Bariatric Patients

[nswparamedic]

I am a Paramedic in New South Wales, Australia. We currently have a "unit" that specifically deals with the transportation of Bariatric Patients, we have two day shift crews (2 people per truck) and we have on call facilities out of hours. We currently have 5 specialised vehicles in NSW alone, with multiple in other states. The largest patient in NSW we have come across so far is around 430kgs. (950lbs)

Moving forward with our ideas to make things easier, we have an electric/hydraulic stretcher that takes up to 500kgs (1100lbs)our 2 newest vehicles have these. We have hovermats for manouvering in their houses on flat surfaces and hoverjacks that will lift them up to chest height ( I'm 5"9'), we are looking into portable lifters as well, but over here, I am battling to find anything over 270kgs (595lbs).

Our vehicles are something a little different to our standard ambulances. Obviously, they are trucks, but we also do intensive care transfers ie when people are on ECMO (lung bypass), balloon pumps etc, because we have the extra room in our vehicle it makes life so much easier!

I am interested in seeing what everyone else does to manage these types of patients....we are now doing up to 8 jobs a day, that is just in New South Wales, and as people are learning what we have available, we are getting alot busier. They are even looking for the rural transfers at upgrading their fixed wing aircraft to take 260kgs (573lbs).

I will add some pics of our equipment as time goes on..

[Don1977]

My company has 3 Bariatric stryker cots, we use at least 2 of them once a day between regular transports and emergencies. Our rule is 4 people for these patients that are 300lbs and above with a supervisor present, if they are 500 and up, we try to get an extra person, We have patients that was 1,000 lbs already and 7 of us to move. We don't have hover mats or anything fancy, just us. We do have slide boards but they can do more bad then good at times, depends on patient. Sadly, we do have crew members that can't lift worth a damn so we like to send the "lifting" EMT's and medics which is me most of the time when I'm working and not on a call. We use MOD ambulances and our Freightliner for these patients. Any other questions, just ask...

[Just Plain Ruff]

My company has 3 Bariatric stryker cots, we use at least 2 of them once a day between regular transports and emergencies. Our rule is 4 people for these patients that are 300lbs and above with a supervisor present, if they are 500 and up, we try to get an extra person, We have patients that was 1,000 lbs already and 7 of us to move. We don't have hover mats or anything fancy, just us. We do have slide boards but they can do more bad then good at times, depends on patient. Sadly, we do have crew members that can't lift worth a damn so we like to send the "lifting" EMT's and medics which is me most of the time when I'm working and not on a call. We use MOD ambulances and our Freightliner for these patients. Any other questions, just ask...

The company I worked for recently had the most AWESOME lifting system. 2 crew members and maybe a first responder. Isn't that the most awesome system?

For those who have the funding to provide the level of support and equipment that are in the two above posts, KUDOS to your forward thinking department. Our system provides workman's comp as a benefit to it's employees who might be injured on the job. That's a great thing.

Can you read my sarcasm towards the situation?

[Don1977]

The company I worked for recently had the most AWESOME lifting system. 2 crew members and maybe a first responder. Isn't that the most awesome system?

For those who have the funding to provide the level of support and equipment that are in the two above posts, KUDOS to your forward thinking department. Our system provides workman's comp as a benefit to it's employees who might be injured on the job. That's a great thing.

Can you read my sarcasm towards the situation?

I hear that Ruff....lol....sometimes we dont have crews to assist us and have to John Wayne it, Ive done 450-500 lbs with me and my partner, I think it depends on the person if they can lift or not. Im good with heavy patients and the pts with 30 steps, try to avoid them, but you know how that goes.......

Edited June 24, 2010 by EMTDON970

[uglyEMT]

LOL Ruff beat me to it.

Our bariatric equipment is the crew, the responding LEOs, and a call into dispatch for a lift assist which brings out the fire dept.

Now we have the Pt on a stretcher or stokes, 3 EMTs 2 cops and however many fire guys (usually 4 or 5 show up in full gear minus the SCBA) usually crammed into a 1 bedroom appartment on the 3rd floor! So 9 or 10 plus the patient trying to make it work. Gotta Love It

I wish we had some of that stuff the OP mentioned. Would make life alot easier. so would the Pt living on the ground floor

Thankfully most of my crew does wear back braces or cares them in the rig so if we are the responding, we can put them on. I just wear mine under the uniform all day.

[BushyFromOz]

I am a Paramedic in New South Wales, Australia. We currently have a "unit" that specifically deals with the transportation of Bariatric Patients, we have two day shift crews (2 people per truck) and we have on call facilities out of hours. We currently have 5 specialised vehicles in NSW alone, with multiple in other states. The largest patient in NSW we have come across so far is around 430kgs. (950lbs)

Moving forward with our ideas to make things easier, we have an electric/hydraulic stretcher that takes up to 500kgs (1100lbs)our 2 newest vehicles have these. We have hovermats for manouvering in their houses on flat surfaces and hoverjacks that will lift them up to chest height ( I'm 5"9'), we are looking into portable lifters as well, but over here, I am battling to find anything over 270kgs (595lbs).

Our vehicles are something a little different to our standard ambulances. Obviously, they are trucks, but we also do intensive care transfers ie when people are on ECMO (lung bypass), balloon pumps etc, because we have the extra room in our vehicle it makes life so much easier!

I am interested in seeing what everyone else does to manage these types of patients....we are now doing up to 8 jobs a day, that is just in New South Wales, and as people are learning what we have available, we are getting alot busier. They are even looking for the rural transfers at upgrading their fixed wing aircraft to take 260kgs (573lbs).

I will add some pics of our equipment as time goes on..

I dont have much to offer you cause we used your experience with bariatric trucks when victoria had ourse developed.

Are you still using the isuzu trucks or the long wheel base sprinters now?

[snoopy911]

Anything over 300 lbs is an automatic manpower call for my company, and they send out an additional crew. We have the ferno power stretchers in the bariatric trucks, with the removable bariatric side piece. They are usually pretty good about manpower, anything that comes over 300, we don't even have to ask for manpower, they dispatch it automatically. There is one patient, (which I have not had the privledge of having) that is 1,000 lbs and i believe they sent 10 guys.

[WolfmanHarris]

Our system for lift assist and bariatrics has a few parts.

For lift assist we are under policy and dispatch rules to be sent another EMS unit rather than FD unless FD is specifically needed for rescue/extrication, or another EMS unit will be delayed. Lift assist request is entirely at the discretion of the crew and can be based on terrain, close quarters, or weight.

Currently all our Ambulances have the Ferno tracked stair chair. We also have 3 stryker power cots in service that we initially trialed with more coming for all the trucks. We have also been told that when it's available for purchase to expect the power load system on all our vehicles as well. All part of the service's transition to "No Lift."

For true bariatrics (over 350lbs) we have a few vehicles in each district that have the infrastructure to be converted for bariatric. They have the extra wiring and mounting points to centre mount the stretcher and install the winches. The idea here is that it is more likely that one of the bariatric capable trucks will be available to co-respond along with the initial crew.

The bariatric equipment is carried by the Special Response Unit in their single response trucks. This includes airbags, slider boards, the ramps and winches and the large body adapter deck for the stretcher. They respond to the scene, set up the equipment and truck and coordinate the movement while the initial crew focuses on the call.

[mrsbull]

This post is EXACTLY why I had the gastric bypass.I can imagine how embarrassing having FD and EMS providers need help to lift me. how sad. I was 305 at my highest weight now I am not I am a LOT smaller 160ish, I feel better and dammit I look HOT now

I have had some problems but nothing I would take back. Being a size 24 in womens (54 ish in mens) to a 8 in womens (34ish in mens) tends to make ya feel much better about things. Also helps me to have compassion for those who are heavy. Dosent mean that I dont look the same way most do. Just more compassionate.

Carry on!

[Quakefire]

I was just looking at a manual Stryker bariatric cot, rated for something like 800 pounds full height and a whopping 1600 pounds at lowest (how would you get 1600 pounds up the foot or so to the cot). It also had an attachment for what I would assume to be a winch., it all makes my back hurt.

My experience is with the 500 pound range of patients on a stryker hydraulic cot in a standard unit. Even that is difficult (we had to tie the lifting net around the pt. kept them from over hanging the stretcher too much) We do not have a specialized unit available for these patients.

I've never seen an ECMO that would make for a very interesting transfer