How Patient Obesity Affects Emergency Departments

Obese Patient

The Centers for Disease Control and Management describes obesity in three words: Common. Serious. And costly.

Nearly 80 million adults in the United States are obese and the list of adverse health effects related to obesity are long — think heart disease, stroke and type 2 diabetes, to name a few.

And the cost? According to the CDC, the healthcare costs associated with obesity was nearly $147 billion in 2008.

In emergency departments across the U.S. patient obesity presents an array of challenges for doctors, nurses and staff who manage care. Physical exams are more challenging as rolling the patient is more difficult, and examining the patient’s whole body can be difficult.

A study published in Emergency Medicine Australasia concurs, noting that when treating obese, and morbidly obese patients, measuring blood pressure, inserting IVs, positioning patients and performing other medical procedures are all increasingly hard.

“BMI most strongly correlated with difficulty in finding anatomical landmarks, venous pressure measurement, physical examination, patient positioning and procedures generally, especially cannulation and venipuncture,” the report concludes.

EDs, doctors, nurses and staff have countered these challenges with common sense solutions. EDs turn to things such as lifting equipment; larger blood pressure cuffs and beds; and increased staff to help with mobilization and positioning. While these extra initiatives come with a price tag, they all are necessary to provide the quality of care patients who are obese deserve when visiting the ED.

However, surprisingly, whether patients are obese or not may not have a serious impact on average length of stay. In a 2005 study published in Academic Emergency Medicine, researchers were surprised to find that obese patients and non-obese patients presenting to the ED with abdominal pain had similar experiences:

  • Length of stay for obese patients was 457 minutes, while non-obese patients LOS measure higher at 486 minutes.
  • 3.2 laboratory studies were conducted for obese patients versus 2.9 for non-obese patients.
  • Rates of consultation were four percent less for obese patients
  • Admission rates were six percent lower for obese patients.

Does this surprise you? What strategies has your ED implement to better treat patients who are obese? Please comment below or feel free to drop me a line

Centers for Disease Control and Prevention: “Adult Obesity Facts.”

Emergency Medicine Australasia: “Obesity significantly increases the difficulty of patient management in the emergency department.”

Academic Emergency Medicine: “Obese patients with abdominal pain presenting to the emergency department do not require more time or resources for evaluation than nonobese patients.”