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Proper Patient Positioning for Bariatric Patients

Excess body weight increases the workload on the heart, circulatory system, joints and ligaments. Respiratory function is compromised in individuals who are obese because of increased weight on the chest. The supine and prone position may cause the patient difficulty breathing due to pressure on the diaphragm, although placing a wedge under the patient can offer relief. Skin breakdown is also a challenge because moisture and fluid from skin-prep solution can become trapped in tissue folds. Adipose tissue is not well vascularized and the pressure resulting from positioning can cause a decrease in circulation. It is extremely important that perioperative nurses intermittently reevaluate the patient’s position throughout surgery and adjust as necessary.^{1, 2}

When preparing for morbidly obese patients (individuals with a BMI greater than 40), it is important to verify that the OR table can support the patient’s weight and is equipped with side extensions if they are necessary. AliMed has a wide selection of table accessories to accommodate patients of size, including table width extenders which adds 8" to each side of the table. The safety strap must be long and wide enough to secure the patient safely. In some instances, two straps are required – one for the upper body and another for the lower extremities. The AliMed Bariatric Super Strap is extra-strong, extra-wide and provides a secure padded fit. The Bariatric VeriClean, has dual straps and a larger panel to secure the patient, and allows for high level disinfection between cases for greater infection control.

When available, lifting devices should be used to transfer the patient. AliMed’s Soft Rollboard reduces the risk of injury to staff during transfers, by reducing peak force in the shoulders and lower back.  AliMed’s Soft Rollboards are also MR-safe, radiolucent, and antimicrobial making them perfect additions to a facility's Safe Patient Handling protocols.

References

1. Burlingame B, Davidson J, Denholm B, et al. Guideline for positioning the patient. Guidelines for Perioperative Practice. 2017;1. DOI: 10.6015/psrp.17.01.e1.
2. Rowen L, Hunt D, Johnson KL. Managing obese patients in the OR. OR Nurse. 2012; 6(2):26-36.

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