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Beefed-Up Bariatric Unit
By
Jul 29, 2004, 08:05
Courtesy the EMS House of DeFrance
http://www.defrance.org
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As the medical community
tries to care for an American population that grows more overweight each
year, Southwest Ambulance is unveiling its new ambulance for patients
450 to 1,000 pounds.
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| Dorothy Porter, paramedic
and public affairs director with Southwest Ambulance, Arizona loads a
special gurney, 11 inches wider than standard ones, onto the bariatric
ambulance for patients more than 450 pounds. |
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| Porter
shows the roomy interior of Southwest Ambulance's new bariatric unit, an
ambulance for patients weighing 450 to 1,000 pounds. |
The ambulance has an extra-large gurney and a ramp-and-winch system to
load patients safely and with dignity, said Dorothy Porter, director of
public affairs for Southwest.
There are fewer than a dozen such rigs in the country, including one
each in Mesa, Phoenix and Benson, Porter said. The clearest indication
of the need for this type of ambulance in Tucson was the 750
"lift-assist" calls Southwest handled over the past year,
Porter said. Those generally involve obese patients.
"I think in the beginning we probably will see it used several
times a week. I think it's going to become a very popular unit,"
she said.
The ambulance has a beefed-up suspension system and dual rear wheels to
bear the extra weight. But the biggest difference between the bariatric
ambulance and a standard one is the size of the gurney and the addition
of ramps and an electronic winch to load patients, Porter said.
At 30 inches, the gurney is 11 inches wider than a regular one. It can
bear 1,000 pounds, twice as much as the standard cot.
Getting patients onto the larger gurney will still be difficult and may
requiring rolling them onto tarps first. But once patients are on the
gurney, it is rolled to a ramp at the back of the ambulance, hooked to a
steel cable on the winch and drawn up the ramp into the cabin, Porter
said.
With a standard gurney, a large patient can be left hanging off the
sides. That's if he can fit on the gurney at all. The larger gurney
should accommodate most people comfortably.
When moving an extra-large person into an ambulance, a gurney is
generally kept in its lowest position, about 12 inches off the ground,
because it may topple or collapse. Until now, this has meant crews have
had to lift patients farther to get them into ambulances, said John
Cole, Southwest's operations manager.
The challenges increase with the size of the patient.
Tucson Fire Department Deputy Chief Joe Gulotta, in charge of its
emergency medical services, said when a patient is too heavy for the
standard gurney, TFD has had to improvise.
Porter shows the roomy interior of Southwest Ambulance's new bariatric
unit, an ambulance for patients weighing 450 to 1,000 pounds.
"Some of these patients weigh in excess of 600 pounds... . We have
to strip the gurney and gurney mounts out of the back of the vehicle and
use tarps to move them around. Oftentimes, we have to call in additional
engine companies just to help us move the patient. It's not a
comfortable position for the patient to be in. It's a little bit
humiliating at times and it's difficult for firefighters to do it. But
without any specialty equipment, like this bariatric unit, we have to do
with what we have," he said.
If a patient can walk on his own, he is walked to the rear of the
ambulance where he sits on a tarp and is dragged inside, Gulotta said.
If a patient can't walk, the crew has to use tarps and the pure lifting
power of six to eight firefighters to move them into the ambulance, he
said.
Gulotta said TFD is putting out the word to its personnel to request the
ambulance when handling very large patients, particularly in situations
that are not emergencies when the patient can wait a little longer.
Southwest's business is mostly taking patients to and from medical
facilities for specialty care, rather than emergency calls, but Porter
said the ambulance will be available for all types of calls involving
obese patients.
"I'm really excited that they have this piece of equipment,"
Gulotta said. "I think it's going to be something good they use for
the customers they take back and forth from different medical facilities
and it's going to be available to the 911 system... . We'll definitely
take advantage of it as we can."
A fully equipped ambulance costs about $80,000. Porter said
modifications to prepare this ambulance for obese patients cost a
"reasonable" $3,000. And the ambulance can still be used for
patients who are not obese.
The new ambulance is part of a trend of specialty medical equipment for
the obese that is growing with the American waistline.
University Medical Center, for example, has hospital beds and gurneys
that will hold patients up to 660 pounds. They have wheelchairs that are
twice as wide as a normal chair and hoists over patient beds that can
lift up to 800 pounds, said Viki Alexander, patient care manager of
UMC's emergency department.
She estimated UMC sees five to 10 patients a month who weigh more than
400 pounds.
"I've been a nurse for 25 years and we used to occasionally have
someone really big, but not as often as we do now," she said.
The obese patients, she noted, are also younger than she has seen in the
past.
Photos courtesy TRICIA McINROY
Story by Anne T. Denogean |
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