-
This article is both heartbreaking and alarming...
- Nov 2, 2009 at 8:03 PM
- By
- Comments (7) Total Views (238) Everyone can see this journal post.
Crews need heavy-duty gear for obese patients
05:46 PM EST on Monday, November 2, 2009
PORTSMOUTH (AP) -- The woman weighed as much as 1,000 pounds, and that required a special blend of creativity and muscle from the city ambulance crew tasked with transporting her to the hospital.
Two fire engines and a ladder truck arrived, increasing the people on hand to about a dozen. Firefighters unbolted stretcher brackets and other equipment from the floor of the ambulance, which they backed up to the stoop of the patient's home.
They strapped together two backboards to create a ramp. Twenty-four hands grabbed the edges of a salvage tarp and, with the patient aboard, slid her out of the house and into the back of the ambulance. Lt. Chandra Dorsman propped herself against the woman's back to help her remain sitting up and able to breathe on the way to the hospital.
That was an extreme example of something city ambulance crews here and around the country are seeing more of: super-heavy patients.
To help accommodate them, and to reduce back injuries suffered by paramedics and firefighters trying to lift them, agencies have invested in costly equipment and modified some of their practices.
Portsmouth in recent years has replaced its standard gurneys with battery-driven hydraulic "power stretchers," said Capt. Paul Hoyle, Emergency Medical Services manager. They're rated to safely hold 700 pounds and lift at the touch of a button, at nearly the cost of a small car: $8,000 each.
Virginia Beach rescue squads added electric lifts to fewer than a dozen of their stretchers, said Bruce Nedelka, EMS division chief.
Medical Transport, a private ambulance service, has added eight oversized stretchers to its statewide fleet, four of them in South Hampton Roads, said Elizabeth Beatty, district field supervisor. Her company also operates an oversized ambulance, based in Virginia Beach, that gets requests from across Virginia.
Back injuries from lifting patients is the Portsmouth department's top malady, but since it bought its new stretchers, the number has gone down, Hoyle said. He said the stretchers pay for themselves because lifting injuries cost the city more in worker's compensation.
"When you're dealing with someone like that, and you're using a rolled-up sheet -- get real," he said.
Technically known as bariatric patients, the morbidly or clinically severe obese -- typically 100 or more pounds overweight -- are the fastest-growing segment of the rising obesity rate in the United States, according to a 2007 Rand Corp. study and Dr. Margaret Gaglione of Tidewater Bariatrics in Chesapeake.
In practical terms, Portsmouth Fire, Rescue and Emergency Services considers bariatric those patients weighing more than 350 pounds. In even more practical terms, "for us, bariatric patients are where the old procedures don't work," Hoyle said.
Excess weight contributes to more ailments -- heart, circulation, breathing -- which leads to more ambulance calls. Portsmouth transports about 20 extra-heavy patients each week, Hoyle estimated. Requests for lifting help occur almost daily in Virginia Beach, Nedelka said.
The issue has become a frequent subject for the profession's publications.
The online version of the Journal of Emergency Medical Services two years ago predicted sales of beefed-up stretchers would almost double between 2004 and 2012. Another article offered tips such as parking ambulances on slight down slopes to ease loading.
EMSresponder.com has recounted news coverage of debates in some areas over whether to charge higher fees for heavier patients, to cover the cost of special equipment and extra staffing. Portsmouth has no such plans, Hoyle said. The Web site also has discussed use of lifting apparatus and retrofitting or adding special vehicles, even larger-capacity helicopters, to get away from forklifts and flatbed trucks.
The publications and local rescue workers said it's about safety, for patients and themselves. They said it's also about patients' dignity.
Typically, the patients already are anxious, as some might not have left their homes in years -- and that can exacerbate their medical problems, said Beatty of Medical Transport.
"It's very stressful," Beatty said. "You're not moving furniture."
Sometimes, though, necessity nudges aside dignity. The Virginia Beach Fire Department installed a permanent ceiling anchor and hoist system in the home of one frequent patient who weighed more than 500 pounds, Battalion Chief Tim Riley said.
Once, a Virginia Beach ladder truck lifted a wire-mesh Stokes stretcher -- like those used between ships at sea -- to remove a patient through a second-story window, Nedelka said.
Chesapeake has used its technical rescue team to rig up pulley systems, Capt. Sam Gulisano said.
Along with too-narrow doorways and stairwells, paramedics must wrestle with other issues. Portsmouth ambulances carry extra-long blood pressure cuffs that can encircle wider arms, and canvas-like tarp carriers outfitted with multiple handles for tight spaces.
If they could find the funding, Hoyle said, they'd like to buy an even stronger stretcher his ambulances could share. Norfolk has one, which can hold 850 pounds sitting up and 1,600 pounds lying flat, plus a bariatric tarp, Battalion Chief Harry Worley said.
Beatty has given presentations at symposiums about moving larger patients and has fielded calls for information from as far away as Canada. It's an issue that doesn't appear to be going away.
"We're seeing an incredible, incredible increase in the number of patients who are super obese," she said.
(Copyright 2009 by The Associated Press. All Rights Reserved)
*****On one hand, I think it's thoughtful of them to take the patients' dignity into consideration, but on the other hand, I'm wondering why, instead of spending money to accomodate their disability, can't they spend money to help them so that emergency care isn't needed as often? I know not everyone can get the gastric bypass because my Uncle Louis, God rest his soul, weighed >550 lbs and couldn't get the procedure done due to the risk of cardiac arrest. I wonder if it would help to send nutritionists and dietitians to their homes or even personal trainers to get them to do some form of excersise. Reading this story really hit home with me because it made me think of my uncle. He passed away last year at the young age of 44. He gained a lot of weight from his medication, became depressed from the weight gain, and used food to comfort that depression. So it was a vicious cycle that ended up costing him his life. We all tried to help him, and obviously he knew he needed to lose weight and wanted to, but I think with the help of a professional, he would've been able to stay on a healthy track. Just a thought...the fact that the number of bariatric patients is rising makes me very sad. I saw what my uncle went through, and to know that the number of people experiencing his ailments is really quite scary.
Comments:
I have seen the shows numerous of times. Its really sad. BU whats sad after watching these obese people in the hospital surrounded by doctors, dieticians, personal trainers, and FAMILY....You see them sneaking in fastfood. hiding food. It basically comes to the point where they have to stop this obsessive behavior. Its like quitting smoking. Its a bad habit. I just lost over 55 lbs. in a year. You consume food for many of years and then when you have to stop...its a life change. you have to be willing to give it up. And its sad that healthcare has to go up, and paramedics have to supe up their equiptment for them. I think its really sad that this society has come to this.
Thank you and yes I agree. The people that sneak in fast food think that they are helping when really they are aiding in killing their loved one. It's a heartbreaking shame. Society sugar coats problems instead of solving them and it's very upsetting.
WOW!!! i never thought about EMTs having to help people of this size. This really shows that our society needs to start healthy eating habits FROM BIRTH. Most families eat so much junk. I get sick to my stomach when i'm in line at the grocery store, i will see a family who are all OBESE and i see a bunch of HORRIBLE UNHEALTHY foods in their grocery cart. it makes me feel bad for them but also makes me want to help them
This really shows that our society needs to start healthy eating habits FROM BIRTH. Most families eat so much junk. I get sick to my stomach when i'm in line at the grocery store, i will see a family who are all OBESE and i see a bunch of HORRIBLE UNHEALTHY foods in their grocery cart. it makes me feel bad for them but also makes me want to help them
I have a little different take on this. I feel more empathy for the EMT and FD crews that have to figure out how to transport these people and have to worry about the risk to their own health because someone else is committed to an unhealthy life. As well, they have to use a resource pool that is already strained and underfunded, again, because people are being ridiculous.
I am overweight. I blame no one but myself. However, before I get to the point where I need a forklift to get out of my home, I have changed my diet. Sometimes it works, sometimes it doesn't. My family does not enable me, my DH is very good about gently saying that he wants to eat more healthy for both of us, and let's cook and deal with food together.
It's a combination of the obese person not having any self control, and refusing to see that there is a problem, much like a drug addict. And the family enabling like any other addict's family.
So to me, while I think it is a personal problem, like any other addiction, that sort of thinking is not going to make it go away. Let's treat it like an addiction. The addict has to hit rock bottom - you would think the shame of having to break down a wall or be fork lifted out a window would do it, but it doesn't. Instead you see people bitching about their dignity. If you cared about your dignity, you would not be abusing your body this way.
While I think it's nice that the medical personel are worried about the obese person's dignity, the safety of the EMT/FD comes first. Let's face it, there is no dignified way to hoist someone out of a home. Like addicts, the obese people need to have their addiction dragged into the light.
OP, I am sorry for your uncle. I truly am. But if you all could not stage an intervention, you could not help him. He had to reach a place where he wanted help, and unfortunately, he did not reach that place. I am so sorry.
I think though, until we look at the morbidly obese the same way we look at the meth addict, see that the addiction is just as harmful and destructive to both the addict and their family, and that an addiction mindset has to be used to help the addict - which is complicated because the food cannot be cut cold turkey like drugs are - we will continue to see this. I see those shows also, and I always worry for the people moving the obese person, and always wonder how much it is costing to deal with this person's addiction, just like I do when I see shows about a meth head.
We have to treat this like any other addiction. Just as different drugs require slightly different treatment plans, so does food addiction. Until the addicts take part in this, and work to see the food in a different light, we cannot help but see more of this. I also write this from the POV of someone who is an emotional eater, and has been my entire life. Only in the last two years have I come to terms with it, and begun looking for ways to deal with and combat it. While not morbidly obese, I do understand the food addiction, and can only feel so much empathy for someone who, like a meth head, has abused their drug to the point where they are unable to care for themselves, and must be cared for by others, and occasionally society.
I think most of these people need a psychologist or counselor more than a dietitian. A lot of their problems stem from issues deep rooted in their minds. For one they don't want to leave at all which shows maybe some horrible phobias and also eating and being over weight is more than not a cry for help because of say people eat because they are depressed or whatever. Like the biggest loser helped people Lose tons of weight but after the show many of them were right back where they started. Fix the mind and you can fix the body.
Already a member? Click here to log in
These cases are sad. My Son is an EMT working for a medical transport service. The majority of the patients they have to transport from nursing homes are bariatric patients. He's also a volunteer at the county firehouse. As he put it the saddest, hardest and funniest all at the same time. call they had to go on was in town. An over weight women. ( she was close to or over 500lbs.) Fell through a concrete porch. The city had to call them because they had the biggest wench. The main problem with this call was the fact they had to jerry rig two harnesses around her just to get her out. When they have to jerry rig things they are not as safe the equipment doesn't work the way it's suppose to. Something does need to be done. Unfortunately most of them refuse to see there is problem. When he takes them to their appointments the Doctors do try to get them to what they need but they refuse. In the nursing homes, family sneak in food because the patient is complaining they are hungry. And so on.