n CME : Your SA Journal of CPD - Guide to the emergency management of morbidly obese patients : main article




The emergency care of morbidly obese acutely ill or injured patients presents special problems both outside and inside the hospital emergency department.

Adequate preparation is required in order to provide adequate care.
Position the morbidly obese patient in the semi-Fowler's or reverse Trendelenburg position at 45º to protect the airway.
Always administer high-flow, high-concentration oxygen to all morbidly obese patients, as they are chronically hypoxic.
Use the 2-person, 4-handed technique during manual bag / valve / mask ventilation.
Use adequately sized cuffs when attempting blood pressure measurements.
Plan intravenous access carefully and use appropriate size needles and cannulas to ensure success and prevent repeated attempts.
Radiological and surgical specialist advice may be necessary for diagnostic procedures that cannot accommodate the patient owing to physical limitations.
Use ideal body weight or adjusted body weight measurements when calculating most emergency dosages and titrate where necessary.
Do not be afraid to ask for advice when necessary.


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