The Network for People Fighting for Fat Rights
EMTs having trouble with lardasses
By SARA SHEPHERD
The Kansas City Star Area ambulances are transporting more supersize patients than ever — several a day, including some as large as 800 pounds.
And as the number of morbidly obese Americans goes up, emergency crews are straining their backs and budgets to get them to hospitals.
Especially during a life-threatening emergency, the process requires not only brute strength, but creativity on the fly.
Area ambulance workers have enlisted brawny firefighters, makeshift pulleys, tarps, plywood and even a hydraulic-lift truck to get patients up or down stairs, through narrow hallways, out of houses and on the road.
“There’s a surprise around every corner,” said Jeff Johnson of Johnson County Med-Act. “If somebody’s life is on the line, we’ll do everything that we can to help that individual. But we also have to be very careful for our own safety.”
Although specialty equipment is making the process easier for ambulance workers and more dignified for patients, the devices are expensive and still not widely used.
American Medical Response (AMR) in Independence is the only area ambulance provider — and one of a relatively small number nationwide — to have a bariatric ambulance.
The vehicle features a reinforced floor and shocks, a ramp and a motorized winch to pull a loaded gurney into the back. While AMR’s standard cots hold 450 pounds, the bariatric cot can support 850 pounds in the extended position or 1,600 pounds when lowered.
Kansas City’s Metropolitan Ambulance Services Trust (MAST) plans to add a similar unit to its fleet this fall.
AMR bought the ambulance to handle an increasing number of 350-pound-plus patients who need regular transportation to dialysis or other medical treatments, said operations manager Cam Hendry. But it is also dispatched to other cities when needed for scheduled transports and 911 calls.
In May, AMR recorded more than 60 transports in its bariatric unit. That is double the number from May 2008 and triple the number from January 2008.
In 2007, MAST transported only a couple of patients heavier than 400 pounds each month. This year it has averaged more than 20 such calls per month.
Some big challenges
When moving extra-large patients, predicaments abound.
About two years ago, Johnson County Med-Act was called to help an approximately 800-pound man who went into cardiac arrest in the basement of his home, Johnson said.
Medics performed CPR. Firefighters constructed a pulley system using the winch on their truck and a tree in the yard. About 15 people helped pull the man up the stairs and out of the house on a tarp.
Paramedics got the patient to a hospital, although he died a few days later, Johnson said.
Years earlier, workers had to cut a hole in a Johnson County house to remove the body of an 800-pound man who died before paramedics arrived.
MAST operations manager Tom Collins recalled transporting an extremely obese man who lived in a house with a hill outside.
Paramedics found him surrounded by food containers and lying in his own waste — a common state for patients so large they are unable to walk.
Under Kansas City ordinance, MAST can’t turn down anyone who wants an ambulance ride to the hospital unless circumstances are logistically impossible, Collins said. Someone more than 1,000 pounds, for example, might require a crane to move.
“If it’s beyond the capabilities of the system, it’s beyond the capabilities of the system,” Collins said, but he added that paramedics are known for short-order problem-solving. “Usually, if it needs to get done, they can figure out how to get it done.”
About 10 years ago, when extremely obese patients were rare, MAST always called firefighters to help with them.
Collins said up to a dozen people slid patients on a huge tarp that firefighters normally used to shield equipment from the rain and hoisted them onto the floor of the ambulance. Firefighters waited days for the tarp to be retrieved from the hospital and disinfected.
In one case, when responders couldn’t get a 750-plus-pound man into the ambulance, they called a medical supply company and borrowed a truck with a hydraulic lift, Collins said. A paramedic grabbed his equipment, climbed in with the patient and headed to the hospital.
Most providers now have special tarps that are more comfortable for patients and take fewer workers to lift.
Costly, risky calls
Calls involving extra-large patients can be dangerous and expensive.
Unwieldy patients are at risk of being dropped or falling off too-narrow cots. Responders risk back injuries from heavy or contorted lifting.
AMR and MAST send two crews, or four staffers, to calls involving bariatric patients.
Extra-heavy patients or more complex extrications require even more hands.
Ambulance workers welcome specialized equipment to help with the job, said Connie Meyer, president-elect of the National Association of Emergency Medical Technicians and an EMS captain for Johnson County Med-Act.
“They’re finally starting to get us some things to handle patients safely,” she said. “We have lots more larger patients than we’ve ever had, and they tend to have more medical problems.”
The equipment is becoming more common, Meyer said, but it remains cost-prohibitive for many providers.
AMR has about 30 bariatric ambulances in the 250 communities it serves nationwide, according to company officials.
AMR in Independence began deploying its bariatric unit in 2005.
“The patients got safer and more comfortable transport, and we reduced the number of workplace injuries,” said field supervisor Jason Krout.
MAST expects to have a bariatric ambulance deployed by fall, said governmental relations director Jason White. The specialized unit and cot are estimated to cost about $30,000 more than other new ambulances, which run more than $100,000 each.
Last week the Shawnee County Commission in Kansas agreed to allow AMR in Topeka to nearly double ambulance costs for patients weighing 350 pounds or more — an effort by the company to offset costs of its recently deployed bariatric unit.
Krout said AMR of Independence charges about $200 more for the bariatric unit than a regular ambulance ride, mainly to help with equipment maintenance costs.
Sensitivity is a must
A 600-plus-pound man that MAST transported regularly more than 10 years ago eventually became angry with the way he was being moved — on a borrowed fire department tarp carried by a dozen people, then lying on the floor of the ambulance.
“It wasn’t meant to be mean, but it was the only way that we could transport him,” Collins said.
Collins said MAST regularly transported another patient so embarrassed by the loading process that she cried during every trip. To help her feel better, Collins said, he usually climbed into the back of the ambulance and held her hand.
Peggy Howell, spokeswoman for the National Association to Advance Fat Acceptance, said most people really want to do things for themselves and feel humiliated when they can’t.
“Weight already carries a lot of stigma with it, and people are very often demeaning and negative toward fat people,” she said.
Even when specialized equipment is lacking, Howell said, providers should treat large patients with the same respect and care that they would anyone else.
Krout said Independence’s bariatric patients seem grateful for the special equipment.
“We just protect their dignity,” he said, “and that’s the big thing for them.”
Extreme obesity
More than one fourth of U.S. adults are obese, and more than 6 percent are classified as morbidly — or extremely — obese.In the 1960s, fewer than 1 percent of Americans were morbidly obese, according to the National Center for Health Statistics. By the early 1990s, the rate reached 3 percent.
Obesity is classified as having a body mass index of 30 or higher. Morbidly obese people have a BMI of 40 or higher and typically weigh more than 100 pounds over their healthy body weight.
Examples: A 5-foot-6-inch person weighing more than 250 pounds or a 6-foot person weighing more than 300 pounds.
BMI, calculated using height and weight, provides a reliable indicator of body fatness for most people.
The Kansas City Star Area ambulances are transporting more supersize patients than ever — several a day, including some as large as 800 pounds.
And as the number of morbidly obese Americans goes up, emergency crews are straining their backs and budgets to get them to hospitals.
Especially during a life-threatening emergency, the process requires not only brute strength, but creativity on the fly.
Area ambulance workers have enlisted brawny firefighters, makeshift pulleys, tarps, plywood and even a hydraulic-lift truck to get patients up or down stairs, through narrow hallways, out of houses and on the road.
“There’s a surprise around every corner,” said Jeff Johnson of Johnson County Med-Act. “If somebody’s life is on the line, we’ll do everything that we can to help that individual. But we also have to be very careful for our own safety.”
Although specialty equipment is making the process easier for ambulance workers and more dignified for patients, the devices are expensive and still not widely used.
American Medical Response (AMR) in Independence is the only area ambulance provider — and one of a relatively small number nationwide — to have a bariatric ambulance.
The vehicle features a reinforced floor and shocks, a ramp and a motorized winch to pull a loaded gurney into the back. While AMR’s standard cots hold 450 pounds, the bariatric cot can support 850 pounds in the extended position or 1,600 pounds when lowered.
Kansas City’s Metropolitan Ambulance Services Trust (MAST) plans to add a similar unit to its fleet this fall.
AMR bought the ambulance to handle an increasing number of 350-pound-plus patients who need regular transportation to dialysis or other medical treatments, said operations manager Cam Hendry. But it is also dispatched to other cities when needed for scheduled transports and 911 calls.
In May, AMR recorded more than 60 transports in its bariatric unit. That is double the number from May 2008 and triple the number from January 2008.
In 2007, MAST transported only a couple of patients heavier than 400 pounds each month. This year it has averaged more than 20 such calls per month.
Some big challenges
When moving extra-large patients, predicaments abound.
About two years ago, Johnson County Med-Act was called to help an approximately 800-pound man who went into cardiac arrest in the basement of his home, Johnson said.
Medics performed CPR. Firefighters constructed a pulley system using the winch on their truck and a tree in the yard. About 15 people helped pull the man up the stairs and out of the house on a tarp.
Paramedics got the patient to a hospital, although he died a few days later, Johnson said.
Years earlier, workers had to cut a hole in a Johnson County house to remove the body of an 800-pound man who died before paramedics arrived.
MAST operations manager Tom Collins recalled transporting an extremely obese man who lived in a house with a hill outside.
Paramedics found him surrounded by food containers and lying in his own waste — a common state for patients so large they are unable to walk.
Under Kansas City ordinance, MAST can’t turn down anyone who wants an ambulance ride to the hospital unless circumstances are logistically impossible, Collins said. Someone more than 1,000 pounds, for example, might require a crane to move.
“If it’s beyond the capabilities of the system, it’s beyond the capabilities of the system,” Collins said, but he added that paramedics are known for short-order problem-solving. “Usually, if it needs to get done, they can figure out how to get it done.”
About 10 years ago, when extremely obese patients were rare, MAST always called firefighters to help with them.
Collins said up to a dozen people slid patients on a huge tarp that firefighters normally used to shield equipment from the rain and hoisted them onto the floor of the ambulance. Firefighters waited days for the tarp to be retrieved from the hospital and disinfected.
In one case, when responders couldn’t get a 750-plus-pound man into the ambulance, they called a medical supply company and borrowed a truck with a hydraulic lift, Collins said. A paramedic grabbed his equipment, climbed in with the patient and headed to the hospital.
Most providers now have special tarps that are more comfortable for patients and take fewer workers to lift.
Costly, risky calls
Calls involving extra-large patients can be dangerous and expensive.
Unwieldy patients are at risk of being dropped or falling off too-narrow cots. Responders risk back injuries from heavy or contorted lifting.
AMR and MAST send two crews, or four staffers, to calls involving bariatric patients.
Extra-heavy patients or more complex extrications require even more hands.
Ambulance workers welcome specialized equipment to help with the job, said Connie Meyer, president-elect of the National Association of Emergency Medical Technicians and an EMS captain for Johnson County Med-Act.
“They’re finally starting to get us some things to handle patients safely,” she said. “We have lots more larger patients than we’ve ever had, and they tend to have more medical problems.”
The equipment is becoming more common, Meyer said, but it remains cost-prohibitive for many providers.
AMR has about 30 bariatric ambulances in the 250 communities it serves nationwide, according to company officials.
AMR in Independence began deploying its bariatric unit in 2005.
“The patients got safer and more comfortable transport, and we reduced the number of workplace injuries,” said field supervisor Jason Krout.
MAST expects to have a bariatric ambulance deployed by fall, said governmental relations director Jason White. The specialized unit and cot are estimated to cost about $30,000 more than other new ambulances, which run more than $100,000 each.
Last week the Shawnee County Commission in Kansas agreed to allow AMR in Topeka to nearly double ambulance costs for patients weighing 350 pounds or more — an effort by the company to offset costs of its recently deployed bariatric unit.
Krout said AMR of Independence charges about $200 more for the bariatric unit than a regular ambulance ride, mainly to help with equipment maintenance costs.
Sensitivity is a must
A 600-plus-pound man that MAST transported regularly more than 10 years ago eventually became angry with the way he was being moved — on a borrowed fire department tarp carried by a dozen people, then lying on the floor of the ambulance.
“It wasn’t meant to be mean, but it was the only way that we could transport him,” Collins said.
Collins said MAST regularly transported another patient so embarrassed by the loading process that she cried during every trip. To help her feel better, Collins said, he usually climbed into the back of the ambulance and held her hand.
Peggy Howell, spokeswoman for the National Association to Advance Fat Acceptance, said most people really want to do things for themselves and feel humiliated when they can’t.
“Weight already carries a lot of stigma with it, and people are very often demeaning and negative toward fat people,” she said.
Even when specialized equipment is lacking, Howell said, providers should treat large patients with the same respect and care that they would anyone else.
Krout said Independence’s bariatric patients seem grateful for the special equipment.
“We just protect their dignity,” he said, “and that’s the big thing for them.”
Extreme obesity
More than one fourth of U.S. adults are obese, and more than 6 percent are classified as morbidly — or extremely — obese.In the 1960s, fewer than 1 percent of Americans were morbidly obese, according to the National Center for Health Statistics. By the early 1990s, the rate reached 3 percent.
Obesity is classified as having a body mass index of 30 or higher. Morbidly obese people have a BMI of 40 or higher and typically weigh more than 100 pounds over their healthy body weight.
Examples: A 5-foot-6-inch person weighing more than 250 pounds or a 6-foot person weighing more than 300 pounds.
BMI, calculated using height and weight, provides a reliable indicator of body fatness for most people.
Replies to This Discussion
-
Permalink Reply by Plant Walks on -
I wonder who Zucchini is and why this article is posted here with the word "lardasses." Plus-sized clients should be regarded the same way as, say, wheelchair-bound clients, whose chairs are heavy. Would it be right to be cruel and insulting to people in wheelchairs who need accessibility, or to take it out on them if they need their chairs carried up staircases or onto public buses because there weren't ramps or other mechanisms to help them?
Or is it simply a matter of realizing that entryways to buildings, and buses, need wheelchair accessible design and equipment?
Well, it's the same thing with equipment for plus-size people, plus providing plus-sized people with services so that they don't end up in dreadful and inhuman circumstances such as living surrounded by their own wastes or unable to get out of the basement. A person in such a situation needs home assistance, just as many types of people do, and accessible housing.
It seems to me Zucchini is laboring under the myth that greater weight is merely a choice and that if we only "chose" differently, we would be slim. Well, I've been trying to be thin(ner) ever since I was thin, when my ignorant and fat-paranoid pediatrician put me on a starvation diet, and that (the dieting) is precisely what made me binge while slowing my metabolism, causing me to endlessly put on weight. Now I struggle to STOP going hungry and skip meals, even though I know that STOPPING my self-starving is what I need to do. I've been the same weight now for 5 years (within a range of 10 lbs, and mostly 5 lbs.), since I finally figured out that DIETING, the very solution doctors recommend, was what was causing the bingeing and cravings for foods high in fat and sugar.
So before being quick to blame fat people for being fat, it's important to realize that there may be extenuating circumstances, such as a fat-hating diet culture and doctors who have been brainwashed into believing that dieting (undereating) will cause weight loss, when in fact, it promotes weight gain.
© 2009 Created by Krissy D on Ning. Create Your Own Social Network
