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Very obese people about to undergo surgery need special attention and equipment, which has prompted the Association of Anaesthetists of Great Britain and Ireland to develop guidelines for these situations.
“Treating morbidly obese patients poses extra challenges for anaesthetists,” Dr. Alastair Chambers, the chair of the working group that drew up the guidelines, said in a statement.
Such patients, he explained, “are more likely to suffer serious complications during or after surgery and anaesthesia—including blood clots, wound infections and breathing problems—and post-operative death rates tend to be higher in these patients.”
The guidelines, which were released last week, make several key recommendations. One is that hospitals should designate an anesthetist and surgical team member to be responsible for ensuring that equipment and processes are in place for managing obese patients.
Another recommendation is that at least one operating room and a few critical care beds should be usable for very obese patients. Moreover, beds, trolleys and operating tables should be clearly marked with a maximum weight load.
The guidelines also say that hospitals need to make sure equipment and staff needed to turn a very obese patient are on hand in case of emergency.
In addition, there should be appropriately sized garments and items such as blood pressure cuffs available for obese patients, and their psychological and personal needs should be addressed.
The authors of the guidelines note that every major hospital “is likely to have to deal with patients whose weight exceeds 150 kilograms, and some of these will present as emergencies.” The Association’s press release notes that about 23 percent of men and women in the UK are obese, and that 2.9 percent of women and 1 percent of men have a BMI (body mass index) of 40 or more, indicating severe obesity .