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Immobility and the Bariatric Population

Immobility and the Bariatric Population. Presented By: Skila Jennings, PT, MEd in Exercise Physiology Jennifer McCollum, MPT, Back School Coordinator. Immobility can lead to…. Skin breakdown DVT Pneumonia/Breathing dysfunction Atrophy of musculature Emotional components. Skin Issues.

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Immobility and the Bariatric Population

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  1. Immobility and the Bariatric Population Presented By: Skila Jennings, PT, MEd in Exercise Physiology Jennifer McCollum, MPT, Back School Coordinator

  2. Immobility can lead to….. • Skin breakdown • DVT • Pneumonia/Breathing dysfunction • Atrophy of musculature • Emotional components

  3. Skin Issues • Increased risk of cellulitis • Increased risk of skin breakdown due to increased pressure • Skin breakdown due to shear forces • Moisture in folds

  4. Breathing • Lungs do not increase in size with obese patients. • The diaphragm is fully able to descend due to the increase adipose tissue, thus decreasing their vital capacity and tidal volume. • Hyperventilization leads to increased risk for DVT

  5. Atrophy • Decreased muscle strength • Decreased muscle endurance • Decreased efficiency of already compromised cardiovascular system

  6. Emotional factors • Depression • A feeling of failure • Anxiety or guilt over needing so much help • Embarrassment

  7. Other metabolic concerns • Temperature control, excess sweating • Misuse of protein • Affect on resting metabolic rate • Diabetes control • Contractures at foot/ankle

  8. Proper Equipment • Manual Handling equipment • Bariatric FWW • Gait belt • Maxi slide • Lift equipment including appropriate slings • Appropriate size • Bariatric bed • Yes it takes more staff, but we got to get these folks moving!

  9. Transfers • Use proper equipment • Use mechanical advantage of bed • Block knees

  10. References • Davis, Crawford (2002) Persistant leg ulcers in an obese patient with venous insufficiency and elephantitis. Journal of wound ostomy and continence. 29:55-60 • Groszek. D (1982) Promoting wound healing in the obese patient. Advances in skin and wound care. 5;1132-8 • Guillet C, Masgrau A, Doirie Y (2011) Is protein metabolism changed with obesity? Curr. Opinion Clinical Nutrition Metabolic Care. • Maklebust, Seiggreen (1992) Pressure ulcers: Guidelines for prevention and nursing management. 2nd Edition. Springhouse corporation. Manual Handling Operations Regulations (1992) • Milton Stokes (2004) The impact of obesity on Healthcare delivery. • Trimble T (2003) Outsize patients – a big nursing challenge! Emergency Nursing World

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