Bariatric emergencies

[mariomike]

Toronto uses ambulance buses to transport bariatric emergencies.

The high floor is a steep lift from the curb.

The City just added a custom built Bariatric ambulance to the fleet. Complete with a bariatric cot and a power lift tailgate.

This should help reduce WSIB claims.

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[Oldgateboatdriver]

Maybe I am missing something here, @mariomike : How is the barometric pressure increased for the patient? Is the whole interior of the ambulance pressurized?

 

[Blackadder1916]

This should help reduce WSIB claims.

How many of those injuries are caused getting an already stretchered patient into the bus vice getting the fat b******d onto the cot and down the stairs, or later during transfer at destination?

Occupational Injury Claims Related to Patient Lifting and Moving in a Safety-Oriented Emergency Medical Services Agency - PMC

Background: Patient lifting injuries remain a significant hazard to Emergency Medical Services (EMS) providers despite preventative and mitigative strategies. Objective: To better characterize the nature of occupational injury involving patient and ...

pmc.ncbi.nlm.nih.gov

. . . Forty-two (51.2%) of these injuries occurred when the provider was lifting, transferring, or carrying a patient, not involving a stretcher. . . .

 

[Colin Parkinson]

Maybe I am missing something here, @mariomike : How is the barometric pressure increased for the patient? Is the whole interior of the ambulance pressurized?

That's what I thought as well, we have had to deal with a number patients requiring barometric chambers after diving accidents.

 

[KevinB]

TIL what Bariatric meant.

 

[Oldgateboatdriver]

Oops!. Sorry, got it now @KevinB and @mariomike . I googled "bariatric chamber" and it answered with what is a hyprebaric chamber. Obviously, AI is no smarter than I am.

 

[mariomike]

How many of those injuries are caused getting an already stretchered patient into the bus vice getting the fat b******d onto the cot and down the stairs, or later during transfer at destination?

"What's took you so long?"

 

[OldSolduer]

Several years ago the City of Winnipeg bought an ambulance for really big people as the standard ones were not up to the task

 

[mariomike]

Several years ago the City of Winnipeg bought an ambulance for really big people as the standard ones were not up to the task

Metro used to send this. A 34 inch lift from curb to deck.

 

[mariomike]

That's what I thought as well, we have had to deal with a number patients requiring barometric chambers after diving accidents.

Aka Hyperbaric chamber.

 

[lenaitch]

I remember watching a series a few years ago about EMS in the northern prairies/territories. A lot of patient transfers are by contract air carriers and it seems most don't have cargo doors. The one episode followed how they rigged up a roller system - like they use in warehouses - to get a very bariatric patient through the door then a tight turn into the cabin.

I guess at some point, dignity goes out the window.

We had to deal with a bariatric sudden death in an old, very remote old house in northern Ontario. He was on the second floor with a narrow, steep staircase that did not have a straight approach. There was a window that overlooked a shed-type roof as part of the ground floor. He, indeed, went out the window.

 

[mariomike]

We had to deal with a bariatric sudden death in an old, very remote old house in northern Ontario. He was on the second floor with a narrow, steep staircase that did not have a straight approach. There was a window that overlooked a shed-type roof as part of the ground floor. He, indeed, went out the window.

A "Gilbert Grape" shut-in.

"It's going to take a crane to get her out."

 

[medicineman]

Maybe I am missing something here, @mariomike : How is the barometric pressure increased for the patient? Is the whole interior of the ambulance pressurized?

Bariatric = Mr Creosote/disc popping...Barometric=ear popping

Several years ago the City of Winnipeg bought an ambulance for really big people as the standard ones were not up to the task

The pink "Technical Transport Unit" , so as not to advertise it's a bariatric patient. I thought when I first saw that rig it was the paediatric/neonatal critical care transport unit.

 

[mariomike]

Don't see any lights and sirens on it, or any or any of their "Technical Transport " vehicles.

They don't appear to be part of The City of Winnipeg 9-1-1 system.

Looks like a private non-emergency transfer service, staffed by "Patient Transport Specialists".

https://patienttransport.ca/about/

 

[Blackadder1916]

Alberta defines it as . . .

https://publicshare.albertahealthservices.ca/teams/policydocuments/1/clp-prov-ems-bariatric-response-ambulance-ps-ems-06.pdf

1. Patient Subset
1.1 A bariatric patient is any patient that weighs greater than 150 kg (330 lbs.) and is also broken down into two subsets.

a) Level 1 Bariatric Patient means patients weighing (actual or estimate) between 150 kg (330 lbs.) and 225 kg (500 lbs.) and or having an abdominal width greater than 68.58 cm (27 inches).

b) Level 2 Bariatric Patient means patients weighing (actual or estimate) greater than 225 kg (500 lbs.)

And how many it should take to move one . . .

4. Minimum Levels of Supporting Providers
4.1 High potential for injury to both patient and provider requires minimum levels for supporting providers based on the subset of bariatric patient and bariatric equipment used. Minimum supporting provider levels are clearly outlined in the supporting Provincial Bariatric Response for Ground and Air Ambulance Procedure.

 

[Staff Weenie]

One friend used six firefighters and a canvas tarp to move a 500+ lb patient out of a house. They used cooking oil to help move them through the doors one roll at a time. Another VSA patient had lived on a mattress on a raised concrete slab in the basement.

I was naive enough then to ask how you do CPR on a massive patient who is VSA - the answer is that you put on a show for the family knowing it's not doing anything.

 

[medicineman]

Don't see any lights and sirens on it, or any or any of their "Technical Transport " vehicles.

They don't appear to be part of The City of Winnipeg 9-1-1 system.

Looks like a private non-emergency transfer service, staffed by "Patient Transport Specialists".

https://patienttransport.ca/about/

View attachment 102024

That they are...because of the difficulty transporting them emergently. If they're in need of ALS care or greater, an ALS paramedic or critical care RT goes as medical escort.

 

[medicineman]

One friend used six firefighters and a canvas tarp to move a 500+ lb patient out of a house. They used cooking oil to help move them through the doors one roll at a time. Another VSA patient had lived on a mattress on a raised concrete slab in the basement.

I was naive enough then to ask how you do CPR on a massive patient who is VSA - the answer is that you put on a show for the family knowing it's not doing anything.

I remember helping transfer a patient from KGH to the airport when doing routine ride alongs with Kingston EMS - didn't have bariatric stretchers then (around 1999/2000 IIRC) and the security straps wouldn't stretch - I basically secured the patient to the airevac cot and ambulance stretcher with every triangular bandage we could find in our ambulance and the back up one that came with us. Patient was around 450lbs, stretcher was rated to 325. Was even harder getting them onto the aircraft, was almost like bringing a couch through a door - slicing the pie, scootch in a bit, slice it some more. We have a critical care transport plane now out of Winnipeg that has a wide cargo hatch and wide body to allow easier ingress/egress for patient as well being able to accommodate crew and equipment better.