Monday, February 20, 2012

Care of the Morbidly Obese Trauma Patient presents an excerpt from "Care of the Morbidly Obese Trauma Patient", with Susan M. Gallagher (RN, MSN, CNS) on a nurses' perspective on the challenges of caring for morbidly obese patients in a hospital setting. The full one hour educational video available at also features Blanca Crandall, Patricia S. Choban, MD and Rosaline Parson, RN, BSN, CEN, CCRN and covers ways to improve the physical, emotional, and social needs of obese patients; why patients are reluctant to accept care and how that impacts skin and wound care in the hospital setting; common, predictable and preventable skin and wound complications, care suggestions; the value of using appropriate equipment and the safety risks standard hospital equipment may pose for the obese patient.

Obesity is now recognized as a major health problem in the United States; over 32% of the U.S. population is obese and the problem is not limited to adults. Although increases in the prevalence of overweight and obesity have been observed around the world, the United States has the highest prevalence of obesity among the developed nations.

The number of hospitalizations in which obesity was noted on admission has increased significantly compared to the overall increase in hospitalizations for any condition. While obese individuals undergoing weight reduction surgery account for some of these patients, many of them also seek health care for treatment of co-morbidities such as diabetes, sleep apnea, or orthopedic problems or for matters unrelated to the obesity, such as trauma or childbirth. The morbidly obese patient presents particular challenges to nurses providing their care.
Earlier nursing literature on weight reduction surgeries cautioned nurses to have additional staff available to assist in providing care, and to assemble specialized equipment to cope with providing care and transferring a patient with a large body mass, yet the requirement of increased staff to provide care for the morbidly obese  has received only limited additional attention in the literature.

ICU physicians also need to be aware of physiologic changes occurring with obesity that become relevant during critical illness. Special challenges are encountered when caring for the obese patient in the ICU, including airway management, bedside procedures and testing, nutritional support, drug dosing and nursing care.