Morbidly Obese and EMS

December 24th, 2007 · No Comments· 24 views

Keeping all of the Federal privacy laws in mind…

There’s overweight and there’s way overweight. When you are morbidly obese, you become unable to stand or move around easily, and for some people nearly impossible.

For the EMT, a morbidly obese patient presents several problems. Transportation is one. Most ambulance gurneys are rated at 500 pounds. A much larger patient risks the failure of your gurney and injury to the patient.

Such a patient may not fit through doors in his or her home. If immobile, they require six, eight or ten people to move them.

Their sheer weight tends to limit how they can be placed. Some cannot breathe any longer on their back due to the weight of their stomachs pressing up against their diaphragm.

Taking precautions against further injury may be impossible. A backboard becomes the equivalent of a thong when place under some patients.

CPR is very difficult, with your patient’s chest a foot thicker than normal, and defibrillators are an issue as well. The normal current settings do not apply to a person with that much fat covering their heart.

Some ambulance agencies have solved some of the problem. Rural Metro in Rochester, New York, has an ambulance dedicated to such patients. A ramp replaces the necessity to lift a gurney into the ambulance. The gurney is replaced with a cart, resembling nothing more than an old fashioned baggage cart from railroad days, with a mattress added to it.

When faced with a morbidly obese patient, don’t be afraid to call for lifting assistance. Eight or ten people may be needed to move your patient. If a specialized transport, like the Rural Metro one is available, get it. The alternative is a very unsatisfactory transport in the emptied back of your rig, with your patient on the floor and all the gurney devices removed to make room for your patient.

Always look for your mechanical advantage whenever you have weight to move. That is especially true with the morbidly obese. Don’t carry when you can slide. Don’t lift without enough people or without moving your patient to the optimum position for any transfer.

Remember, the morbidly obese patient is still a patient. He or she will still be in pain, scared, and have any of the host of maladies that afflict mankind. Treat your patient and not his size.