Bariatric Patients

[1EMT-P]

How does your EMS agency handle bariatric patients? Do they send additional resources? Do they have specialized equipment to move these patients?

I’ve noticed that my patients seem to be getting bigger with complex health problems, but yet we aren’t being given any additional resources. 

 

[Just Plain Ruff]

well I'm not really working in EMS - I'm actually trying to get a Trauma Analyst position so hopefully will get good news soon. 

 

but I know that many of the agencies in my area have dedicated Bariatric units.  For transfers especially they will send the bariatric unit as well as a fire truck to help with lifting.  

As for on scene (non hosp), the responding unit will get there and determine if it's bariatric and they will call for the bariatric unit.  I think KC MO has 3 Bariatric ambulances so the response time isn't terrible unless all bariatric trucks are already on calls.  

 

As for smaller services who cannot afford to purchase or man a designated bariatric truck,  hope fully they have a network of fire departments/first responders who can help out.  

That's what I know.  I do have a couple of friends on different departments in the KC area that would probably be willing to chat with you if you have further questions.  

 

[medicgirl05]

I ran a call on an 800lb+ person. He was unresponsive, and we couldn't even get our ambulance onto his property because of mud. We called a bariatric truck 3 hours away, and we worked on extricating him from the residence to the road while we waited. We loaded his hospital bed onto a flatbed trailer(2 of the wheels broke on the bed), we had to take the door frame off of the double French doors to fit him out, and it took a small army of people. Eventually we loaded his mattress into the bariatric truck, and secured him with webbing. He was too big for the bariatric truck, but we had no safer options. The entire time the family was yelling at us for it taking so long. Terrible call, but he turned out to be ok. After he recovered and lost about 150lbs they put him back in that house so some day another crew will have to probably do the exact same thing to get him out. In our area we don't really have resources for bariatric patients. It's frustrating to me that people put themselves into those types of situations and then get mad when we aren't able to handle it quickly.

[Just Plain Ruff]

We had to remove about a 10x10 part of a patients wall because not only was his family the proud owner of a bariatric patient but they were also hoarders and we had ZERO ability to get the guy out from his back room

Parents enabled this guy and would go out and buy him thousands of calories per meal and not do anything about helping him address an issue that he had been educated on - overeating.  

He was proud of his 735 pounds and had plans of getting larger.  He even had a girlfriend who was half his size. 

One day he didn't eat anything and his sugar bottomed out, even though he took his insulin and lantus, metformin and Victoza that morning which didn't help us in getting his sugar up.  He also had a horribly infected foot caused by an ingrown toenail which thus caused him to get beginnings of sepsis. 

So we could not get this guy out of his room through his door, the window was a 4x5 window which didn't help.  So we just cut a huge hole in his room wall, backed up a flatbed trailer to the hole and took 11 of us with a tarp to get the guy to the flatbed.  

Same amount at the hospital to get him off the flatbed.  It was the longest 10 minute ride to the hospital I ever had.  

so embarassing for the patient, we tried to give him dignity during the transfer but by the time we had cut the hole in the wall it seemed like the entire town was there to watch.  

sadly, 3 days after admission he passed due to sepsis from the infected foot.  

[Off Label]

On 1/17/2018 at 1:35 PM, Just Plain Ruff said:

sadly, 3 days after admission he passed due to sepsis from the infected foot

I'd say he died from complications of obesity. 

[Just Plain Ruff]

53 minutes ago, Off Label said:

I'd say he died from complications of obesity. 

Yeah, there is that.  But they said it was Sepsis that killed him but he was in no condition to fight that infection.  

[1EMT-P]

It’s sad to see patients suffer because of health related issues. We should be able to provide these patients with additional resources so they can improve their health.

[Off Label]

2 hours ago, 1EMT-P said:

We should be able to provide these patients with additional resources so they can improve their health.

What additional resources would have helped here? 

[Just Plain Ruff]

To add a little more into the mix, there were 2 of the most respected physicians(one was the patients own physician) on scene with us, they left their offices to come help us.  And let me tell you, they were really big helps. (hope you read the sarcasm)  Competing orders, trying to sign papers to get him transferred directly up to the city so those big city docs could take care of him but we weren't about to transport this guy to the city on a flatbed.  

In the end, he spent 3 miserable days in the ICU at our facility and finally passed.  

 

[yakc130]

On 2/8/2018 at 4:44 PM, 1EMT-P said:

It’s sad to see patients suffer because of health related issues. We should be able to provide these patients with additional resources so they can improve their health.

If they have no desire to take care of themselves, there isn't much that you can do for them no matter how hard you try.