FDNY - Law Suit Filed for 500-lb man who was dropped

[Guest Dept 10]

gee i was thiking flatbed tow truck of course weather permiting

[ny10570 745]

Jacobi hospital box truck with hydraulic lift gate...its been done before. When not approaching marine mammal size a sked is a great choice. If the pt is too big then the sked goes on the floor of the bus and a K-12 makes quick work of the stretcher hook at the ambulance door.

[mfkap 0]

No where has it been mentioned on how these people get transported to the hospital. The stretchers can not handle those kinds of weights. Its fine to rig ropes and all types of systems to remove the obese pt. from the building, now what.

There is a new breed of bariatric ambulance that is around. They have ramps and winches to load the stretcher up to 1300 lbs. (http://www.transaferamps.com/) and stretchers that can hold up to 1600lbs (http://www.stryker.com/en-us/products/PatientHandlingEMSandEvacuationEquipment/EmergencyCotsChairs/AmbulanceCots/MX-ProBariatricTransport/index.htm). I read something about NYC looking into it (http://publicsafety.com/article/article.jsp?id=4408&siteSection=7) but I don't know the outcome. I also heard that there were a few operating in Westchester, but am unsure where.

As is obvious from the comments here, the "professionals" in Westchester don't feel that obese people are in fact human, and really we should just throw them out the window and laugh when they go splat. Maybe set up some pins at the bottom of the stairs and then go bowling. It is really disgusting to me that people who consider themselves professional, and in the business of helping people, would publicly post jokes and insult obese people, who call us in their time of need, when they need help the most. Hey, as long as you can feel better about yourself, because you aren't THAT fat.

For the people involved in emergency services that care about their patients, and not just the in-shape, attractive, young ones, I have a question: Is there a paid service in Westchester that has a bariatric ambulance? Our agency was talking about this last night, and it would be great if we could get an agreement or information so if we have an extended extrication of a bariatric patient from a residence, we could have the bariatric ambulance respond from a distance for transport? It seems that most places don't have a plan, such as the PD scrambling for a moving van (which is ok, at least they tried and treated the person with respect for their condition) but I think that working on a plan would be a good idea. Maybe we can put our powers for good and actually put together a plan that can be distributed to agencies? Maybe get the county in on it? Actually HELP people who need help? Just a thought.

Edited February 14, 2008 by mfkap

[x635 4,066]

You know, who are we to judge our patients?

Bariatric medicine is become one of the newest EMS buzzwords, due to a growing obesity epedemic in the US.

Do we make fun of someone we had to cut out of a car because they "can't drive"? Or do we go back to the firehouse and boast about the "pin job" we had.

Now, we get called to take a sick patient, who happens to weigh 500lbs. (for some people, weight is not an easy thing-some people have NO metabolism, education, proper nutrition or access to, etc). We get him to the ambulance, and whine about it.

THEN, the patient is dropped, and caused injury. If FDNY is at fault, then bariatric medicine is a situation they need to address.

Maybe we should all take a lesson from University Hospital EMS-Newark's Rescue- they specialize in removing bariatric patients. They have all kinds of tools and tricks to move obese patients.

There are some good ideas here, let's learn from one another and cut the high and might judging our patients crud.

[Guest alsfirefighter]

This is a significant issue that I was trying to address in my capacity as EMS Coordinator of my FD. They make extra large reeves that have a higher weight capacity and give the ability to be rigged so the obese patient can be in a more seated position.

As far as stretchers, most carry a 500 lbs. weight limit, but generally the several morbidly obese patients I have dealt with have gone right on the floor. To be honest I've thought about several times calling local businesses to see if they would allow use of the forklift by their employees to get the patient in the ambulance. Most OR's have slide rollers for patient movement, get the ED stretcher and the roller and it makes a pretty difficult move a bit simpler.

As far as having patients "in that situation" signing a release prior to movement, you have to be cautious. Regardless of what "situation" you think persons are in you would have to have all patients sign a similar release.

Hopefully most of the BS will be seen within the court or common sense will prevail. If he wasn't strapped down he wasn't and that generally is a standard of patient movement in EMS and tech rescue. However, the BS is they acted in a good faith manner with the best interest of the patient in mind and that should be simple enough for a quick common sense settlement.

[Guest]

Here's another one for you....for those relying on helo's for trama and such, don't anticipate them taking a patient over 350lbs.

Edited February 16, 2008 by FFD55

[Guest]

No where has it been mentioned on how these people get transported to the hospital. The stretchers can not handle those kinds of weights. Its fine to rig ropes and all types of systems to remove the obese pt. from the building, now what.

I had a similar situation where the pt. was 450+ lbs. and was in a wheel chair. He lived on the ground floor of an apartment building. Easy so far. He had a ramp out the door. Still easy. When we got him outside there was no way he would fit on the stretcher, nor would the stretcher hold him and no way would he fit into a van ambulance. We had P.D. look for a moving van with a ramp. Could not find a moving van when you need one.

No moving van, Plan "B". Being that he was 3 blocks from the hospital we pushed him to the hospital in his wheel chair.

Lucky the weather was good and he was close to the hospital. What "if", weather bad or not close, then what.

We have all seen the extended operations to get someone out of a building and to the hospital on a pre-arranged basis, but if its an emergency, "what will you do".

Just something to think about.

They make bariatric stretchers that can hold up 800 pounds or more.

Edited February 16, 2008 by DOC22
CAPS

[Goose 188]

When i do a heavy job i always tend to wonder if the patient ever feels for us. I mean, trying to wrestle someone that heavy down the stairs, then rolling 500 pounds of meat back and forth and in and out of different moving equipment isn't exactly safe or easy. There are some nice tools out there to facilitate bari transport, but how often is a bari going to tell the 911 operator he/she weighs in at 500 pounds?

As far as feeling for the patients...i understand the genetic linkage to obesity, but there is just something about walking into a patient's room only to have them tell ya to wait while they finish their pizza or Chinese food and then go "oooh, i feel sick...., i think i may vomit..." or "i'm havin' trouble breathin" I don't mean to sound cold, but if i just rammed a slice of pizza or a carton of pork fried rice down my throat i would feel sick too and if my lungs had to fight against 500 pounds of flesh i would have difficulty breathing as well!

In my eyes, you have to draw the line somewhere...

[NWFDMedic 58]

I was reading this article and I couldn't help but think that a 500 lb. patient shouldn't require such an elaborate setup. Then again, I wasn't there, I don't know the condition of the stairs, the apartment, etc.

The agency I work for provides bariatric services with 5 of our larger ambulances equipped with Ferno stretchers with LBS (large body surface) add-ons. I've had relative success moving patients on these stretchers at weights in excess of 600 lbs. We don't have any specialized lift gates or anything on the ambulance, so getting the stretcher into the ambulance is still a manual task, but many hands make (relatively) light work.

The only issue I have with bariatric transports is that we are getting more and more of them and as a profession we really don't have any training in lifting and moving bariatric patients other than what we had in EMT class. I've found that when you get to the scene of these calls, improvisation seems to be the normal mode of operation. You have to stand back, assess the situation, and figure out a way to complete the task at hand. Maybe it's time that we start looking at some of these various improvisation techniques, refining them, and coming up with some tips, training and guidelines for moving bariatric patients.

The good news... good EMS providers are usually good at improvising.