facility. But contrast those expenditures with the potential costs of
workers' compensation, broken equipment, lost business and law-
suits, and they're likely to be a wise investment.
7. Sensitivity training
In general society, "fat-shaming" is prevalent. In the medical world,
however, it's also depressingly widespread.
"Make sure the staff understands how it feels to be an obese patient,
recognizing the stigma that's involved and how patients oftentimes
shy away from medical staff," says Ms. Williams-James. "A lot of doc-
tors and other professionals aren't very sensitive to that stigma issue
with patients. They might speak to them in an insulting way or blame
them for the state of their bodies. We do extensive education on this.
You have to be very conscious of these patients you're taking care of,
through all aspects — from the moment a patient walks through the
door till the moment they're discharged, even after they get home."
8. Airway management
Obese patients' airways are frequently described as "difficult," so
anesthesia providers must take precautions and extra care in the OR.
OSA, which is common in obese people, is of particular concern.
According to a May 2012 report by the American Society for
Metabolic and Bariatric Surgery (ASMBS), "Peri-Operative
Management of Obstructive Sleep Apnea" (osmag.net/xRUzG6),
obese surgical patients with OSA are at high risk for pulmonary com-
plications, and increased risk for venous thromboembolic complica-
tions. ASMBS recommends that obese patients with moderate to
severe OSA be treated with CPAP before and after surgery.
A big problem when diagnosing OSA, however, is that a patient who
lives alone might not know he has it. Dr. Sinha recommends an
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