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Dade Fire-Rescue Fully Equipped to Aid the Obese

MIAMI -- Miami-Dade Fire Rescue officials received the emergency dispatch: a man in Southwest Miami-Dade was having trouble breathing.

One fact complicated the otherwise routine call. The man weighed about 750 pounds.

But rescue workers had a solution for an emergency that would have once forced workers to build an improvised stretcher or in some extreme cases bring a patient to the hospital in a flatbed truck.

This year the department retrofitted three rescue trucks as bariatric transport units -- with a special ramp and lift system that allows them to transport people who weigh up to 1,100 pounds to the hospital.

"Over the years we've noticed we've been responding to an increasing number of patients who are quite heavy, for certain in excess of 500 pounds," the maximum weight on the department's current stretchers, said Lt. Eddy Ballester, a fire rescue spokesman.

Across the country, 34 percent of Americans are obese. "Obesity prevalance in the United States has increased dramatically over the past several decades," said Karen Hunter, a spokeswoman for the Centers for Disease Control and Prevention.

About 23 percent of Floridians are obese, according to the CDC.

That's up about 10 percent from 1990, when about 13.5 percent of Floridians were obese.

Using grants, the Miami-Dade department spent about $35,000 to retrofit the bariatric units, purchase the stretchers and install the system used to lift the patient inside.

"Not only is this going to prevent injuries to firefighter-paramedics but it will allow a more rapid response," Ballester said.

SPRAINS AND STRAINS

Over the years, numerous firefighters have suffered back sprains and strains from lifting obese patients, he said. The modified units also allow patients to be moved more quickly and in a dignified manner.

"Historically it has taken longer for obese patients," Ballester said. "Sometimes we'd call a Home Depot to get one-inch plywood to support them."

Since the beginning of the year, the special units have been used for about a dozen calls for patients weighing more than 500 pounds.

The units are also used for regular calls.

The stretcher has a special platform that attaches to the top, giving it a 10-inch wider surface area than other stretchers. Specially designed handles make for easier maneuvering.

Once on scene, the paramedics attach two ramps that align with the wheels of a stretcher. A round metal ring on the end of the stretcher attaches to a steel hook inside the truck.

With the flick of a toggle switch, the machine whirs into action and the steel cable pulls the stretcher inside -- without rescue workers having to lift it.

"One of the biggest things firefighters retire from is back injuries," Miami-Dade fire rescue Capt. Mary Giles said while standing in the driveway of Hialeah Gardens Station 28, where one of the units is housed.

"Having the winch saves us all our backs, having to lift the stretcher into the rescue [vehicle]."

The Broward Sheriff's Office Technical Rescue Team does not have the motorized ramp system.

When calls come in for obese patients, the Broward team uses special boards that attach on top of stretchers that can hold up to 1,000 pounds.

They also use more firefighters to help lift the person.

JUSTIFYING COST

"I would love to have [the Miami-Dade] system, but the problem we see is the cost and justification," said Capt. Mike Nugent. "We have those calls, but we can't justify the cost of that equipment for the call volume."

Fire officials in Miami-Dade did not have numbers of calls for obese patients before the units were retrofitted, saying that while it's a small portion of the population, they wanted to ensure the same level of care that other patients would receive.

"We were looking to ensure dignified transport for the small segment of our community that is often forgotten," said Elizabeth Calzadilla- Fiallo, a department spokeswoman.

Leslie Yates, regional sales manager for Ferno Washington, the company that sold Miami-Dade much of the equipment to retrofit the units, said they have given quotes to five other departments in the state interested in getting the same technology.

The company would not say what other departments in the country had been outfitted with the equipment, but said they've seen about a 10 percent increase yearly in the sale of products used to transport bariatric patients.

"The larger patients have never been able to be transported in a dignified manner," Yates said. "It used to be many years ago they'd lay them on sheets or mattresses."

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