Sunday, 08/28/05State's obesity epidemic strains EMTs Expensive equipment needed to care for those as big as 1,600 poundsBy CLAUDIA PINTOStaff WriterIt took 12 Nashville emergency responders to log-roll the 1,075-pound man with chest pains onto a tarp. But they couldn't lift him into the ambulance.
An hour passed while the rescuers scrambled to build a makeshift ramp out of metal beams. As they pulled him up the ramp and onto the floor of the ambulance, he was crying.
The incident illustrates a growing problem sparked by Tennessee's rising obesity rate: The difficulty in transporting obese patients is delaying their treatment, as well as putting emergency workers at risk for injury.
Metro Emergency Medical Services' Steve Meador said 30 years ago there were maybe three or four such calls a year. Now there are one or two calls a day, the deputy chief says.
"When there's an emergency, we need to get people to the hospital as quickly as possible," Meador said. "With larger patients, sometimes we are on the scene for an hour or longer. We have to dismantle the stretcher to make room as well as call in extra personnel to help lift them. It's not an ideal situation."
In response, emergency agencies are creating "bariatric ambulances," which can easily load and safely carry patients who weigh more than 400 pounds.
While still rare, bariatric ambulances are catching on because of the nation's ever-expanding waistline. So far, they've popped up in cities such as Phoenix, Seattle, Denver and Portland.
Pride Care Ambulance Service, a private company in Nashville, got one in November. Wilson County Emergency Management Agency acquired one in May, and Meador said Metro's is expected to be on the road by Oct. 1.
"Our business was called upon to respond to more and more of these patients, so this was our response," said Brian Williams, Pride Care's director of operations. The company gets about 10 calls each week to transport severely obese people, he said.
To create the specialty ambulances, a ramp and remote-controlled electric winch-and-pulley system are added to a normal ambulance. The pulley system moves the stretcher up and down the ramp. The ambulances are outfitted with a wider stretcher that can hold as much as 1,600 pounds.
"Our regular stretchers can only hold 500 pounds, so a lot of times they have to be transported on the floor," Meador said. "Right now, there's really no way to secure these patients."
The cost of the new gear and modifications is about $30,000, he said.
Tennessee ranks fifth in the United States in obesity with a rate of 25.6%, according to 2002-04 data from the Centers for Disease Control and Prevention.
One in 50 Americans is morbidly obese, according to a 2003 RAND Corp. study. Those numbers are up from one in 200 in 1986.
To be classified as morbidly obese, a person must be at least 100 pounds overweight. A typical severely obese man weighs 300 pounds at 5 feet, 10 inches, while a typical severely obese woman weighs 250 pounds at 5 feet, 4 inches.
"Like everyone else, these particular patients expect good health care," Meador said. "They expect good emergency response. This new equipment will help us cut that time in half."
Trying to move someone so large can be not just difficult but dangerous. Wilson County Emergency Management Agency Officials said they got the ambulance in hopes of preventing employees from getting back and leg strains and missing work.
"We've had quite a few injuries," said Doug McQuary, assistant chief of the agency's ambulance division.
Since Pride Care got its special ambulance, back injuries among employees have been cut in half, Williams said. More than 20 workers had such injuries in the first nine months of 2004, vs. fewer than 10 in the first nine months of 2005.
Back injuries account for more than one-third of all on-the-job injuries for EMS workers, Williams noted.
"We need to move our patients safely and comfortably and not injure our employees in the process," he said. "This equipment is a way to do that."
Glynn Richardson, Pride Care's operations supervisor, said before the bariatric ambulance, her greatest fear was dropping a patient. At 5 feet, 5 inches tall and 130 pounds, she admits that it was daunting trying to lift patients who weigh hundreds of pounds, even with the help of seven other people.
"With this, you don't exert yourself as much," Richardson said. "It's made it a whole lot easier."
Source
Tennessean.com