blood flow can help,
says Dr. Morton. If
you're still having
trouble, he suggests
trying to place lines
in 2 spots: the saphe-
nous, a finger-
breadth above and
lateral to the medial
malleolus; and the
deltopectoral groove,
where the cephalic
vein is generally easy to access.
• Pressure injuries. Preventing skin injuries is key when caring for
high-BMI patients. "Pad the extremities, and make sure things like
armband socks, which can cause pressure sores and cut the patient's
skin, aren't applied too tightly," says Ms. Pate.
When it comes to preventing pressure injuries, you may want to take
a page out of Einstein Medical Center's playbook. The facility in East
Norriton, Pa., which hasn't had a patient suffer skin-related harm in 2
years, has a simple but effective way to flag patients who are at an
increased risk for pressure injuries. Any patients with a BMI of 35 and
above (as well as patients with a BMI below 19, in a surgery lasting 3
hours or longer, or a Braden Scale score of 16 or below) are given a
green bouffant cap to wear instead of the usual blue one. There's also a
green placard placed in the patient's chart, so it's clear to all staff which
patients are at a greater risk for injury.
A call for compassion
If your facility is serious about giving high-BMI patients the best care
O C T O B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 3 7
• HIGH RISK Patients with high BMIs are at greater risk for pressure injuries, so put
an emphasis on proper padding and positioning.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
