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Expanding waistlines, hospitals pinched

Rising levels of obesity in Australia is putting extra pressure on emergency doctors and other hospital staff.

A review of patients arriving at a Melbourne hospital's emergency ward has found almost 60 per cent were overweight or obese, posing an array of extra challenges to those providing medical care.

The added difficulties ranged from positioning overweight patients for a scan or examination through to finding veins and other "anatomical landmarks" on the body.

"Doctors reported more difficulties than nurses and radiographers," writes Jeremy Kam, an advanced medical science student at the University of Melbourne.

"Doctors reported that physical examination, palpation of the chest or abdomen, finding anatomical landmarks, and general procedures were most affected by the level of obesity.

"Nurses reported that patient positioning and mobilisation, assistance with clothes and intravenous cannulation were most affected."

Radiographers also reported troubles moving overweight patients into position for a scan while "obtaining a good image" was also more problematic.

The study took in about 750 patients brought to the emergency ward at Austin Hospital over the six months to March 2009.

Less than half of the patients had a normal and healthy weight or were underweight, based on an assessment of body mass index (BMI).

Just 8.5 per cent were underweight while 32.8 per cent of the patients had a healthy weight.

Thirty per cent were overweight while a further 23.7 per cent were obese and 4.1 per cent were morbidly obese.

The study noted the prevalence of overweight and obesity in the community was "rising, with the largest relative increase being the morbidly obese".

The number of overweight and obese people identified in the study was well above levels seen in the broader community, showing how these people were more likely to require emergency hospital care.

In general, the management of an overweight patient's injury or illness "did not increase until the BMI was in the obese or morbidly obese range", the study also found.

The paper is published in the journal Emergency Medicine Australasia.


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