Bariatric Cots and Type II Ambulances

[armywifeemt]

Does anyone have any opinions on the use of bariatric cots in type II ambulances? I'd appreciate the perspective of some other EMTs on the safety of this practice for both the crew and the patient. How many of you have been asked/told by employers that you had to transport a bariatric patient on a bariatric cot in a type II ambulance? How many of you have then had to go on and do runs for normal sized patients with this configuration? What do you think of it?

I'm looking for a healthy debate on the matter. I don't have a deliberate goal. I just want to see what the general consensus is.

 

[DesertMedic66]

Bariatric cots fit in normal type 2 ambulances?

All the bariatric cots I have seen are in type 3 ambulances that have upgrades to it (ie ramps for the cot and a winch to pull them up)

 

[Aprz]

I've only used bariatric cots in type IIs at both companies I've worked. No problems with it.

 

[armywifeemt]

I've only used bariatric cots in type IIs at both companies I've worked. No problems with it.

Just curious... how much room does this leave you for patient care/how do you administer patient care?

 

[exodus]

Just curious... how much room does this leave you for patient care/how do you administer patient care?

Just enough to fit your legs in with your feet facing sideways. I always end up half laying on the bench to fit while doing bp's, and then sitting on the bench, behind the head where it's tilted up so I can still talk and see the pt.

Safe meh, manageable, very.

 

[Shepard]

When I was in EMT on my ridealong I did a shift on a transport rig. Type II Sprinter. We used a stryker bari cot for a Bari transport. There's enough room for a foot sideways next to the pt and a leg up on the bench. Its functional but not really ideal.

 

[Aprz]

Sit at the captain's chair. </kidding>

I cannot recall having to awkwardly sit on the bench seat. I think I may have had to rotate my feet to get by, but I can't remember. Maybe when I get back to the station, I'll check ot out.

 

[Anjel]

At least a couple times a month. I sit half laying on the bench with my legs hanging off the end of the bench.

If the pt arrested we would be screwed. But other than that. It's doable.

 

[usalsfyre]

Doable from what theses guys say, but we restrict bari cots to boxes from a comfort and appearance standpoint.

 

[Handsome Robb]

Sit at the captain's chair. </kidding>.

why kidding? I sit in the airway chair all the time...

We only have type IIIs and it's still tight with a bari gurney. I can't imagine putting one in the back of a type II.

 

[VCEMT]

Never, there is a bariatric rig for that. However, we've managed to get those really huge bariatric patients on a regular gurney.

 

[Meursault]

I've used both Stryker MX-PRO bariatrics and Ferno 35-X with the LBS Jr. bariatric top. The Strykers fit in our Type IIs, but there's only a few inches of space from the stretcher edge to the bench; patient care is near-impossible and the service uses the Ferno stretchers exclusively in Type IIs.

I hate everything about the Ferno 35-X, and the LBS Jr. top is poorly designed, too. They do fit in Type IIs with adequate space for movement, though.

Since you're fishing for validation, I should probably answer the original question.

I don't see any safety problems in transporting stable patients on a bariatric cot/stretcher/"patient transporter" in a type II. Likewise, normal-sized patients can be secured to a bariatric stretcher comfortably and safely, especially if you have removable strap extenders. Too much space is a lot less problematic than too little, and padding goes a long way.

The crew safety issues associated with bariatric transports have nothing to do with the amount of space in the ambulance (unless the patient's supine, the shoulder straps are on wrong, and your partner stops short; squish!).

The improvement in patient safety and comfort from using a bariatric stretcher is substantial, and it improves crew safety, too. Against that, there's the remote possibility that the patient will deteriorate en route and desperately need an intervention that can only be performed by someone sitting next to them with their feet pointing forward.

 

[Tigger]

We do it frequently. We have a few Ferno LBS junior tops for our 35x stretchers. With four people loading its generally not a problem getting the patient in. However since the cot is wall mounted, we cannot take complete advantage of the having the "wings" of the LBS in the halfway down position so as to increase the stretchers surface area. The cabinets are in the way on the right side, and there's barely any room for your legs on the bench on the left. For BLS IFT it's not too big of a deal, I'm a tall guy and can still weasel my way next to a 500lb patient to get a BP. I sit in the captain's chair for most of the ride though.

If the patient is exceptionally large, we'll use a medic truck (box), but dispatch is quite loathe to do this...

 

[Meursault]

we cannot take complete advantage of the having the "wings" of the LBS in the halfway down position so as to increase the stretchers surface area.

I never realized that was the idea until I looked at the Ferno site.

/me hangs his head in shame for not reading the manual like the stretcher says.

I'd be too worried that the load would shift and the patient would slide off or tip the cot. There aren't many doorways that you could fit that through, either.

 

[Hunter]

We use the stryker LBS stretcher in type II all the time. There's no leg room and usually I'll sit indian style on the bench or just lay down on the bench for any treatment.

 

[Aprz]

why kidding? I sit in the airway chair all the time...

We only have type IIIs and it's still tight with a bari gurney. I can't imagine putting one in the back of a type II.

Cause it's such a simple work around/alternative to what everyone is saying. BLS wise, I wouldn't be able to get a blood pressure unless I used the neck , we don't have automated BP on BLS here.

My previous company used ferno everything. The one that has feet room somebody describe, that's probably the one we had. I don't remember making any other difference in the call except a bigger gurney and lift assist.

 

[Imacho]

Any one have a pt so large, you had transport with out the gurney and antlers?

 

[DesertMedic66]

Any one have a pt so large, you had transport with out the gurney and antlers?

Not on my unit but my partner and I did help a fire department unload their patient from the back. They left their fire chief at the residence with the gurney and the antlers. Carry alls can be a wonderful creation.