Ambulances now have winches and ramps

paramedichopeful

paramedichopeful

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Apparently the newer ambulances have a winch and a roll-out ramp to help get obese patients into the back. Here is the link to the page where I saw this:
http://emsresponder.com/web/online/Top-EMS-News/Rates-Rise-for-Obese-Kansas-Ambulance-Patients/1$9796

I know this is going to save a lot of backs but isn't it a little mean and embarrasing for the patients? I mean, being told you're to fat to fit on a regular cot and you're so heavy we have to use a flat-bed tow truck to get you to the hospital?
 
Nothing new. Not to be rude, but really this is just part of the business and has already been posted. It's called a bariatric unit.

Embarrassing? Do you not think they don't know they are fat or obese? What else is someone supposed to do?

R/r 911
 
re

EMS work in steps and the first to steps are

1. BSI

2. Scene safety. which equals 1. MY safety first, 2. My partners second and 3. the rig. Patient is number 4. So anything they can do to improve 1, 2, and 3 takes precidence over the patient. Harsh as it seems it's our reality
 
Not exactly breaking news... however, some counties do not have bariatric stretchers. I remember a EMS call in another county, and they were calling mutual aid to look for a stretcher or bariatric unit that could support the patients weight.

It is embarrassing but its our job to accommodate and transport obese patients in the safest way possible.
 
paramedichopeful said:
I know this is going to save a lot of backs but isn't it a little mean and embarrasing for the patients? I mean, being told you're to fat to fit on a regular cot and you're so heavy we have to use a flat-bed tow truck to get you to the hospital?
Click to expand...

a regular cot has a weight limit. depending on the model 500-600 lbs. There are bariatric stretchers that can handle up to 700-800 lbs. there was recently a pt in Buffalo, NY where there had to remove part of the wall to remove a pt from the 2nd floor. this pt was so large she never went on the stretcher, they put her on a tarp and put her on the floor of the ambulance. I believe you can find video of it from a news station in buffalo.

I am not going to hurt myself or my partner for an obese pt. I have a wife and kids to think about which are more important to me than embarrassing an obese pt that WON'T fit on a regular stretcher. If I get hurt, I am unable to provide for my family. And I can guarantee that the obese pt won't provide for my family.

Obesity is fact of the job these days. but remember from Basic class, who is the most important person on a scene?....I am. Who is 2nd most important?...My partner.
 
If my mind serves me correctly (don't quote me on this), I remember in Frederick County, MD, a really obese patient filed a lawsuit with the county based on discrimination due to weight. Apparently, the patient was transported by EMS in a regular ambulance and the patient had to be placed directly on the floor of the ambulance of which the patient found to be demeaning.

I believe the outcome was the County had to have a bariatric equipped ambulance available for the obese population in the County.
 
I remember years ago in Brooklyn, NY a guy by the name of Hudson weighed over 1,000 pounds. He had to be removed from his apartment by a fork lift after a section of the wall was removed. this happened prior to me being in EMS and was all over the NY news.

There are bariatric stretchers that are weighted higher than normal stretcher and go up and down like normal stretchers. then there are these flatbed cart things that look like they were taken from Home Depot with a winch.
 
I had a partner who hated putting the ramps out for one of our bariatric patients who weighed 600lbs

I told her if she wanted to pay for my back, be my guest. She always said it made him "feel bad"

I told her well he's well aware of his situation and I don't care. He was a fun patient to be honest. Was kinda bummed when he passed away.
 
They usually know they are a problem and aren't to omean about it, but if you're 700 pounds like one lady was, you had to have passed 300 and 400 at some point!

We had a bariatric cot but ended up using the regular one b/c it was a power cot and the bariatric was not and owuld have required a LOT of heavy lifting. I was working for a private at the time and we and one other private were the only ones with units capable of carrying that large of a patient. We had power cots that lifted up to 750 i think and a bari that lifted up to 850 (non power). The other service had a ramp and winch but the pt would be on the floor and no cot so getting them into the hospital would pose another lifting issue. With ours we only had to lift them once. We were called on a 911 call for this lady's abdominal pain. The FD didn;t have units to handle her.
 
My company doesn't have these yet but we're looking at rigs that have them. Eliminating any lifting is a good thing. The biggest cause of a back injury is lifting in an odd position or at a wierd angle, it's never fun to lift a heavy patient but you still have a chance at blowing out your back with the 80lb granny.

Actually the childrens hospital ambulance has the ramps, really helps loading the incubator cot.
 
marineman said:
My company doesn't have these yet but we're looking at rigs that have them. Eliminating any lifting is a good thing. The biggest cause of a back injury is lifting in an odd position or at a wierd angle, it's never fun to lift a heavy patient but you still have a chance at blowing out your back with the 80lb granny.

Actually the childrens hospital ambulance has the ramps, really helps loading the incubator cot.
Click to expand...


Now those are HEAVY
 
paramedichopeful said:
Apparently the newer ambulances have a winch and a roll-out ramp to help get obese patients into the back. Here is the link to the page where I saw this:
http://emsresponder.com/web/online/Top-EMS-News/Rates-Rise-for-Obese-Kansas-Ambulance-Patients/1$9796

I know this is going to save a lot of backs but isn't it a little mean and embarrasing for the patients? I mean, being told you're to fat to fit on a regular cot and you're so heavy we have to use a flat-bed tow truck to get you to the hospital?
Click to expand...

Such is life. I'm a huge advocate for the dignified treatment for morbidly obese, but sometimes dignity gives way to necessity. If they are too big, they are too big. By trying to save their feelings and fit them in regular sized stretchers or not use a lift or winch, you are not only risking your safety and wellbeing but their safety and well being too.
 
We don't have lifts, but we have 2 bari gurneys. For our NICu, we have a lift.
 
We have a bariatric unit, the cot is rated for 1400lbs in the full down position (where it is locked by the company.) When raised, the rating goes down to 800lbs. Because of that the company has locked the gurney in the down position, and then provided us with several different methods of getting patients onto the gurney. The unit also has a ramp and winch to assist in getting the pt in and out of the ambulance safely.

I acknowledge the fact that there often isn't a lot of dignity in how we have to move bariatric patients, but in reality, there just aren't a lot of options in some cases. With the US developing more and more morbidly obese people who are non ambulatory heavy duty hardware is going to become a reality for any branch of the healthcare industry.
 
My company has one bariatric unit that is typically not on the road unless needed. It is awesome for transports because those are typically planned and don't usually require an emergent transfer. We have had more than one morbidly obese person just on the floor of an ambulance on a 911 because the bariatric was already in use. Yes it sucks for the patient. Blowing out my back would suck a lot more.
 
Our new trucks have all been outfitted with the necessary fittings for the bariatric equipment so that when a bariatric call comes in, the idea is that rather then needing a specific truck, they call for back-up from the Special Response Unit (Tactical team that also covers operational support, bariatrics, etc) who comes with the ramps, winch and adapter deck for the stretcher and set it up on the truck already on scene. This is still being phased in but most of our trucks should be so equipped if plans continue. They may not, as the most recent bid is looking at tail lifts being standard on all trucks instead to limit lifting on all calls, not just bariatric.
 
I've never understood why those incubator units don't come with an 'L' collapsible bottom like the manual cots do or a power lift like the stryker power cots...
 
Most of the bari-patients I've transported are more worried about me than themselves, and have no problem with anything we do to make our jobs easier. Fact is, a ramp and a wider (and more stable) stretcher would probably increase comfort and reduce the fear of being dropped. My only gripe is trying to wedge a bariatric stretcher into a Type II. Everything fits, but it's a squeeze.
 
Where I work we have the Sprinter type ambulances and recently we got a call for a 700 pounder. When we got there we found him sitting in a chair, soaked through with all kinds of rot and filth. It took me and my partner and 6 fire fighters to lift this guy onto a tarp and carry him out to our gurney. I used to love the Sprinters because they are so tall, now I think I have a preference for really big boxy types. A ride in the back squeezed up nice and cozy with that piece of work is all the convincing I need to get a bariatric unit for our company!:wacko:
 
point made. I understand about safety. But why won't the regular cots hold the heavier pt.? The ones used around here have electronic lift with a battery pack out of like a cordless drill and they can lift almost 1500 lbs. The EMS director says that it is not uncommon to roll someone into the ER with 2 or 3 people on top of them doing CPR, taking vitals, etc. Has anyone ever seen this? I mean, it's cramped enough for me to get on there (back when I had that stinkin' head on wreck I measured 6'2'' and had freakishly wide shoulders. Now I'm 6'4'' and still have really wide shoulders. How can you have room for 3 people on there when 1 person does good to fit on?
 
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