obese pt unable to be loaded into ambulance

At that point around here they get a ride on a flatbed wrecker
 
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This happened in the Redding, CA area ~ 5 years ago. 900+ lbs. Patient hadn't got up from the couch she was sitting on for over 2 years. Wall removed from side of home. Patient along with couch lifted using a fork lift and she was placed on a flatbed tow for transport. Upon arrival at ED they found that the fabric of the couch cushions had migrated into her skin which then grew around it, fusing it to her. Never quite understood how this could have happened as she had to have eliminated her bowel at some point and lifted from the couch.
 
A while ago before I showed up, I guess my service had to cut the wall out of a house to get someone out. He had been lying on a mattress on the floor forever and had built a cinder-block wall at the foot of his bead so no one could see into the room.

Apparently the rescue/extrication squad had to cut him out and he was dragged out onto the floor of the amb which was minus the gurney.
 
The way we handle bariatric calls is this:
- Initial crew responds as per deployment plan
- Either the dispatch info or Pt. contact determines bariatric call
- Six vehicles (two per district) are equipped to handle our bariatric equipment
- Special Response Unit (SRU) is rolled with bariatric equipment and for lift assist.

Our bariatric equipment consists of
- transfer flats
- airbags for lifting
- ramps
- winch
- centre-mount stretcher with bariatric adaptor deck

Our bariatric capable trucks are our standard Demers units with the wiring and electrical systems in place to handle the winch system, an adjustable mounting for the centre-mount stretcher and the attachment points for the ramps.

The bariatric equipment is kept in our two SRU trucks which are pick-up truck based response units. SRU also handles our tactical, MCI, rescue support, rehab, etc.


This brings to mind a call that happened in a neighbouring county a couple years back. They had a 16y/o M come in in heart failure. He was over 800lbs (no exact weight) and swirling the drain. He had a complicated medical Hx that I'm not privy too, but I know it included some severe developmental delays. The hospital called for air for CCT to Sick Kids. The crew arrived and started their treatment. One of the medics asked for a weight for fuel consumption. Unfortunately the Pt. maxed out the scales they had available. While the crew debated how they'd get an accurate weight one of the pilots came in to check on the delay. He took one look at this poor kid and said something to the effect of "Guys, he's not going to physically fit in the chopper." Sure enough he was too big to physically fit.
 
I don't know of a couch in Redding that would hold 900 lbs

We had a pt around 500 lbs, severely obtunded and had to negotiate a narrow hallway with a bend. We had six people on scene, but on the bend we could only use four, one had the head and one had the legs. My coworker (who was my active duty crew chief when I wasn't working civilian ambulance) was stuck with the hips and injured his back. Had to tie her onto the ambulance litter with sheets.
 
Another call comes to mind. Not my call, but happened at a service in my area.

Called for a chest pain call to a basement apartment accessible only from the backyard walk-out. Pt. very obese, exact weight I don't know. No real access other than from the end of the street down the length of backyards, in mucky, snowy early spring conditions.

Working with FD the inital plan was to extend the boom on the ladder truck, sling the patient underneath and withdraw her that way. Unfortunately the Captain determined that the Pt. was beyond what the truck was for fully extended and the fear was the truck would tip. They ended up need to bring a JCB into the backyards, chew up the lawns like crazy and pull her out that way.
 
Corky said:
This happened in the Redding, CA area ~ 5 years ago. 900+ lbs. Patient hadn't got up from the couch she was sitting on for over 2 years. Wall removed from side of home. Patient along with couch lifted using a fork lift and she was placed on a flatbed tow for transport. Upon arrival at ED they found that the fabric of the couch cushions had migrated into her skin which then grew around it, fusing it to her. Never quite understood how this could have happened as she had to have eliminated her bowel at some point and lifted from the couch.
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The hospital didn't call in a couple of plastic surgeons, did they? Because that is an exact match for an old episode of nip/tuck...<_<
 
Measure diameter of pt.
Go to your local Caterpillar (TM) Dealership
Borrow a tire with same diameter hub
Insert patient
Roll 'em, roll 'em, roll 'em!
 
triemal04 said:
The hospital didn't call in a couple of plastic surgeons, did they? Because that is an exact match for an old episode of nip/tuck...<_<
Click to expand...

Because if something happened in a TV show it couldn't possibly happen in real life.
 
Sasha said:
Because if something happened in a TV show it couldn't possibly happen in real life.
Click to expand...
Well yeah. Or is it everything that happens on TV happens in real life? I get confused sometimes...:D
 
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