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Emergency Medicine Cases

Episode 69 Obesity Emergency Management

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 8 September 2015

⏱️ 66 minutes

🧾️ Download transcript

Summary

Current estimates of the prevalence of obesity are that a quarter of adult Canadians and one third of Americans are considered obese with approximately 3% being morbidly obese. With the proportion of patients with a BMI>30 growing every year, you’re likely to manage at least one obese patient on every ED shift. Obese patients are at high risk of developing a host of medical complications including diabetes, hypertension, coronary artery disease, peripheral vascular disease, biliary disease, sleep apnea, cardiomyopathy, pulmonary embolism and depression, and are less likely compared to non-obese adults to receive timely care in the ED. Not only are these patients at higher risk for morbidity and mortality, but obesity emergency management is complicated by the patient’s altered cardiopulmonary physiology and drug metabolism. This can make their acute management much more challenging and dangerous. To help us gain a deeper understanding of the challenges of managing obese patients and elucidate a number of important differences as well as practical approaches to obesity emergency management, we welcome Dr. Andrew Sloas, the founder and creator of the fantastic pediatric EM podcast PEM ED, Dr. Richard Levitan, a world-famous airway management educator and innovator and Dr. David Barbic a prominent Canadian researcher in obesity in emergency medicine from University of British Columbia....

Transcript

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0:00.0

Welcome to the Emergency Medicine Cases podcast.

0:05.8

I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine

0:10.5

from EMC studios in Toronto.

0:13.7

Dr. Andrew Slowis.

0:15.7

Happy trees, happy EVOI.

0:18.0

What's going to happen to those when I put them on positive pressure?

0:20.7

Emergency medicine physician and assistant professor of Adult and Pediatric Emergency Medicine

0:24.9

at Vanderbilt University in Nashville, Tennessee.

0:27.6

You can't get anything about it everywhere, man. Rich Levittan, here for your enjoyment.

0:31.0

Dr. Rich Levittan, professor at Dartmouth and University of Maryland, who worked in high-volume

0:35.4

inner-city trauma centers for 25 years in New York City and Philadelphia now works in a rural hospital in Maine.

0:42.3

Getting lost in pink tissue is a problem.

0:45.3

So I think the easiest way to remember the position to put these patients in is to think about them in line at KFC, Duncan Donuts, Mickey D's.

0:56.1

And Dr. David Barbick, Assistant Professor UBC, Department of Arrudency Medicine.

1:00.9

Most people will probably have to end up intubating on a stool.

1:03.5

Exactly.

1:04.0

I need three stools.

1:05.0

There's so many awesome pearls in there.

1:10.5

I hear the numbers.

1:12.4

About a quarter of adult Canadians and a third of Americans are considered obese,

1:17.7

with about 3% being morbidly obese.

1:21.1

And the proportion of patients with a BMI over 30 is growing every year.

...

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