XL Ambulances ?

[Guest]

The obesity epidemic must be really out of control !!!!!

local6.com

XL Ambulances Brought Into Service For XL Patients

POSTED: 3:24 pm EST March 29, 2006

UPDATED: 3:40 pm EST March 29, 2006

LAS VEGAS --

A Las Vegas company is putting a new extra-large ambulance into service to handle extra-large patients.

American Medical Response called the $250,000 rig its bariatric unit. It bought it at the request of the Clark County Fire Department.

The vehicle looks like a regular ambulance. But it's extra-wide, and has a larger gurney, a winch and ramps capable of loading up to 1,600 pounds.

A company official said that in the last six months, AMR has handled 75 calls involving patients that weighed more than 600 pounds.

He said moving someone that large in a regular ambulance poses safety problems for the patient -- and for paramedics and ambulance crew members.

[Guest KFD236]

Well the obesity epidemic I guess is on the rise but I guess you really never notice until you have to pay $250,000 for an extra large ambulance. You don't really hear about it around here but when you do people act like they have never heard of an 800 pound man that needed transport to the ER after a mva, but I guess it is all to common in Clark County.

Edited March 30, 2006 by kfd-exchief

[Guest]

Well the obesity epidemic I guess is on the rise but I guess you really never notice until you have to pay $250,000 for an extra large ambulance. You don't really hear about it around here but when you do people act like they have never heard of an 800 pound man that needed transport to the ER after a mva, but I guess it is all to common in Clark County.

←

Quite true, it is a really rare occurance around here. But then again we're a... well not small, but not huge town, so we don't have the amount of people as a city like Las Vegas.

But still, 75 calls in 6 months about people over 600lbs? That's insanity.

[cas2383 22]

Maybe that number is nationwide? AMR runs a large patient unit in CT as well with the same type of equipment mentioned above.

[Guest]

Nationwide would make more sense, otherwise I'd say watch out for all the buffets in Las Vegas.

[Guest]

It looks like that # of calls was for Clark Co. alone...

Special Ambulance Handling Obese in Vegas

The Associated Press

Wednesday, March 29, 2006; 4:56 PM

LAS VEGAS -- An ambulance company has responded to oversize needs in southern Nevada by providing an ambulance equipped to handle patients weighing 500 pounds or more.

"We're getting more and more requests to transport larger patients every day," said Roy Carroll, operations manager at American Medical Response, one of two companies with Clark County Fire Department contracts to provide medical transport in and around Las Vegas.

Crews have called 75 times in the last six months for additional manpower to handle morbidly obese patients, said Chris Piper, a western regional spokesman for Greenwood, Colo.-based AMR. He said the largest patients weighed more than 500 pounds.

Carroll, in Las Vegas, called handling large patients difficult and unsafe for patients, paramedics and emergency medical technicians.

"Not only does this person not fit, there's a chance he or she could fall," Carroll said. "Our job is to get that patient to where they need to be safely and in a dignified manner. Traditional ambulances can't do that."

The company recently put into service a $250,000 bariatric ambulance, which looks like its other 80 ambulances, but is extra-wide and has a larger gurney, a winch and ramps capable of loading up to 1,600 pounds.

Clark County spokesman Bob Leinbach called the need for the larger ambulances obvious.

"If you don't think it's needed, all you have to do is look around," Leinbach said. "Americans are heavier."

The county's other ambulance provider is awaiting delivery of a bariatric ambulance and recently bought four electric gurneys capable of handling patients weighing up to 750 pounds, said Matthew Cox, a spokesman for MedicWest Ambulance.

"There's less stress on the paramedics' backs and it's a better stabilizer for the patient," Cox said.

Of Nevada's 1.7 million adult residents in 2004, the federal Centers for Disease Control and Prevention and the state Health Division estimated that 21 percent, or about 357,000, were obese.

___

Information from: Las Vegas Review-Journal, http://www.lvrj.com

[roeems87 0]

just cut the person in half, then you can use two real size ambulances...

kidding of course...

Edited March 30, 2006 by roeems87

[csf248 0]

Any Pics?

[BedfordFire 7]

At this rate, we're gonna have manufacturers like Seagrave building super sized ambulances...

Only in America

[JBE 328]

There's some department in either PA or one of the Mid-Western states that uses a Heavy Rescue type apparatus as an ambulance. I thought it was a bit of overkill, but apparently they were ahead of the curve.

[Eagle24 2]

Any Pics?

←

pics of a 600 lb person being loaded into an XL ambulance?...possibly with a system of pulleys? let me know if you get your hands on one of those lol-i'd like to see that...as for the 75 calls-that's horrible cuz you know those EMT's probably had to pull them up/down a few flights of stairs with a stair chair or reeves...the big guys never live on the bottom floor

[John Meeker Jr 0]

I have seen a very minor car accident where the Driver had to be cut out of the car because they were to big to be removed any other way. The person was not able to get them selves out and there was no rome to rotate the patient on to a back board.

Prior to extrication the car had minor damage. But remove a door or two and a B post and the car was toast. The owner understood and said do what you have to.

[Guest]

HandiRamp System

This medical ramp system is comprised of; a pair of 1500 lb capacity channel track ramps with anti-slip tape and inherent wheel guide, a 12 volt 3000 lb capacity winch, a 1500 lb capacity block & tackle, a pair of cordura tow straps, and an MX-Pro 1600 lb capacity bariatric gurney.

This system allows EMS workers to load a patient into the ambulance without having to lift, pull, or push at all. The winch and gurney do all the work and the patient is then not jostled by being lifted.

The ramps themselves are made of durable, extruded aluminum tracks with an inside diameter of 6". There are no difficult to manipulate buttons or telescoping parts to get caught on.

The simplicity of this system makes it so effective. There is no lifting of the gurney, which in many cases can pose the problem of it tipping over. Every aspect of this system makes it comfortable and safe for the patient and the EMS technicians.

Package Specs -

Strong Extruded Aluminum Ramps with 1500 lb capacity

Available in 10',11' or 12' long

Easy to use straight ramps

2 inch safety curb to keep gurney on tracks

3000 lb capacity 12 volt winch

1500 lb capacity block & tackle

1" x 3' cordura straps (pair)

Mx Pro 1600 lb capacity gurney

Oct 11, 2005 ourtesy of

http://www.handiramp.com/

Edited March 30, 2006 by hoss

[Guest]

If the person is that obese, do what has always been done. Call the fire department for lift assistance. Once you get the patient into the back of the bus and locked in, you really have no problem.

[JustSomeGuy 0]

I think if you call this ambulance and you need the wench you have to say "super size me"

[ny10570 745]

If the person is that obese, do what has always been done. Call the fire department for lift assistance. Once you get the patient into the back of the bus and locked in, you really have no problem.

←

Thats fine for the 300 to 400 lb pts. When they push 600 they start to stretch the load limits of stretchers (which by the way are usually measured at the ground position). Not only is lifting the pt a problem, but how are you gonna fit all that person onto the stretcher?? They are only so wide. I've seen people have to tie a pt to the stretcher with bed sheets. In this area, I believe the only Bariatric bus is a transcare rig base dout of Wappingers.

[grumpyff 1,159]

If the person is that obese, do what has always been done. Call the fire department for lift assistance. Once you get the patient into the back of the bus and locked in, you really have no problem.

←

I have done it with 300-400 lb patients, it still is a strain on everyone invovled. I can't imagine trying to lift someone larger than 600 lbs.( I did a call for a large patient, who was able to walk to our stretcher, and when she sat on it, the stretcher promptly lowered itself from a raised position). Using a large group of people to lift can cause a greater chance to drop the patient, and cause all sorts of injuries to patient and crew alike. Guess what, do you think FD is going to follow you to the emergency dept? I think not. Good luck trying to find enough people at the hospital to help at any time of the day, especially in the middle of the night. This system makes it safer for everyone involved.

Edited March 31, 2006 by grumpyff

[SHFD781 0]

I just found this on AMR's website. I guess Las Vagas wasn't the first to purchase an oversized ambulance.

This one in Evansville, Indiana in 2004

NEW AMBULANCE WILL TRANSPORT 1,600 LB. PATIENTS

Evansville, IN, June 6, 2004 – In an effort to further improve service for the Evansville-metro area and its citizens, American Medical Response (AMR) has developed a new Specialty Transport Unit designed to better meet the transportation needs of patients weighing up to 1,600 lbs. Deaconess Hospital provided financial assistance to equip this specially designed unit for the transportation of the extremely heavy, or bariatric, patients.

The Community Advanced Life Support Consortium has been looking at the increasing volume of transports of very large patients reported by AMR for the past year. "This is a substantial financial commitment for us, not only to develop but also to operate," said Jerry Key, General Manager of AMR. " Deaconess Hospital offered to assist us financially to acquire the special equipment to outfit this unit, as they understood what a barrier this was for these patients and for the medical transport providers."

The standard equipment in the ambulance industry is pressed to accommodate these larger and heavier patients. This has been a potential safety hazard for patients and the crews who transport them. AMR developed this new system to significantly decrease the risk, and increase the comfort and dignity of bariatric patients.

The new Specialty Transport Unit incorporates a larger type-3 ambulance which has a box-type patient compartment with a van cab and chassis. This unit will provide the necessary room for the patient and crew in the back of the unit. The unit will carry a new style cot that is wider than a standard ambulance gurney and can hold up to 1,600 lbs. This cot will provide greater comfort and safety for the patient and safer lifting for the crew.

AMR has designed new ramps to use when loading or unloading the patient. These ramps will allow for a smoother and more comfortable lift for the patient. The ramps will also prevent the crews from needing to manually lift the patient, which could potentially risk unnecessary injuries. Also on the unit is a specially designed winch system to help the crews load and unload the patient. This will reduce the strain on the crews and act as a safety to prevent the gurney from getting out of control.

And this one in Portland OR in 2003

NEW AMBULANCE WILL TRANSPORT 1,000 LB. PATIENTS

PORTLAND, OR, February 3, 2003 – In an effort to further improve service to the Portland-metro area and its citizens, American Medical Response (AMR) has developed a new Bariatric Unit to better meet the transportation needs of patients weighing up to 1,000 lbs. AMR has specially designed this unit for the transportation of bariatric patients in the Portland-metro area because none other existed until today.

The word bariatric stems from the Greek word barros, which translates to heavy or large. Nearly one- quarter of U.S. adults are obese (according to www.niddk.nih.gov.) Obesity is defined as someone having a body mass index (BMI) greater or equal to 30. A BMI greater than 40 is considered extreme obesity.

The standard equipment in the ambulance industry is pressed to accommodate these larger and heavier patients. This has been a potential safety hazard for patients and the crews who transport them. AMR developed this new system to significantly decrease the risk, and increase the comfort and dignity of these patients.

The new Bariatric Unit incorporates a larger than normal type 3 ambulance which has a large, box-type patient compartment with a van cab and chassis. This unit will provide additional room for the patient and crew in the back of the unit. The unit will carry a flat cot that is wider than a standard ambulance gurney and can hold up to 1,000 lbs. This cot will provide greater comfort for the patient and safer lifting for the crew.

AMR has designed aluminum ramps to use when loading or unloading the patient. These ramps will allow for a smoother and more comfortable lift for the patient. The ramps will also prevent the crews from needing to manually lift the patient, which could potentially risk unnecessary injuries. Also on the unit is a specially designed winch system to help the crews load and unload the patient. This will reduce the strain on the crews and act as a safety to prevent the gurney from getting out of control.

AMR crews are specially trained in the use of this equipment and in the transport of these patients. AMR anticipates running up to two calls per day in the Portland-metro area with the new Bariatric Unit.

[Guest KFD236]

I have done it with 300-400 lb patients, it still is a strain on everyone invovled.  I can't imagine trying to lift someone larger than 600 lbs.( I did a call for a large patient, who was able to walk to our stretcher, and when she sat on it, the stretcher promptly lowered itself from a raised position).  Using a large group of people to lift can cause a greater chance to drop the patient, and cause all sorts of injuries to patient and crew alike.  Guess what, do you think FD is going to follow you to the emergency dept?  I think not.  Good luck trying to find enough people at the hospital to help at any time of the day, especially in the middle of the night.  This system makes it safer for everyone involved.

←

Well belive it or not my father and several other guys had to go to the ER because the patient was larger than 600 and they needed to transfer him on to the bed in the hospital from the ambulance.

[ems-buff 81]

All I have to say is Harrison new bus has a hydrolic back for when the Pt is so big they can use the bus for help J/K

[SRS131EMTFF 471]

This development in the world of EMS and ambulances is unacceptable. The obese are taking their own lives in their hand when they chose to be obese. Obesity is a chose and lifestyle. We should not have to accomadate by you do. Therefore, an XL bus should only be used in very large urban areas with high rates of obesity, not just anywhere. This is becaue it costs so much, it takes a lot of man power and the chance that the bus will be used frequently are very unlikely. That is the end of my little rant.

[ny10570 745]

This development in the world of EMS and ambulances is unacceptable.  The obese are taking their own lives in their hand when they chose to be obese.  Obesity is a chose and lifestyle.  We should not have to accomadate by you do.  Therefore, an XL bus should only be used in very large urban areas with high rates of obesity, not just anywhere.  This is becaue it costs so much, it takes a lot of man power and the chance that the bus will be used frequently are very unlikely.  That is the end of my little rant.

←

Its not our job to judge our patients and the circumstances that resulted in their current conditon. The fact that someone is supressing some horrible childhood memory with fat and sugar is of on concern to us. We are there to treat our patients to the best of out ability. The vast majority of the things that kill people is a result of their stupidiy. Are you not going to put out their fire becuase it was started by their stpuid use of one outlet for a half dozen heaters?? And why should only a large urban area have a bariatric bus?? If there are morbidly obese pt's that need transport you need a larger ambulance. No company is going to install a bariatric unit unless it is cost effective. Besides, madicaid and medicare pay extra for bariatric rigs and lift assists. Obesity is good money for the healthcare industry...so long as those treated are well insured. Hypertension, high cholesterol, diabetes, congestive heart failure, joint replacement, gastric bypass the list goes on and on. There is huge money to be made. Add to that the money all ready pushed into the food industry, and I say bring 'em on. I LOVE FAT PEOPLE!!

On side note, add the elderly to this (the baby boomer generation is in their 60's and 70's) and you have a rapidly growing healthcare industry that will see huge growth in the comming years.

[JustSomeGuy 0]

Its not our job to judge our patients and the circumstances that resulted in their current conditon.  The fact that someone is supressing some horrible childhood memory with fat and sugar is of on concern to us.  We are there to treat our patients to the best of out ability.  The vast majority of the things that kill people is a result of their stupidiy.  Are you not going to put out their fire becuase it was started by their stpuid use of one outlet for a half dozen heaters??  And why should only a large urban area have a bariatric bus??  If there are morbidly obese pt's that need transport you need a larger ambulance.  No company is going to install a bariatric unit unless it is cost effective.  Besides, madicaid and medicare pay extra for bariatric rigs and lift assists.  Obesity is good money for the healthcare industry...so long as those treated are well insured.  Hypertension, high cholesterol, diabetes, congestive heart failure, joint replacement, gastric bypass the list goes on and on.  There is huge money to be made.  Add to that the money all ready pushed into the food industry, and I say bring 'em on.  I LOVE FAT PEOPLE!!

On side note, add the elderly to this (the baby boomer generation is in their 60's and 70's) and you have a rapidly growing healthcare industry that will see huge growth in the comming years.

←

Amen 10570,

First I guess I agree with you from my old roots of being a bot scout "be prepared!"

Second, It makes a lot of sense, to keep up with the times and techonology, especially now with these 105lb females (or males)medics and EMTs, this can aid in better treatment, its always best to have the right tool for the job

And last thing I have to say is, comparing the original qoute. This is like saying we do not have a lot of fires in XYZ city/town so we are just gonna sell off a lot of our equipemet, not bother with experimenting new technologys and we are just going to cut back on training and maybe even just show up to the door with a bucket.

[orangEMT246 6]

The ambulance company I work for use mainly van ambulances. We also have two "box" ambulances with special stretchers for "large" patients. The stretcher has wings that attach to the sides and a special mattress for the patient to lay on. This stretcher seems to fit any ambulance with a center floor mount to give the wings the space needed. Other times, without the wings, the stretcher is the same as any other. This is cheaper than buying new special ambulances. The stretcher is also rated for 700 pounds.

[trauma74 111]

This development in the world of EMS and ambulances is unacceptable.  The obese are taking their own lives in their hand when they chose to be obese.  Obesity is a chose and lifestyle.  We should not have to accomadate by you do.  Therefore, an XL bus should only be used in very large urban areas with high rates of obesity, not just anywhere.  This is becaue it costs so much, it takes a lot of man power and the chance that the bus will be used frequently are very unlikely.  That is the end of my little rant.

←

I would like to correct you by saying that obesity is not a choice or a lifestyle! If you ask any doctor they will tell you that obesity is a disease. These people do not choose to be obese. They do not wake up one day and say "I think I am going to eat everything in site and get really fat!". Addiction to food or certain types of food is just as bad as an addiction to alcohol or drugs. As EMTs & Medics we should not judge our patients anyway. We should treat them with the most respect as possible, show them compassion and treat them to the best of our ability.

[Skooter92 7]

1) Insurances pay NOTHING extra to outfit services to handle or transport bariatric patients, as far as I know. If you have evidence that shows otherwise, like some coding modifier, please post it.

2) FD's do and will go the extra mile (or 5 miles to NWHC). Katonah FD went to the ER with my 650lb PIAA patient after they cut him out of the car and helped to get him safely and comfortably settled on the stretcher. During all of this, they were encouraging and supportive towards the patient: not one grumble or unkind word was said. MAJOR KUDOS to Katonah. They came to the ED and waited patiently for as long as it took for the ER to safely get the patient into bed. Again, above and beyond. And not a surly look or word. Please don't ever generalize and slander FDs like that. Those KFD guys are MY frickin' heroes.

[Remember585 815]

So......is this coming to WC?

30A1 - ALS Ambulance

88B1 - BLS Ambulance

99X1 - XL Ambulance?

[firemoose827 324]

Sure...NOW they come out with all this stuff!!! AFTER my back has been blown! Better late than never.

I have lifted with the proper mechanics for as long as I can remeber and still have a bad back. We have tons (excuse the expression) of obese pts up here, some of which are frequent flyers!!

I saw one call where the pt had passed in his SECOND floor bedroom and was 650 lbs. The fd cut the whole wall out and we were able to use a farm tractor with fork attachment to rig a sling and lower him to a makeshift guerney. We than had to transport with the cot tied down to the catch because he didnt fit.

Maybe our county will buy one and use it for county wide responses.

Remember....lift with the knees!!

Jonesy

[roeems87 0]

I would like to correct you by saying that obesity is not a choice or a lifestyle! If you ask any doctor they will tell you that obesity is a disease. These people do not choose to be obese. They do not wake up one day and say "I think I am going to eat everything in site and get really fat!". Addiction to food or certain types of food is just as bad as an addiction to alcohol or drugs. As EMTs & Medics we should not judge our patients anyway. We should treat them with the most respect as possible, show them compassion and treat them to the best of our ability.

I would venture to say smoking is pretty close to being as responsible for deaths (if not incredibly) and sickness as obesity is... Just on a note that hits home with 98% of people in EMS and fire...

Besides... what would be the harm in having an ambulance like that designated for Westchester? One purchased by the DES and in the event that a person "that" big needs transport to the hospital, isn't it our responsibility to help them? Would there be any other case where you feel we should not have the capabilities to transport someone? In the same way that we have all different types of FD trucks and toys that can fight all different kinds of fires and handle all different situations, we should have EMS equipment capable of handling this. Similar to the county's response with the bomb squad, it wouldn't be unreasonable to request the "X-bus" for transport of a patient requiring it.

I think the need for this says a lot about the direction our health nationwide is going (down, in case you were wondering), but it's just another aspect of Emergency Services we need to face when we're providing the best care to our districts.

Edited April 7, 2006 by roeems87

[mesquite5010 0]

Its not that common in vegas. I worked for AMR Vegas for 7 years and never ran a call on someone over 500lbs. Both AMR and MedicWest in Las Vegas were REQUIRED under their new franchise agreements to purchase so called Bariatric units. But every 911 call/transport that a 500lb plus patient has will probably result in an extra transport when is comes time for that person to go to rehab or home.