The growing problems and statistics associated with caring for obese patients in the United Kingdom, are highlighted by Patient.co.uk. (2013). Currently 6 out of 10 adults are overweight, 1 in 4 are obese and around 2 in 100 adults are morbidly obese. These figures are rising, and have tripled since 1980. The United Kingdom now ranks the highest in Europe for its rate of obesity, and this has become known as the “obesity epidemic” in the popular press. (Daily Mail. 2014).
Obesity presents additional challenges for the surgical team; In particular, the various differences in the airway due to obesity, are the primary and principle concern of the anaesthetist. In concurrence, Woodall (2011) points out, that patients who are obese have twice the risk of major airway complications during anaesthesia.
Obesity is defined by Williams and Smith (2008) as an indication of an overweight condition, where excess fat is ubiquitous throughout the body. This case study will examine the adapted care that was employed in looking after Mr X in the anaesthetic room; I will consider effective communication along with the psychological, physical and ethical implications of treating the obese patient and how this might be improved.
Ogden (2007) points out, the cultural obsession with slimness, health, and the aversion to fat found in adults and children, advocating lower self esteem in those individuals who do not conform to the stereotypically beautiful, slim image. Discrimination, has become a taboo in the National Health Service (NHS Choices. 2012), although it is regularly talked about to ensure it does not occur at least explicitly and all patients are be treated with equal respect. However, care will most likely have to be adapte...
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...rance: Patient Focus. In Hind, M. and Wicker, P. (eds.) Principles of Perioperative Practice. London: Churchill Livingstone. p79
Hughes, S.J. and Mardel, A. (2009) Monitoring Obese Patients. In: Hughes, S.J. and Mardel, A. (eds.) Oxford Handbook of Perioperative Practice. Oxford: Oxford University Press. p159
Woodall, N (2011) Obese patients have double the risk of airway problems during an anesthetic, study shows [online]. ScienceDaily. Available from: http://www.sciencedaily.com/releases/2011/03/110329192328.htm [Accessed 05 April 2014].
WHO (2014) WHO surgical safety checklist and implementation manual [online]. World Health Organization. Available from: http://www.who.int/patientsafety/safesurgery/ss_checklist/en/ [Accessed 05 April 2014].
Yahoo.com (2014) BMI Chart [online]. Available from: http://uk.images.search.yahoo.com/images [Accessed 06 April 2014].
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
Obesity is clinically defined as a body mass index (BMI) of above 30kg/m2 and is the accumulation of excess adipose tissue1. It is currently viewed as an epidemic due to the increasingly large proportion of adults who are now obese, with the incidence rapidly rising in the recent years. In a five year period from 1995-2000 there was a predicted increase of 100 million obese individuals world-wide 2. In UK it is estimated that over 25% of adult males and females are obese and it is thought that these figures will continually rise with estimations that 60% of adult men and 50% of adult woman with be obese by 2025.3 Being a huge burden on the NHS, it has been predicted that £5 billion a year is spent on preventing and treating the complications of excessive weight in the UK, which is almost 5% of the total NHS budget (£5billion/£108billion).4 The cost of obesity on the NHS will rise to correlate with the increasing incidence illustrated.
Interest in the social aspects of obesity is nothing new. Jeffrey Sobal has written extensively about the social and psychological consequences of obesity , including the stigmatisation and discrimination of obese and even overweight individuals (Sobal 2004).
"Treating Obesity Vital For Public Health, Physicians Say." Science Daily. 2006. Web. 10 May 2014. .
Obesity has been accepted in the American society as a norm. According to the U.S. office of the Surgeon General, in 1999, 6 in 10 American adults were classified as obese or overweight (McMurray, par. 5). In order for one to be classified as obese they’re body mass index (BMI) must be 30 or greater. The number of obese in America has continued to increase. It has been estimated by The World Health Organization that 300 million people will be obese by 2025 (Bailey 3). Since obesity comes with many health risks, many feel it should be treated as a disease.
Obese people account for thirty seven percent of the United States population, but obesity- related diseases such as diabetes and hypertension account for sixty one percent of healthcare costs in the United States every year. The costs increase to billions of dollars which puts a huge strain on not only the economy but healthcare also. Obesity is a big problem in America and everyone either knows someone who is overweight or they’re overweight themselves. Treatment for obesity is having an active lifestyle, weight loss medication, or weight loss surgery.
Obesity is now considered a global epidemic, with particularly concentrated numbers in the United States. In 2011-2012 more than one-third of U.S. adults were estimated to be obese (National Center for Health Statistics, 2013). Due to the increasing prevalence of the epidemic, anesthesiologists must manage a significant number of clinically obese patients. A large range of physiological variations are associated with obesity, including cardiac, respiratory, and metabolic functions (Leykin, v). The areas of concern for anesthesiologists when operating on the obese can be separated into three perioperative stages: preoperative, intraoperative, and postoperative.
Individuals need to understand the use of anesthesia always comes with risks. In most cases, however, it's safe when administered by someone with the proper training. Certain individuals, such as those with obstructive sleep apnea or ones who are obese, need to speak to their physician before being sedated, as their risk of complications is higher.
Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Helath, 100(6), 1019.
Bariatric surgery or the weight-loss surgery is an operation performed on abnormally obese people with a body mass index greater than 40 and is a service provided by an inter-disciplinary team – psychiatric, endocrine, rehab, nutritionist, cardiologist, and pulmonologist. Studies have shown that in seriously obese people, having weight loss surgery means they are likely to live longer because of the less risk of stroke, heart attacks, some types of cancer, and liver diseases. By dividin...
The delivery of anesthesia to surgical patients is safer today than ever before. Advancements in technology such as end tidal carbon dioxide monitoring, oxygen saturation monitoring, video laryngoscopy and safer medication profiles are just a few examples in the realm of anesthesia that assist in protecting patients from potential harm. As the face of healthcare payments change into a patient-satisfaction and outcomes-driven model, it is important for the specialty of anesthesia to continue to find ways to keep patients safer by examining current accepted practices in anesthesia and challenging and changing practices that continue to place patients at risk for harm.
In the UK, the number of obesity cases has more than doubled between 1980 and 2014. The most recent data from the health survey England shows that in 2014 more than half of women (58%) and men (65%) were either overweight or obese (Health Survey England). Hence the government foresight projections suggest that 50 percent of the UK population may become obese by 2050. (Foresight, 2007). To classify an individual to be ‘obese’ is determined by their Body Mass Index(BMI). A value of 30 or more would put an individual in this
“Tackling Obesity in England.” House of Commons – Public Accounts – Ninth Report. 4 August 2004. .
The World Health Organization defines obesity as the “abnormal or excessive fat accumulation that presents a risk to health”. (WHO, 2014). It is considered to be a medical condition which may reduce a person's life expectancy due to the negative effect it can have on our health and well-being. An epidemic is said to affect a disproportionately large number of people in a population and spreads rapidly. In recent decades, it has been suggested that we are facing an obesity epidemic. Obesity has been considered as a disease by some for over sixty years. It is more common globally than being underweight. The purpose of this essay is to look at the history of obesity and how it is defined. It will look at some of the causes and consider the effects. It will consider how obesity is framed, whether we are indeed in the midst of an epidemic, or if this suggestion is merely moral panic.
Obesity is not a new notion or phenomenon in history. Centuries ago some cultures and societies saw obesity as the most noteworthy platform for wealth, social status, and sexual appeal. The influential Greek physician Hippocrates was among the first to record the negative effects of excessive weight and poor diet on the human body. While advancements in medicine and public health have helped improve life expectancy, obesity is becoming a silent yet visible threat to these milestones especially with the influence of technological innovation on the day-to-day of humans.