completely flat, writes Dr. Brodsky, recommending that you tilt the
operating table or place a wedge under the patient, and that you place
the patient in a head-up position before induction of general anesthe-
sia.
The Trendelenburg position and prone position are "not well tolerat-
ed" by obese patients, writes Mr. Dybec. He says they are best suited
to the lateral position.
10. Post-op complications
Once the obese patient is out of the OR, complications could
arise. One area of particular concern during recovery is airway
management and respiratory support, writes Mr. Dybec. Another
is reddened skin areas that might indicate pressure injuries.
There's a higher risk of readmission with obese patients, too,
which could result in penalties to your facility under changing
health policy regulations, according to a March 2014 report,
(osmag.net/C3tQtN) in PeerJ, an open-access peer-reviewed jour-
nal.
Is your OR prepared?
Obesity is likely to continue to rise in America. It's worth the time and
effort to develop explicit standards, processes and protocols that
address the care and accommodation of obese patients. At the very
least, perform a self-audit to ensure you're handling obese patients
safely and humanely, in every way possible.
OSM
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 9
Premature attempts at laryngoscopy
before the patient is anesthesized is
the No. 1 cause of aspiration in the OR.
