has no actual or potential
conflict of interest in relation to this presentation The
author/speaker has no actual or potential conflict of interest in
relation to this presentation Vendor products mentioned and/or
shown as examples Vendor products mentioned and/or shown as
examples No unapproved or off-label usages will be discussed No
unapproved or off-label usages will be discussed
Slide 3
Objectives Define obesityDefine obesity Review American and
world statistics regarding the prevalence of obesityReview American
and world statistics regarding the prevalence of obesity Review of
the pathophysiology of obesityReview of the pathophysiology of
obesity Identify co-morbidities associated with obesityIdentify
co-morbidities associated with obesity Identify special
considerations related to trauma in the obese patientIdentify
special considerations related to trauma in the obese patient
Discuss challenges to prehospital and hospital providers in
ergonomicsDiscuss challenges to prehospital and hospital providers
in ergonomics Discuss sizism, social stigma & sensitivity in
dealing with the obese patientDiscuss sizism, social stigma &
sensitivity in dealing with the obese patient
Slide 4
Obesity Defined Condition of an excessive proportion of adipose
tissue to total body weight that may lead to an unhealthy
state.
Slide 5
Obesity Defined Definitions for Adults For adults, overweight
and obesity ranges are determined by using weight and height to
calculate a number called the "body mass index" (BMI)*. BMI is used
because, for most people, it correlates with their amount of body
fat. An adult who has a BMI between 25 and 29.9 is considered
overweight.An adult who has a BMI between 25 and 29.9 is considered
overweight. An adult who has a BMI of 30 or higher is considered
obese.An adult who has a BMI of 30 or higher is considered
obese.
Slide 6
Obesity Statistics - World Obesity is a modern problem -
statistics for it didObesity is a modern problem - statistics for
it did not even exist 50 years ago. not even exist 50 years ago.
Worldwide, obesity has more than doubled since 1980Worldwide,
obesity has more than doubled since 1980 In 2008, more than 1.6
billion adults were overweight*In 2008, more than 1.6 billion
adults were overweight* In 2010 more than 40 million children under
theIn 2010 more than 40 million children under the age of 5 were
overweight age of 5 were overweight 65% of the world's population
live in countries where overweight and obesity kills more people
than being underweight65% of the world's population live in
countries where overweight and obesity kills more people than being
underweight Overweight / obesity are the 5th leading risk in global
deaths**Overweight / obesity are the 5th leading risk in global
deaths**
Slide 7
Obesity Statistics - World
Slide 8
Obesity Statistics U.S. A third of American adults are
overweightA third of American adults are overweight More than
one-third of adults (35.7%) are obeseMore than one-third of adults
(35.7%) are obese Combined, 68.8% of Americans are either
overweight or obeseCombined, 68.8% of Americans are either
overweight or obese The CDC estimates 42% of Americans will be
obese by the year 2030The CDC estimates 42% of Americans will be
obese by the year 2030 After smoking, obesity is America's biggest
preventable cause of premature death At the current rates of
increase, obesity related health care costs are expected to exceed
$300 billion by 2018 more than double the $147 billion reported in
2008At the current rates of increase, obesity related health care
costs are expected to exceed $300 billion by 2018 more than double
the $147 billion reported in 2008
Slide 9
Obesity Statistics U.S.
Slide 10
In 2001, no state had an obesity prevalence of 30% or more.)In
2001 the initiative Healthy People 2010 was introduced to spearhead
lowering obesity rates to below 15% (In 2001, no state had an
obesity prevalence of 30% or more.) No state met the nation's
Healthy People 2010 goal.No state met the nation's Healthy People
2010 goal. Healthy People 2010 Healthy People 2010 Rather, in 2010,
there were 12 states with an obesity increase of over 30%.Rather,
in 2010, there were 12 states with an obesity increase of over
30%.
Slide 11
Pathophysiology Why Are We Bigger?
Slide 12
Pathophysiology
Slide 13
Pathophysiology High caloric intakeHigh caloric intake Low
level of physical activityLow level of physical activity Low level
of metabolismLow level of metabolism High insulin sensitivity?High
insulin sensitivity? Lack of anti-obesity hormone?Lack of
anti-obesity hormone? Why Are We Bigger?
Slide 14
Role of Brain Neurotransmitters Neurotransmitters govern the
bodys response to starvation and dietary intakeNeurotransmitters
govern the bodys response to starvation and dietary intake
Decreases in serotonin and increases in neuropeptide Y are
associated with an increase in carbohydrate appetiteDecreases in
serotonin and increases in neuropeptide Y are associated with an
increase in carbohydrate appetite Neuropeptide Y increases during
deprivation; may account for increase in appetite after
dietingNeuropeptide Y increases during deprivation; may account for
increase in appetite after dieting Cravings for sweet, high-fat
foods among obese and bulimic patients may involve the endorphin
systemCravings for sweet, high-fat foods among obese and bulimic
patients may involve the endorphin system
Slide 15
Obesity: A Higher Risk Heart diseaseHeart disease
DiabetesDiabetes HypertensionHypertension StrokeStroke
OsteoarthritisOsteoarthritis Kidney disease/stonesKidney
disease/stones Psychiatric issuesPsychiatric issues Impaired body
imageImpaired body image DepressionDepression Loss of self
esteemLoss of self esteem
Slide 16
Obesity: A Higher Risk Heart Disease Overall increase in both
morbidity and mortality Coronary artery disease Atherosclerosis and
hyperlipidemia Hypertension CHF Sudden cardiac death Peripheral
vascular disease As weight increases risks get higher
Slide 17
Obesity: A Higher Risk The Diabetes Epidemic The prevalence of
Type 2 diabetes worldwide has more than doubled since 1980The
prevalence of Type 2 diabetes worldwide has more than doubled since
1980 Estimated 153 million three decades agoEstimated 153 million
three decades ago 347 million in 2008347 million in 2008 2 biggest
risk factors for Type 2 (NIDDM) diabetes are heredity and weight2
biggest risk factors for Type 2 (NIDDM) diabetes are heredity and
weight Over 80% of type 2 diabetic patients are overweightOver 80%
of type 2 diabetic patients are overweight
Slide 18
Obesity: A Higher Risk Effect of Obesity on Diabetes In normal
food metabolism, glucose enters the bloodstream.In normal food
metabolism, glucose enters the bloodstream. Glucose is the primary
source of fuel for the bodyGlucose is the primary source of fuel
for the body Pancreas secretes insulinPancreas secretes insulin
Insulin moves glucose from the bloodstream into muscle, fat, and
liver cells, where it can be used as fuelInsulin moves glucose from
the bloodstream into muscle, fat, and liver cells, where it can be
used as fuel
Slide 19
Obesity: A Higher Risk Effect of Obesity on Diabetes In the
obese, food metabolism is slowed down because of lack of exercise.
This causes the glucose level to exceed what the body can handle.In
the obese, food metabolism is slowed down because of lack of
exercise. This causes the glucose level to exceed what the body can
handle. Excessive levels of glucose make it difficult for the
pancreas to regulate, leading to insulin resistance which results
in type II diabetes.Excessive levels of glucose make it difficult
for the pancreas to regulate, leading to insulin resistance which
results in type II diabetes. THE MORE OVERWEIGHT OR OBESE YOU ARE,
THE GREATER YOUR RISK OF DIABETES!!
Slide 20
Obesity: A Higher Risk Mean age: 12-14 years oldMean age: 12-14
years old Girls > BoysGirls > Boys 94% are in minority
groups94% are in minority groups 74-100% have a strong family
history74-100% have a strong family history 70% of overweight
children become overweight adults70% of overweight children become
overweight adults Children and Obesity + Diabetes
Slide 21
Obesity: A Higher Risk Pulmonary Problems Decrease in lung
volume Increased work of breathing Higher airway resistanceHigher
airway resistance Higher chest wallHigher chest wall Decreased
complianceDecreased compliance Flattened diaphragmsFlattened
diaphragms Altered lung volumesAltered lung volumes About 70% of
people with OSA are obeseAbout 70% of people with OSA are
obese
Slide 22
Obesity: A Higher Risk Pulmonary Problems Pulmonary
hypertension secondary to:Pulmonary hypertension secondary to:
HypoxiaHypoxia Pulmonary vasoconstrictionPulmonary vasoconstriction
Depressed heart functionDepressed heart function
Slide 23
Obesity: A Higher Risk Pickwickian Syndrome
Obesity-hypoventilation syndrome Obesity-hypoventilation syndrome
5% -- 10% of morbidly obese5% -- 10% of morbidly obese Left and
right sided heart failure commonLeft and right sided heart failure
common Obstructive sleep apneaObstructive sleep apnea
HypoxiaHypoxia HypercapniaHypercapnia Marked daytime
somnolenceMarked daytime somnolence Chronic respiratory
acidosisChronic respiratory acidosis
Slide 24
Obesity: A Higher Risk Cancer Mortality Men:Men: StomachStomach
ProstateProstate Women:Women: BreastBreast UterusUterus
CervixCervix OvaryOvary
Slide 25
Obesity: A Higher Risk Obstetrics and Gynecology Female
infertilityFemale infertility Disrupted menstruation and
ovulationDisrupted menstruation and ovulation Early
menstruationEarly menstruation Urinary incontinenceUrinary
incontinence Abnormal laborAbnormal labor Increased progression to
Cesarean sectionIncreased progression to Cesarean section Increased
fetal sizeIncreased fetal size Pre-eclampsia and
eclampsiaPre-eclampsia and eclampsia Gestational
diabetesGestational diabetes
Obesity: A Higher Risk Obesity and Trauma Higher incidence of
pelvic fracturesHigher incidence of pelvic fractures Less likely to
wear seat beltsLess likely to wear seat belts Subcutaneous fat
hides physical findingsSubcutaneous fat hides physical
findings
Slide 28
Obesity: A Higher Risk Obesity and Trauma Obese patients with
critical injuries from blunt trauma have worse outcomes than do
leaner patients*Obese patients with critical injuries from blunt
trauma have worse outcomes than do leaner patients* Patients with
higher BMIs had longer stays in both the intensive care unit and
the hospitalPatients with higher BMIs had longer stays in both the
intensive care unit and the hospital Required more days of
ventilator supportRequired more days of ventilator support
Significantly increased risk for acute respiratory failure,
pneumonia, and urinary tract infectionSignificantly increased risk
for acute respiratory failure, pneumonia, and urinary tract
infection
Slide 29
Obesity Challenges Prehospital Delays due to problems in moving
and transportDelays due to problems in moving and transport
Appropriate sized gurneysAppropriate sized gurneys Excessive tissue
impeding access for IV fluids, taking BPExcessive tissue impeding
access for IV fluids, taking BP Mobilization of
manpowerMobilization of manpower Managing airwaysManaging airways
Pulse oximetryPulse oximetry
Slide 30
Obesity Challenges Airway Difficulties with intubation and
BVMDifficulties with intubation and BVM Preoxygenation is
criticalPreoxygenation is critical Desaturation is
quickerDesaturation is quicker Sit upright or semi recumbentSit
upright or semi recumbent as long as possible as long as possible
Reduced pulmonary complianceReduced pulmonary compliance Higher
ventilatory pressuresHigher ventilatory pressures May need to
occlude pop-offMay need to occlude pop-off valve to ventilate valve
to ventilate
Slide 31
Obesity Challenges Rolled towels or blanketsRolled towels or
blankets Between scapula Displaces breast tissue Chest wall can
obstruct handle Under the occiput Allows for sniffing position
Creates more space for the handle Shorter than average
handleShorter than average handle Adjustable angle
laryngoscopeAdjustable angle laryngoscope Airway Techniques
Obesity Challenges Anticipate a Difficult Airway Awake
techniques if possibleAwake techniques if possible Pre oxygenate in
reverse TrendelenburgPre oxygenate in reverse Trendelenburg For RSI
consider increased dose of medsFor RSI consider increased dose of
meds LMA has increased risk for aspirationLMA has increased risk
for aspiration Neck anatomy distorted due to excess tissueNeck
anatomy distorted due to excess tissue
Slide 34
Obesity Challenges Sphygmomanometry Inadequate width and
circumference can artificially elevate blood pressureInadequate
width and circumference can artificially elevate blood pressure
Cuff width to arm circumferenceCuff width to arm circumference
Ratio of 2 : 5Ratio of 2 : 5 Bladder length 80% arm
circumferenceBladder length 80% arm circumference Important to have
variety of cuffsImportant to have variety of cuffs May need to use
thigh cuff in the morbidly obeseMay need to use thigh cuff in the
morbidly obese
Slide 35
Obesity Challenges Pulse Oximetry Tissue thickness impedes
light wave transmissionTissue thickness impedes light wave
transmission Other areas of placement:Other areas of placement:
EarlobeEarlobe Fifth digit of hand or footFifth digit of hand or
foot NoseNose LipLip Temporal arteryTemporal artery
Slide 36
Obesity Challenges Intravascular Access Landmark vessels not
visualized or palpatedLandmark vessels not visualized or palpated
Multiple attempts, delayed accessMultiple attempts, delayed access
Higher complication ratesHigher complication rates Secondary to
multiple sticksSecondary to multiple sticks Wound infectionsWound
infections PhlebitisPhlebitis ThrombosisThrombosis Standard 1.5-in
needles not long enoughStandard 1.5-in needles not long enough 3-4
in needles and catheters preferred3-4 in needles and catheters
preferred
Slide 37
Obesity Challenges Improving Success for IV Access Apply
heatApply heat Light tapping over vesselsLight tapping over vessels
Active pumping of extremityActive pumping of extremity
UltrasoundUltrasound Topical nitroglycerin*Topical nitroglycerin*
IntraosseousIntraosseous Reactive HyperemiaReactive Hyperemia
Occlude with BP cuff 3-4 minutesOcclude with BP cuff 3-4 minutes
Release 10-15 mmHg below diastolicRelease 10-15 mmHg below
diastolic
Slide 38
Obesity Challenges ECG Difficulties Difficult landmarks for
lead placementDifficult landmarks for lead placement Decreased or
inconsistent voltageDecreased or inconsistent voltage Increased fat
deposits around the heartIncreased fat deposits around the heart
Flat/inverted T waves inferior leadsFlat/inverted T waves inferior
leads Consistent change in obesityConsistent change in obesity
Non-specificNon-specific
Slide 39
Obesity Challenges ECG Differences P, QRS, and T wave axes were
more leftwardP, QRS, and T wave axes were more leftward More
LVHMore LVH Left atrial abnormalityLeft atrial abnormality T wave
flattening in the inferior and lateral leadsT wave flattening in
the inferior and lateral leads Prolonged QT intervalProlonged QT
interval
Slide 40
Obesity Challenges Hospital Equipment Costs
Slide 41
Obesity Challenges EMS Challenges Transporting people in a
manner that is as safe as possible both for the personnel and their
patients, as well as in a respectful mannerTransporting people in a
manner that is as safe as possible both for the personnel and their
patients, as well as in a respectful manner 2000-2001 injuries
related to transferring and handling of patients represented
greater than 50% of Workers Compensation annual costs.2000-2001
injuries related to transferring and handling of patients
represented greater than 50% of Workers Compensation annual costs.
Usually only 2 or 3 people are available to move a patient from one
spot to anotherUsually only 2 or 3 people are available to move a
patient from one spot to another Just one injury could mean the end
to an EMT or paramedics careerJust one injury could mean the end to
an EMT or paramedics career
Slide 42
Obesity Challenges Meeting the Challenge EMS providers must
conduct pre- planning exercises to prepare for attending to special
situations.EMS providers must conduct pre- planning exercises to
prepare for attending to special situations. Experts advocate for
the following:Experts advocate for the following: creation of
policy and procedurescreation of policy and procedures
pre-trainingpre-training continuing educationcontinuing education
request for lift assistancerequest for lift assistance community
involvementcommunity involvement use of bariatric equipmentuse of
bariatric equipment Even with the best intentions, treating and
transporting morbidly obese patients will take more time than
almost any other type of call to which EMS responds
Slide 43
Obesity Challenges Obstacles to Removal Removal
considerations:Removal considerations: How to be packagedHow to be
packaged Stokes stretcherStokes stretcher Body bagBody bag
MethodMethod Carry dragCarry drag LowerLower Ropes or slingsRopes
or slings Removal route to ambulanceRemoval route to ambulance Need
for additional resourcesNeed for additional resources Collapse
unitCollapse unit ForkliftForklift Flatbed truckFlatbed truck
Slide 44
Obesity Challenges Obstacles to Removal Non-mobile
patientsNon-mobile patients Patients unable to fit through
doorwayPatients unable to fit through doorway Solution can be in
removal of walls or windowsSolution can be in removal of walls or
windows Requires heavy rescue equipmentRequires heavy rescue
equipment Rescuers with engineering/construction experienceRescuers
with engineering/construction experience Can lead to building
collapseCan lead to building collapse Risk of injury to patient and
crewRisk of injury to patient and crew
Slide 45
Obesity Challenges Obstacles to Transport Removing patient from
sceneRemoving patient from scene Packaging and
transferringPackaging and transferring Moving to the
ambulanceMoving to the ambulance TransportationTransportation
Slide 46
Obesity Challenges Transferring Standard backboardStandard
backboard Patient may not fitPatient may not fit Board unable to
support weightBoard unable to support weight Rescuers must grasp
and maintain board, lift carry and maneuver in syncRescuers must
grasp and maintain board, lift carry and maneuver in sync Must lift
from ground level to waistMust lift from ground level to waist
Restricts breathing from prolonged period of lying flatRestricts
breathing from prolonged period of lying flat
Slide 47
Obesity Challenges
Slide 48
Transferring Options to the standard backboardOptions to the
standard backboard Specialized backboardsSpecialized backboards
Basket stretchersBasket stretchers Reeves stretchersReeves
stretchers Warehouse style cartsWarehouse style carts
Slide 49
Obesity Challenges Various Response Methods used by EMS
agencies Patients that are too heavy for a 2-person medic unit can
request fire departmentPatients that are too heavy for a 2-person
medic unit can request fire department MAN-S.A.C. rated at 1600
lbs.MAN-S.A.C. rated at 1600 lbs. Heavy duty collapsible litters
rated at 600 lbs.Heavy duty collapsible litters rated at 600 lbs.
Dispatching trucks with additional personnel for liftingDispatching
trucks with additional personnel for lifting Flagged address so
initial responses include extra crews if availableFlagged address
so initial responses include extra crews if available Hold-harmless
contracts if patient exceeds rated capacity of the
stretcherHold-harmless contracts if patient exceeds rated capacity
of the stretcher
Slide 50
Obesity Challenges More Questions than Answers Is there a
demand for a stretcher that could carry persons in excess of 500
lb?Is there a demand for a stretcher that could carry persons in
excess of 500 lb? Would a larger stretcher require a larger
ambulance?Would a larger stretcher require a larger ambulance?
Would a larger stretcher require a different locking device?Would a
larger stretcher require a different locking device? Would a larger
ambulance stretcher allow enough room to provide patient care?Would
a larger ambulance stretcher allow enough room to provide patient
care?
Slide 51
Obesity Challenges More Questions than Answers Are there
federal or state regulations requiring mandatory transport of the
morbidly obese patient?Are there federal or state regulations
requiring mandatory transport of the morbidly obese patient? What
liability exposure the provider has when transporting a morbidly
obese patient in an ambulance that cannot secure the transporting
device to the vehicle?What liability exposure the provider has when
transporting a morbidly obese patient in an ambulance that cannot
secure the transporting device to the vehicle?
Slide 52
Obesity Challenges Some Helpful Pointers Size-up building,
check stairs, other escape routesSize-up building, check stairs,
other escape routes Think outside the boxThink outside the box Dont
exceed equipment ratings!Dont exceed equipment ratings! Know cot
capacity and weight limitsKnow cot capacity and weight limits
Appoint safety officer not working on the rescue to oversee health
and safety issuesAppoint safety officer not working on the rescue
to oversee health and safety issues
Slide 53
Obesity Challenges Some Helpful Pointers Size up the sceneSize
up the scene Know patients weightKnow patients weight Match crew
capability with taskMatch crew capability with task Call for
assistance before neededCall for assistance before needed
Slide 54
Obesity Challenges Some Helpful Pointers Locate obese patients,
preplan for future runs to each patients houseLocate obese
patients, preplan for future runs to each patients house Evaluate
patient mobility prior to transportEvaluate patient mobility prior
to transport Scene assessmentScene assessment Door widthDoor width
StepsSteps Vehicle placement so terrain works in your favorVehicle
placement so terrain works in your favor PersonnelPersonnel Have a
back-up planHave a back-up plan
Slide 55
Obesity Challenges In the Hospital Setting
TransportationTransportation ParkingParking Waiting Room (space and
chairs size)Waiting Room (space and chairs size) Restroom / stall
sizeRestroom / stall size Weighing in privacyWeighing in privacy
Small BP CuffsSmall BP Cuffs CT - MRI table sizeCT - MRI table size
Scales with wide base and appropriate weight limitsScales with wide
base and appropriate weight limits Narrow doors &
hallwaysNarrow doors & hallways Size of examination tablesSize
of examination tables Assistance getting on and off
table.Assistance getting on and off table. Small paper exam
gownsSmall paper exam gowns Reaction of other patientsReaction of
other patients Reactions of staffReactions of staff
Slide 56
Obesity Sensitivity Sizism: A form of size (weight) prejudiceA
form of size (weight) prejudice It is a form of discrimination
against obese individuals.It is a form of discrimination against
obese individuals.
Slide 57
Obesity Sensitivity Social Stigma Stereotypes: lazy, stupid,
dishonest, lacking in self control & ambitionStereotypes: lazy,
stupid, dishonest, lacking in self control & ambition Obese
persons make less money than non-obese for same jobsObese persons
make less money than non-obese for same jobs Frequent stigma
exposure is associated with psychological distress, coping efforts,
more severe obesityFrequent stigma exposure is associated with
psychological distress, coping efforts, more severe obesity Often
subjected to negative public responseOften subjected to negative
public response
Slide 58
Obesity Sensitivity Societal Views of the Obese Emotionally
ImpairedEmotionally Impaired Weak willedWeak willed Socially
Incompetent and IsolatedSocially Incompetent and Isolated LazyLazy
Dirty and unkemptDirty and unkempt Intellectually
impairedIntellectually impaired WorthlessWorthless
Slide 59
Obesity Sensitivity Culture Behaviors- Attitudes- Beliefs
Behaviors- Attitudes- Beliefs Culture influences all aspect of ones
life.Culture influences all aspect of ones life. Culture is a
learned system of beliefs, values, and rules that people use to
guide their activitiesCulture is a learned system of beliefs,
values, and rules that people use to guide their activities Culture
shapes behaviors attitudes and beliefs about: fatness, thinness,
eating, food, nutrition, activity and exercise.Culture shapes
behaviors attitudes and beliefs about: fatness, thinness, eating,
food, nutrition, activity and exercise.
Slide 60
Obesity Sensitivity Culture and Body Weight Culture provides
the foundation for how you view the human body (your body and
others)Culture provides the foundation for how you view the human
body (your body and others) What is considered fat is influenced by
culture.What is considered fat is influenced by culture. Body
weight values and beliefs varies from one culture or ethnic group
to another.Body weight values and beliefs varies from one culture
or ethnic group to another.
Slide 61
Obesity Sensitivity Attitudes of Health Professionals Negative
bias from healthcare professionals towards the obese patient can
result in: The patients perception of these negative attitudes and
the related rejection.The patients perception of these negative
attitudes and the related rejection. Reluctance of the obese
patient to seek medical assistanceReluctance of the obese patient
to seek medical assistance
Slide 62
Obesity Sensitivity Language - Terms Non-threatening Accepting
BariatricsObeseOverweight Dignified Care Offensive and Undignified
Fatso/ChubbyPlump/TubbyStocky/Corpulent Stout/Big or Large Frame
Rotund/Heavy Set Bulky/ Well Fed
Slide 63
Obesity Sensitivity Terminology - Used by the Mayo Clinic -
Used by the Mayo Clinic Use of initials EC (Expanded Capacity) to
describe specific bariatric equipmentUse of initials EC (Expanded
Capacity) to describe specific bariatric equipment Equipment is
marked with initials EC in the back right hand corner followed by
weight capacityEquipment is marked with initials EC in the back
right hand corner followed by weight capacity
Slide 64
Obesity Sensitivity Terminology Identifying equipment with EC
avoids the offensive maximum weight or Big Boy labels.Identifying
equipment with EC avoids the offensive maximum weight or Big Boy
labels. EC equipment is identified at a glance with its weight
capacityEC equipment is identified at a glance with its weight
capacity The EC identifier and weight cap. ensures safe and
appropriate use of equipment.The EC identifier and weight cap.
ensures safe and appropriate use of equipment. - Used by the Mayo
Clinic
Slide 65
Obesity Sensitivity See the Person Not the Size Sensitive
treatment of obese patients involves attending to their needs of
comfort, safety, and self-esteemSensitive treatment of obese
patients involves attending to their needs of comfort, safety, and
self-esteem The person, not the obesity, should be the focus of
treatmentThe person, not the obesity, should be the focus of
treatment Ensures that care is provided in a manner that enhances
dignity, acceptance and a sense of worthEnsures that care is
provided in a manner that enhances dignity, acceptance and a sense
of worth
Slide 66
Obesity Sensitivity See the Person Not the Size ..obesity does
not create a psychological burden. Obesity is a physical state.
People make it a psychological burden. Stunkard and Sobal
Slide 67
References and Resources BBC News www.bbc.co.uk/www.bbc.co.uk/
World Health Organization National Institutes of Health Centers for
Disease Control and Prevention. MSNBC - Obesity - The 21st Century
Epidemic PBS - Obesity in America
http://www.pbs.org/newshour/rundown/2012/05/obesity-in-america-by-the-numbers-1.html
Transporting the Morbidly Obese Patient: Framing an EMS Challenge
Journal of Emergency Nursing August 2002 Allison & Saunder,
2000 Sargent & Blancheflower, 1994 Myers & Rosen, 1999 The
Bariatric Population: A New Challenge in Patient Care Ergonomics
VISN 8 Patient Safety Center Hill-Rom Epidemiologists Majid Ezzati
of the School of Public Health at Imperial College London and Dr.
Goodarz Danaei of the Harvard School of Public Health in Boston
American College of Emergency Physicians, Study Shows Obesity
Worsens Trauma Complications