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Gyftopoulos S, Cardoso MDS, Wu JS, Subhas N, Chang CY. Bone Marrow Biopsies: Is CT, Fluoroscopy, or no Imaging Guidance the Most Cost-Effective Strategy? Acad Radiol 2024; 31:2880-2886. [PMID: 38290886 DOI: 10.1016/j.acra.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
RATIONALE AND OBJECTIVES To determine the most cost-effective strategy for pelvic bone marrow biopsies. MATERIALS AND METHODS A decision analytic model from the health care system perspective for patients with high clinical concern for multiple myeloma (MM) was used to evaluate the incremental cost-effectiveness of three bone marrow core biopsy techniques: computed tomography (CT) guided, and fluoroscopy guided, no-imaging (landmark-based). Model input data on utilities, costs, and probabilities were obtained from comprehensive literature review and expert opinion. Costs were estimated in 2023 U.S. dollars. Primary effectiveness outcome was quality adjusted life years (QALY). Willingness to pay threshold was $100,000 per QALY gained. RESULTS No-imaging based biopsy was the most cost-effective strategy as it had the highest net monetary benefit ($4218) and lowest overall cost ($92.17). Fluoroscopy guided was excluded secondary to extended dominance. CT guided biopsies were less preferred as it had an incremental cost-effectiveness ratio ($334,043) greater than the willingness to pay threshold. Probabilistic sensitivity analysis found non-imaging based biopsy to be the most cost-effective in 100% of simulations and at all willingness to pay thresholds up to $200,000. CONCLUSION No-imaging based biopsy appears to be the most cost-effective strategy for bone marrow core biopsy in patients suspected of MM. CLINICAL RELEVANCE No imaging guidance is the preferred strategy, although image-guidance may be required for challenging anatomy. CT image interpretation may be helpful for planning biopsies. Establishing a non-imaging guided biopsy service with greater patient anxiety and pain support may be warranted.
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Affiliation(s)
- Soterios Gyftopoulos
- Department of Radiology, NYU Langone Health, New York, New York, USA (S.G., M.D.S.C.); Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA (S.G.)
| | | | - Jim S Wu
- Department of Radiology, Beth Israel Deaconess Hospital, Boston, Massachusetts, USA (J.S.W.)
| | - Naveen Subhas
- Department of Radiology, Cleveland Clinic, Cleveland, Ohio, USA (N.S.)
| | - Connie Y Chang
- Department of Radiology, Massachusetts General Hospital, Yawkey 6E, 55 Fruit Street, Boston, Massachusetts 02114, USA (C.Y.C.).
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Marshall V, Qiu Y, Jones A, Weller CD, Team V. Hospital-acquired pressure injury prevention in people with a BMI of 30.0 or higher: A scoping review. J Adv Nurs 2024; 80:1262-1282. [PMID: 37788102 DOI: 10.1111/jan.15882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 10/05/2023]
Abstract
AIM(S) To: (1) explore current best practices for hospital-acquired pressure injury prevention in high BMI patients; (2) summarize nurses' experiences in preventing and managing them; (3) explore the association between a high BMI and occurrence and severity of pressure injury. DESIGN Exploratory. METHODS Scoping review. DATA SOURCES Ovid MEDLINE, EBSCO CINAHL Plus, JBI Evidence Synthesis, Scopus, Embase, clinical registries and grey literature (search dates: January 2009 to May 2021). RESULTS Overall, 1479 studies were screened. The included studies were published between 2010 and 2022. Five interventional studies and 32 best practice recommendations (Objective 1) reported low-quality evidence. Findings of thematic analysis reported in nine studies (Objective 2) identified nurses' issues as insufficient bariatric equipment, inadequate staffing, weight bias, fatigue, obese-related terminology issues, ethical dilemmas and insufficient staff education in high BMI patients' pressure injury prevention. No association between hospital-acquired pressure injury occurrence and high BMI were reported by 18 out of 28 included studies (Objective 3). CONCLUSION Quality of evidence was low for the interventional studies and best practice recommendations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Current (2019) International Pressure Injury Guideline to be used despite the low quality of evidence of most best practice recommendations. IMPACT STATEMENT This study addressed hospital-acquired pressure injury prevention in high BMI patients. Greater proportion of studies in this review found no association between high BMI and occurrence of hospital-acquired pressure injury. Nurses need educational interventions on pressure injury prevention in high body mass index people, sufficient staffing for repositioning and improved availability of bariatric equipment. REPORTING METHOD We adhered to relevant EQUATOR guidelines, PRISMA extension for scoping reviews. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Larger clinical trials are needed on repositioning frequency, support surfaces, prophylactic dressings and risk assessment tools to inform clinical practice guidelines on pressure injury prevention in high BMI people. PROTOCOL REGISTRATION Wound Practice and Research (https://doi.org/10.33235/wpr.29.3.133-139).
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Affiliation(s)
- Victoria Marshall
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Yunjing Qiu
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Angela Jones
- Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia
| | - Carolina D Weller
- School of Nursing and Midwifery, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia
| | - Victoria Team
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
- Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia
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Beitz JM, Kennedy-Evans KL. Good Things Don't Always Come in Small Packages: Comprehensive Care of Patients With Class 3 Obesity: An Integrative Review. J Wound Ostomy Continence Nurs 2023; 50:365-374. [PMID: 37713346 DOI: 10.1097/won.0000000000001010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
The epidemic of obesity and morbid obesity is straining the American health care system's ability to provide quality patient care. Patients with Class 3 (also referred to as morbid or severe) obesity require specialized equipment, unique approaches in the delivery of care, and understanding of the biopsychosocial pathophysiologic mechanisms underlying their condition. This article defines Class 3 obesity, its pathophysiology, and discusses issues that arise when providing quality care of these individuals including safe patient handling, right-sized equipment, and empathetic interpersonal care. We also discuss skin and wound care issues associated with Class 3 obesity.
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Affiliation(s)
- Janice M Beitz
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, MAPWCA, ANEF, WOCNF, FNAP, FAAN, School of Nursing-Camden, Rutgers University, Camden, New Jersey
- Karen Lou Kennedy-Evans, RN, APRN-BC, FNP, University of Arizona College of Nursing, Tucson, and K.L. Kennedy LLC, Tucson, Arizona
| | - Karen Lou Kennedy-Evans
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, MAPWCA, ANEF, WOCNF, FNAP, FAAN, School of Nursing-Camden, Rutgers University, Camden, New Jersey
- Karen Lou Kennedy-Evans, RN, APRN-BC, FNP, University of Arizona College of Nursing, Tucson, and K.L. Kennedy LLC, Tucson, Arizona
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4
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Barkhordarian M, Behbood A, Ranjbar M, Rahimian Z, Prasad A. Overview of the cardio-metabolic impact of the COVID-19 pandemic. Endocrine 2023; 80:477-490. [PMID: 37103684 PMCID: PMC10133915 DOI: 10.1007/s12020-023-03337-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/21/2023] [Indexed: 04/28/2023]
Abstract
Evidence has shown that cardiometabolic disorders (CMDs) are amongst the top contributors to COVID-19 infection morbidity and mortality. The reciprocal impact of COVID-19 infection and the most common CMDs, the risk factors for poor composite outcome among patients with one or several underlying diseases, the effect of common medical management on CMDs and their safety in the context of acute COVID-19 infection are reviewed. Later on, the changes brought by the COVID-19 pandemic quarantine on the general population's lifestyle (diet, exercise patterns) and metabolic health, acute cardiac complications of different COVID-19 vaccines and the effect of CMDs on the vaccine efficacy are discussed. Our review identified that the incidence of COVID-19 infection is higher among patients with underlying CMDs such as hypertension, diabetes, obesity and cardiovascular disease. Also, CMDs increase the risk of COVID-19 infection progression to severe disease phenotypes (e.g. hospital and/or ICU admission, use of mechanical ventilation). Lifestyle modification during COVID-19 era had a great impact on inducing and worsening of CMDs. Finally, the lower efficacy of COVID-19 vaccines was found in patients with metabolic disease.
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Affiliation(s)
- Maryam Barkhordarian
- Department of Medicine, Division of Cardiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Arezoo Behbood
- MPH department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Maryam Ranjbar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Zahra Rahimian
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Anand Prasad
- Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Dickerson RN, Andromalos L, Brown JC, Correia MITD, Pritts W, Ridley EJ, Robinson KN, Rosenthal MD, van Zanten ARH. Obesity and critical care nutrition: current practice gaps and directions for future research. Crit Care 2022; 26:283. [PMID: 36127715 PMCID: PMC9486775 DOI: 10.1186/s13054-022-04148-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background This review has been developed following a panel discussion with an international group of experts in the care of patients with obesity in the critical care setting and focuses on current best practices in malnutrition screening and assessment, estimation of energy needs for patients with obesity, the risks and management of sarcopenic obesity, the value of tailored nutrition recommendations, and the emerging role of immunonutrition. Patients admitted to the intensive care unit (ICU) increasingly present with overweight and obesity that require individualized nutrition considerations due to underlying comorbidities, immunological factors such as inflammation, and changes in energy expenditure and other aspects of metabolism. While research continues to accumulate, important knowledge gaps persist in recognizing and managing the complex nutritional needs in ICU patients with obesity. Available malnutrition screening and assessment tools are limited in patients with obesity due to a lack of validation and heterogeneous factors impacting nutrition status in this population. Estimations of energy and protein demands are also complex in patients with obesity and may include estimations based upon ideal, actual, or adjusted body weight. Evidence is still sparse on the role of immunonutrition in patients with obesity, but the presence of inflammation that impacts immune function may suggest a role for these nutrients in hemodynamically stable ICU patients. Educational efforts are needed for all clinicians who care for complex cases of critically ill patients with obesity, with a focus on strategies for optimal nutrition and the consideration of issues such as weight stigma and bias impacting the delivery of care. Conclusions Current nutritional strategies for these patients should be undertaken with a focus on individualized care that considers the whole person, including the possibility of preexisting comorbidities, altered metabolism, and chronic stigma, which may impact the provision of nutritional care. Additional research should focus on the applicability of current guidelines and evidence for nutrition therapy in populations with obesity, especially in the setting of critical illness.
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Ewens B, Kemp V, Towell-Barnard A, Whitehead L. The nursing care of people with class III obesity in an acute care setting: a scoping review. BMC Nurs 2022; 21:33. [PMID: 35090451 PMCID: PMC8796636 DOI: 10.1186/s12912-021-00760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with Class III obesity pose unique challenges to health care staff and organisations. Care requirements of this population are unique and require specialised equipment and knowledge to meet these needs, maintain the quality of care, as well as the safety of patients and staff. AIM To synthesise the evidence on the nursing care of Class III obese patients in acute care settings. METHODS A scoping review informed by JBI. CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase were searched for primary research articles about the nursing management of people classified as Class III obese in acute care. Methodological quality of included studies was assessed; data extracted and synthesised into themes. RESULTS Fourteen studies were included in the review. The synthesis generated three themes: Access to equipment, knowledge and training, patient care, and opportunities to improve care. CONCLUSIONS A paucity of high-quality evidence informs the nursing care of people with Class III obesity in acute care. Access to appropriate equipment dominated the findings of this review. Adequate provision of equipment and education on its use are required. Education to promote engagement with patients, adapting clinical practice and promotion of self-care could improve care and outcomes.
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Affiliation(s)
- Beverley Ewens
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia
| | - Vivien Kemp
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia
| | - Amanda Towell-Barnard
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia
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Hassan EA, Baraka AAE. The effect of reverse Trendelenburg position versus semi-recumbent position on respiratory parameters of obese critically ill patients: A randomised controlled trial. J Clin Nurs 2021; 30:995-1002. [PMID: 33432600 DOI: 10.1111/jocn.15645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/12/2020] [Accepted: 12/31/2020] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES To investigate the effect of reverse Trendelenburg position versus semi-recumbent position on respiratory parameters of obese critically ill patients. BACKGROUND Reverse Trendelenburg position is recommended for obese patients; however, the effect among critically ill patients, especially those on mechanical ventilation, has limited study. DESIGN Randomised, controlled pretest, repeated post-test trial with two parallel groups. METHODS The study started from 13 January 2020-12 March 2020. Adult critically ill patients with a body mass index ≥30 were randomly assigned by computer-generated randomisation to either reverse Trendelenburg position group (intervention) or semi-recumbent position group (active comparator control). Outcome measures were ventilation parameters (dynamic compliance, partial pressure of arterial carbon dioxide and minute volume) and oxygenation parameters (hypoxaemic index and partial pressure of arterial oxygen). Measures were assessed immediately before positioning and after positioning in 10 minutes, 20 minutes and 30 minutes. CONSORT checklist was used to report the current study. SETTINGS Four general intensive care units. RESULTS One hundred and ten patients (55 patients in each group) completed the study. The reverse Trendelenburg position group had a higher improvement than the semi-recumbent position group as estimated by mean differences in their dynamic compliance, minute volume, partial pressure of carbon dioxide, partial pressure of oxygen and hypoxaemic index. CONCLUSION Reverse Trendelenburg position improves obese patients' respiratory parameters more than semi-recumbent position. RELEVANCE TO CLINICAL PRACTICE This study directs nurses to use the reverse Trendelenburg position, which is an important position for enhancing the parameters of ventilation and oxygenation of obese mechanically ventilated patients.
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Affiliation(s)
- Eman Arafa Hassan
- Lecturer of Critical Care and Emergency Nursing, Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Azza Abd Elrazek Baraka
- Lecturer of Critical Care and Emergency Nursing, Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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8
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Chang CY, Husseini JS, Moreira A, Simeone FJ, Yee AJ, Bredella MA, Hasserjian R. CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures. Skeletal Radiol 2020; 49:1285-1294. [PMID: 32232499 DOI: 10.1007/s00256-020-03423-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the pathology results of CT-guided and blind bone marrow aspirations and biopsies. METHODS Ninety-eight consecutive CT-guided biopsies and 98 age- and gender-matched blind (non-CT-guided) posterior iliac crest bone marrow aspirations and biopsies performed in 2017 were reviewed for adequacy of core biopsies and aspirate smears. CT procedure images and CT abdomen/pelvis images were reviewed to evaluate anatomic features of the posterior ilium and soft tissues. Statistical analysis was performed using a T test, Fisher exact test, and Kruskal-Wallis test. RESULTS There was no significant difference in the age and gender of the two groups (p > 0.05). However, the CT-guided group had a higher BMI (p = 0.0049) and posterior soft tissue thickness (p = 0.0016). More CT-guided biopsy samples (CT 93 (95%); blind 77 (79%); p = 0.0006) and aspirate smears (CT 90 (92%); blind 78 (80%); p = 0.042) were categorized as adequate. The CT-guided group had longer core lengths (CT 1.4 ± 0.6 (range 0.3-3.5) cm; blind 1.0 ± 0.60 (range 0-2.6) cm; p = 0.0001). Overall, 131/164 (80%) of the cases had at least one of the described features (slanted posterior ilium (angle > 30°), 30%; rounded posterior ilium, 20%; thick posterior ilium cortex, 13%; focal lesion in posterior ilium, 12%; prior procedure in posterior ilium, 5%; posterior soft tissue thickness > 3 cm, 40%). CONCLUSION CT-guided bone marrow procedures were more likely to result in both adequate aspirate smears and biopsy samples and longer core lengths when compared with blind procedures.
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Affiliation(s)
- C Y Chang
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Cambridge, MA, USA.
| | - J S Husseini
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Cambridge, MA, USA
| | - A Moreira
- Department of Radiology, Centro Hospitalar São João, Porto, Portugal
| | - F J Simeone
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - A J Yee
- Harvard Medical School, Cambridge, MA, USA.,Division of Hematology and Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - M A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Cambridge, MA, USA
| | - R Hasserjian
- Harvard Medical School, Cambridge, MA, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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9
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The Bariatric Patient. J Perianesth Nurs 2019; 34:1289-1291. [PMID: 31801661 DOI: 10.1016/j.jopan.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 11/21/2022]
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10
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Parker BK, Manning S, Winters ME. The Crashing Obese Patient. West J Emerg Med 2019; 20:323-330. [PMID: 30881553 PMCID: PMC6404698 DOI: 10.5811/westjem.2018.12.41085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/16/2018] [Accepted: 12/14/2018] [Indexed: 01/11/2023] Open
Abstract
Emergency physicians (EP) frequently resuscitate and manage critically ill patients. Resuscitation of the crashing obese patient presents a unique challenge for even the most skilled physician. Changes in anatomy, metabolic demand, cardiopulmonary reserve, ventilation, circulation, and pharmacokinetics require special consideration. This article focuses on critical components in the resuscitation of the crashing obese patient in the emergency department, namely intubation, mechanical ventilation, circulatory resuscitation, and pharmacotherapy. To minimize morbidity and mortality, it is imperative that the EP be familiar with the pearls and pitfalls discussed within this article.
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Affiliation(s)
- Brian K Parker
- University of Texas San Antonio, Department of Emergency Medicine, San Antonio, Texas
| | - Sara Manning
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Michael E Winters
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
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11
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Abstract
The health care team must be able to mobilize bariatric patients efficiently and safely. It is challenging to find the proper equipment of sufficient variety to meet the need. Patients can feel self-conscious when staff are struggling to provide care, and staff can be injured when trying to mobilize patients without the proper equipment. This can result in feelings of humiliation for the patient and frustration for staff. Furthermore, staff often experience compassion fatigue when dealing with their frustration around this. This bariatric surgery unit experienced these issues with mobilization of larger patients and participated in the development of a Safe Patient Handling and Mobility program in an effort to gain understanding of the necessary equipment and how to implement such a program. The purpose of this article is to describe the successful implementation of a Safe Patient Handling and Mobility program to reduce staff injury and frustration and to improve the patient experience on a bariatric unit.
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Smigelski-Theiss R, Gampong M, Kurasaki J. Weight Bias and Psychosocial Implications for Acute Care of Patients With Obesity. AACN Adv Crit Care 2018; 28:254-262. [PMID: 28847860 DOI: 10.4037/aacnacc2017446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Obesity is a complex medical condition that has psychosocial and physiological implications for those suffering from the disease. Factors contributing to obesity such as depression, childhood experiences, and the physical environment should be recognized and addressed. Weight bias and stigmatization by health care providers and bedside clinicians negatively affect patients with obesity, hindering those patients from receiving appropriate care. To provide optimal care of patients with obesity or adiposity, health care providers must understand the physiological needs and requirements of this population while recognizing and addressing their own biases. The authors describe psychosocial and environmental factors that contribute to obesity, discuss health care providers' weight biases, and highlight implications for acute care of patients suffering from obesity.
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Affiliation(s)
- Rachel Smigelski-Theiss
- Rachel Smigelski-Theiss is Clinical Nurse Specialist, Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813 . Malisa Gampong is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii. Jill Kurasaki is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii
| | - Malisa Gampong
- Rachel Smigelski-Theiss is Clinical Nurse Specialist, Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813 . Malisa Gampong is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii. Jill Kurasaki is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii
| | - Jill Kurasaki
- Rachel Smigelski-Theiss is Clinical Nurse Specialist, Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813 . Malisa Gampong is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii. Jill Kurasaki is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii
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Altun Uğraş G, Yüksel S, Erer MTI, Kettaş E, Randa S. Are Nurses Willing to Provide Care to Obese Surgical Patients? Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2017.0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gülay Altun Uğraş
- Department of Surgical Nursing, Health School, Mersin University, Mersin, Turkey
| | - Serpil Yüksel
- Department of Surgical Nursing, Division of Nursing, Faculty of Health Science, Necmettin Erbakan University, Konya, Turkey
| | | | - Elife Kettaş
- Medical Faculty, Mersin University, Mersin, Turkey
| | - Serap Randa
- Medical Faculty, Mersin University, Mersin, Turkey
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