selves thoroughly than
average patients do. Rolls,
folds and other difficult-to-
reach places can collect
contaminants, such as bac-
teria, over time.
"You need to pay extra
attention to clean obese
patients really well before
surgery," says Lynn Barker,
RN, BSN, CNOR, general
surgery specialty coordina-
tor at Cone Health in Greensboro, N.C.
5. Equipment and facilities
Many facilities must turn away obese patients because their equip-
ment simply cannot accommodate their weight or girth. OR tables,
gurneys, C-arms, beds, waiting area chairs and other equipment that
aren't designed to handle bodies above certain weights and widths
could break and injure the patient or staff, as well as cause embar-
rassment for the patient. You'll also need special instruments like
longer needles and larger blood pressure cuffs.
In the OR, AORN recommends that padding and positioning devices
maintain a normal capillary interface pressure at or below 32 mm Hg
to reduce the risk of pressure ulcers. In addition, Robert B. Dybec,
RN, MS, CPSN, CNOR, in a July 2004 paper, "Intraoperative
Positioning and Care of the Obese Patient," writes that "appropriate
instrumentation, such as larger retractors, long staplers and long
instruments, must be available." OR table attachments and safety
restraints might be necessary as well.
F E B R U A R Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 9 5
• DIFFICULT AIRWAYS Anesthesia providers should take particular care
with obese patients due to their increased likelihood of obstructive sleep
apnea.
