Bariatrics: EMS bariatric transport

Being that it seems a majority of patients out in the field we transport are significantly heavier than they used to be, are there any studies that can help us decide when a bariatric transport unit should be considered. We do use Stryker powerlift cots and assisted stair chairs and two person crews on all units, but that only helps with weight, not width. We do not have the luxury of a controlled environment and hoisting equipment. We need to justify a bariatric ambulance and stretcher system.

David Shull
Lexington County EMS

Dear David:

We can certainly sympathize with you and if it’s any consolation we believe you have one of the most difficult jobs imaginable…namely manually carrying sick human beings, including some weighing several hundred pounds, under all sorts of adverse conditions, tight stairways, etc.

Obviously you are being asked to perform your job while exceeding OSHA’s maximum 35-pound lifting recommendation several times over.    We are not aware of any combination of equipment or policies that will solve that problem.   However, we do have a few suggestions for you.

• Do whatever you can to prevent musculoskeletal strains.  Stretch adequately before each shift, utilize protective equipment such as weight belts, stay in shape, and practice safe lifting techniques as often as possible.
• Talk to other EMS systems around the country to see how they are solving the problem – for example, how did they justify purchasing a bariatric ambulance and stretcher system?
• Work with your designated occupational health representative to cost-justify the ambulance purchase.   For example, if your system incurs injuries and is responsible for workers’ compensation payments, then you should consider doing a return-on-investment analysis and bringing it to the attention of management.  An ROI calculator similar to the one on our safe lifting portal would be of help.
• For the safety of both employees and patients, every EMS should have clear policies and a pre-planned method of enlisting the support of additional EMS teams or public service employees such as police and fire personnel.  The guidelines should identify patient-transport strategies and set limits on the minimum number of people required to move a patient over a specified weight.