Emerging evidence suggests that bariatric patients are at a higher risk of developing severe COVID illness. This means they may represent a disproportionate share of your patients during the pandemic. If you’re suctioning a bariatric patient, here are six complexities to consider.
Choose the Right Catheter
Many medical providers make the mistake of assuming bariatric patients need a larger catheter. But the size of the catheter depends on the size of the endotracheal tube, not the size of the patient. Most bariatric patients need typically sized catheters for their age.
Do Not Oversuction
It is a myth that bariatric patients need longer or more aggressive suctioning. Though their airways may be slightly more difficult to access, they are anatomically indistinguishable from other airways. Limit suctioning to no longer than 10-15 seconds at a time. If you must do a second pass, ensure you oxygenate the patient before beginning.
Plan on a Difficult Airway
Obese patients are more likely to present with a difficult airway. The strategies for managing a difficult airway in a bariatric patient are indistinct from those you might use for other patients. Keep the patient calm, offer reassurances, and move slowly. Get help from other team members if necessary, and always choose the most skilled team member to manage a difficult airway. Never make negative comments about the patient or their airway.
Treat All Patients as COVID-Positive
No single COVID test is 100 percent accurate, and not all COVID patients have a fever, or any symptoms at all. For this reason, medical providers must treat all patients as if they are COVID positive. You must also assume you or the people you work with have the infection if you want to lower the risk of spreading the disease to vulnerable bariatric patients. Be sure to adopt these strategies:
- Suction a patient from behind a partition, or with as few people in the room as possible.
- Wear personal protective equipment.
- Limit close contact with patients and their family. Talk about care from at least 6 feet away.
- All parties—including patients not being treated—must wear a mask properly, fully covering their nose and mouth.
- Practice aggressive handwashing. Wash hands thoroughly before and after examining patients, before and after suctioning, and before and after touching any equipment that comes into contact with patients.
Be Sensitive to the Challenges of Obesity
Though obesity is harmful to health, so too is weight bias. Most obese patients can tell terrible stories of medical providers who mistreat them because of their weight—everything from doctors mocking them for their size to denying them lifesaving treatment until they lose weight. Bariatric patients know they are too heavy. They don’t need you to remind them or shame them. They, like everyone else, deserve sensitive and compassionate care.
Remember that you do not know their story; perhaps they lost a child and overate to cope. Maybe they took a medication that affected their weight. Or maybe, like millions of other Americans, they are simply struggling to make healthy choices. Never speak negatively about a person’s weight, or tell them that their obesity is the reason they are sick.
Be Prepared to Treat Patients Wherever You Find Them
Moving extremely obese patients can be difficult and perilous in the best of times. During a pandemic, it endangers everyone. Every time you move a patient through a new room or hallway, you expose both the patient and everyone nearby to the virus. The simple act of moving a patient across the hospital may expose dozens of people to a potentially lethal virus. Equipment that enables you to suction patients wherever they are makes everyone safer.
The COVID pandemic shows how important prompt suctioning is for patient care. Emergency portable suction ensures you do not have to move patients and risk exposing them to others, thereby spreading the virus. But not all machines are alike. For help choosing a high-quality device, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.