In an interview with the Sydney Morning Herald, a Melbourne anaesthetist, Dr Balvindar Kaur, has revealed that obesity in Australian children has reached such dangerous heights, that some doctors’ ability to administer health care has been compromised.
Speaking to the SMH’s Julia Medew, Dr Kaur says that anaesthetists are resorting to the use of special equipment, such as ultrasounds and blood pressure cuffs, to find a vein as the layers of fat on obese children’s arms are too thick.
Because of this difficulty, doctors have seen a marked increase in the use of central venous catheters (inserting the needle into the neck), over radial artery catheters in the forearm and wrist, despite increase health risks associated with the former.
Dr Kaur, who practices at the Royal Children’s Hospital and Dental Hospital in Melbourne, also said that children suffering from obesity are far more likely to develop sleep apnoea. The Sydney Morning Herald reported that up to 60% of obese children suffer from sleep apnoea, compared to 1% of children at healthy weight.
“They [obese children] get enlargement of the tissue around the tonsils and that soft tissue obstructs their breathing,” said Dr Kaur, “That’s why they don’t breathe well, that’s why they don’t sleep well and that’s why they don’t necessarily metabolise well because they’re tired all the time …”
However, because of the difficulty administering intravenous catheters due to the fat layers, treating this disorder is proving more and more difficult.
In addition to problems with catheters, doctors are also facing problems due to the children’s high blood pressure (which is often at double what it should be), asthma, and gastric reflux. Obesity can also lead to a sensitivity to drugs like morphine, and painkillers. Because of this, doctors are having to reduce the dosages of painkillers administered, as to not exacerbate pre-existing breathing problems. These problems, which are easily triggered, mean that obese children are more likely to experience low oxygen levels during surgery, and have to be kept in intensive units for longer than usual.
“They’re sensitive to painkillers like morphine. They have a far less requirement because of their abnormal breathing patterns, even after corrective surgery. We don’t give them as much because they won’t resume normal breathing for themselves at the end,” said Dr Kaur, “Most children have a clean, pristine medical history … but with obese children I have to ask about their lungs and other systems … and some of them have heart troubles in their adolescent years that have required stress testing.”
It is problems like these that have prompted Dr Kaur to call for a reassessment of not only the resources and training needed to treat children with obesity, but also for the way Australia addresses the root of the problem.
“Obesity has overtaken smoking as the leading cause of premature death, and is the single biggest public health threat. This is compromising children’s health and development and putting a great strain on medical resources,” said Dr Kaur, “We need a bit more education and means for tackling it. We need upskilling and resources from all angles to allow us to better educate parents and children about this problem.”
Obesity is currently affecting one in five children in Australia.
