I ate lunch with 2 of the EMS crew and one of our ER docs today. The conversation turned to alcohol levels, drug seekers, and morbidly obese patients - sometimes all in one.
Obesity is an epidemic in our country. We all know that. What some people don't realize is how much of a strain it puts on the medical professionals who have to treat them. The EMS crew were discussing a story about how difficult it was to get a 550 lb patient out of her house last week. They had to call the fire department for lifting help as they could not even move her. They talked about a 700+ lb lady we have in our community who they are just waiting to get a call on. They have a plan involving planks from the hardware store and tarps.
Now before I get any nasty comments, they were not making fun of her. They seriously had to plan for how they would be able to transport this patient to receive appropriate medical care at a hospital. The challenge is if they are able to get her to the hospital, what will we put her on? Our stretchers do not accomodate her weight, neither do our hospital beds.
Obesity leads to multiple medical problems, many of which you all already know so I won't repeat or lecture. How do we solve this? Can we? I don't think we can. But we must prepare for heavier and heavier patients as we see more of them every day. We must prepare not only for the physical demands of caring for them, but also the mental demands. We must figure out how to develop a plan of care for every other disease process that accompanies the obesity, and then we must plan how to complete the plan of care without interacting with treatments for the other diseases/conditions. It's a never ending cycle. One with a pretty scary ending.
4 comments:
At my old hospital:
The oldest OR tables were built to handle 250 pounds.
The next tables were built to handle 350 pound patients.
The new ones were built to handle 500 pound patients.
And we had just ordered a OR table with a capacity of 1000 pounds.
It's a fugly trend.
When you figure that our CT can only hold 400 lbs, and the (only) ED bariatric bed is limited to 550 lbs, your 700 lb pt is gonna be SOL when she requires medical attention.
We had a 460 lb patient the other day with a self-inflicted GSW to the head. He was a challenge to say the least. We were actually able to secure him to a backboard & get him to the hospital, where they had to request the 2-patient helo to get him out of town, as the single-patient helo was simply too small to carry him.
I agree with you that we will be unable to solve the problem. We're planning on how to treat them appropriately along with providing for mental health (no derogatory comments, trying to make sure we treat them with respect, even as we struggle to move them). I've already gotten one complaint from trying to remove a large patient from her home. Her hubby felt we were less than professional carrying her out on a tarp.
A story explaining just how grim obesity makes things when it comes to the crunch:
http://traumaqueen.net/?p=669
K
Thanks for the info and the comments. It's going to be huge (no pun intended of course) issue over the next generation and more.....
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