The current Resuscitation Council (UK) guidelines for basic and advanced life support still apply to bariatric patients, however colleagues will need to be aware that some basic skills may be more difficult when caring for a person above average body weight.
Colleagues must be aware of the increased effort involved to perform chest compressions on the patient who has a larger than average body mass.
The girth of the chest, size of arms, for example, may necessitate a change in posture during chest compressions leading to the rescuer becoming fatigued quicker. In these situations, compressions should be alternated between more than one colleague, with one person performing compressions for no longer than one minute where possible.
The current Resuscitation Council (UK) guidelines should be followed (see resuscitation manual) but may need the following adjustments:
Depth of compression
Current guidelines state 5cm to 6cm, however it may be more appropriate to compress to a third of the depth of the chest in a person with a larger than average body mass.
Airway
In a person with larger than average body mass there maybe difficulties sealing a bag-valve-mask due to the amount of excess skin and body fat around the jaw line and neck.
If this is the case switching to another method such as the use of a pocket mask may be effective.
Choking
In a person whose abdominal girth is larger than average which may increase the difficulty for the rescuer to perform abdominal thrusts, chest thrusts should be utilised if possible. Five back blows must always be used in the first instance followed by chest thrusts, use the heels of both hands on the sternum and perform a quick inward thrust.
999 calls
When speaking with call handlers, colleagues should inform them that the patient is larger or bariatric so that the appropriate transport is used.
Action in the event of a patient’s death
Due to the special circumstances, colleagues may wish to discuss sensitively with relatives, arrangements for the transfer of the deceased to the identified funeral home.
The number of undertakers able to provide these services for the patient may be limited.
Further guidance can be sought by contacting the resuscitation service (see directory specialist advisors).
Page last reviewed: January 15, 2025
Next review due: January 15, 2026
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