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ACEP Calls for Bariatric Studies

Oct. 1--Extremely obese people tend to make national news, but not necessarily for humane reasons.

Earlier this month, a rescue crew had to cut a hole in the house of a 900-pound Michigan man, move him with a forklift and take him to the hospital on a flatbed truck.

The story made the news and caught the attention of Larry Roberts in Cumberland County.

Roberts didn't take note because it was sad or bizarre, but because it was so unsafe. If the truck had been in an accident, the patient would have no protection, noted Roberts, the chief operating officer for West Shore EMS and a former ambulance responder.

Those same concerns, combined with more patients weighing more than 350 pounds, prompted West Shore EMS to build a special ambulance two years ago.

The vehicle is fitted with a winch and ramp. It carries a litter, similar to a stretcher, that can hold up to 1,000 pounds and an inflatable device that can raise someone who weighs 700 pounds or more. It's needed about three times a week.

"When you start getting to the point of 350 pounds or more, it becomes very difficult to move that person," Roberts said.

More and more Americans fit that description.

Obesity poses assorted problems in health care, especially for ambulance and emergency room workers, according to the American College of Emergency Physicians, which wants studies to get a better understanding of issues surrounding obese patients.

An article in the October issue of its magazine, Annals of Emergency Medicine, notes that companies that sell special stretchers and lift systems for the super obese are seeing major sales growth.

The ACEP says huge body mass can prevent someone from fitting inside scanning devices, having blood drawn and receiving an accurate diagnosis.

Health care workers sometimes put off tending to them, thinking they must deal with less time-consuming patients first, so they often wait longer.

Giving drugs can be a problem, because there are few studies on proper doses for extremely large people, known as "bariatric" patients.

Before building its bariatric ambulance, West Shore EMS was encountering more and more patients who required help from a second two-person crew and firefighters, Robert said.

The ACEP cites a study of 1,356 emergency medical technicians that found nearly half had suffered back injuries, most often the result of lifting extremely heavy patients.

West Shore's bariatric ambulance is nearing the end of its life. Replacing it will cost about $125,000, compared with about $75,000 for a regular ambulance, Roberts said.

Holy Spirit Hospital also has made accommodations for bariatric patients. It added two rooms that have special beds, chairs and bedside commodes, said Lisa Lewis, chief nursing officer and vice president of patient care services at the hospital.

Holy Spirit has added special stretchers and lifts. It pays attention to width and weight-bearing capacity when buying new equipment, she said.

The hospital also has added larger X-ray and scanning devices to accommodate very large patients, Lewis said.

Another concern involves the dignity of super obese patients.

"One of our core values is the dignity and sacredness of each person we treat," Roberts said.

That can easily be accomplished when you have the right equipment, he noted.

"It's not in any way, shape or form different than typical service when you have the right equipment," he said.


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