Week 1 Flashcards
How does obesity cause cardiac remodelling?
excess body mass results in increased cardiac workload. Leads to Cardiomyopathy and Heart Failure.
- Means increased Cardiac output
- increased blood volume
What are cardiac changes associated with obesity?
- Cardiac remodelling -> cardiomyopathy, Heart Failure
- Arrhythmias
- Hypertension (direct relation between excess weight and elevated BP)
- > sodium retention, activation of the SNS, insulin resistance, genetic activation of RAA’s
What are some respiratory changes associated with obesity?
Obstructive Sleep Apnoea (OSA)
- cessation of breathing due to narrowing oof upper airways during sleep.
- > pharyngeal structures increase in size with deposition of adipose tissue
- > Reduction in airway calibre
- > changes in pharengeal shape
Asthma
- Obese cunts 2x more likely to have asthma
- > decreased airway calibre
- > increased airway responsiveness
- > Chronic inflammatory response
What are some metabolic changes associated with obesity?
Diabetes Mellitus
- 7x more likely in fatty boombatties
Non-alcoholic fatty liver disease
- begin with fatty infiltration - Hepatic Tryglyceride accumulation
- > causes cirrhosis and portal hypertension
Pulmonary hypertension
- Left heart dysfunction
What are some vascular conditions associatred with obesity?
Venous thromboembolism
- chronic inflammation and impaired fibrinolysis
- Immobility
what are respiratory changes in obesity in regards to Work of breathing (increased or decreased)?
increased
why do you need increased force for BVM ventilation with bariatric patients?
- weight of chest wall
- diaphragmatic interference
- redundant tissues
- poor lung compliance
- difficult to maintain sealed mask
what is the first thing to do with airway management with bariatric ppl?
Position is most important.
- > Ramped positioning (lots of pillows under head and shoulder to tilt body a little)
- > if spinal precautions use reverse Trendelenburg position or not?
Why do you consider CPAP with fatties?
Airway splinting
- Improves oxygenation
- pneumatically splints upper airway open
- reduce liklihood of improved atelectasis
-> potential reduction of cardiovascular disease, arrhythmias and stroke
Does being fat change the metabolism of drugs?
Not really. Fat tissue does not metabolise drugs.. Metabolism relies on your leabn weight.
What types of drugs might require constant dose rate after the loading dose to maintain a steady plasma concentration with obese people?
Lipophillic drugs (eg. Midaz /Fent)
cos its metabolised in adipose tissue.
Wy do we put ourselves at risk of an injury with manual handling?
- Patient
- Bystanders
- Built environment
- Exposure
- Experience
What are the two types of manual handling injuries?
Acture - incident/sudden onset
Chronic - cumulative/gradual
What is the Hierarchy of Controls of injury with manual handling?
Elimination - Remove the hazard or hazardous work practice.
Patient assist where able
Substitution - Replace the hazard with a less hazardous option.
Powered stretcher replaces ferno stretcher
Isolation - Isolate or separate the hazard from people not involved in work.
Biohazard bags, sharps container
Engineering - Modify tools or equipment to minimise exposure to hazard.
Evacuation and slide sheets, slide boards
Administrative - Modify work practices to minimise exposure to hazard.
3 Points of Contact work instruction, Lift as last resort
PPE - The weakest control
Knee pads, lumbar support
What are the steps of Dynamic Risk Assessment?
- identify the hazard and risks
- select a plan or action
- assess the plan or action
- monitor and implement
- re-evaluate
