Super-size equipment helps D.C. area EMTs move the obese

By Mary Pat Flaherty
Washington Post Staff Writer
Monday, February 8, 2010

Local paramedics and firefighters don't need to follow television shows about a half-ton teen or biggest losers to track the obesity trend.

They carry that knowledge with them.

Calls for patients weighing 350 pounds come daily in the District. A patient between 400 pounds and 600 pounds is part of every workweek for many crews throughout the region. Patients topping 600 pounds are transported by emergency teams every few months.

Girth is a separate challenge.

"I think everyone has struggled with this issue, and technology is just now coming to grips with it," said Fairfax Deputy Fire Chief Christine Louder.

Across the Washington region and the country, departments have been adapting steadily to plus-size patients. They have added specialty equipment and training to reduce their back injuries and avoid the spectacle of moving a person on planks, tarps or the floor of an ambulance.

Nationwide a few communities, including some near Topeka, Kan., charge nearly double to transport patients over 350 pounds. There is no discussion locally on that front, said officials with the major agencies. But area departments are part of a buying trend expected to double sales of specialty equipment by 2012.

Sales of stretchers designed specifically for very large patients were expected to reach $50 million in 2012, up from $29.6 million in 2004, while sales of specialized lift systems were projected to rise from $75 million to $193 million. The projections were included in a 2007 article for EMS providers written by Raphael M. Barishansky, now chief of public health emergency preparedness for the Prince George's County Health Department.

Reinforced brackets, hydraulic lifts, extensions for belts, harnesses and blood pressure cuffs, and equipment designed so as many as a dozen people at one time can lift a patient are in use in the District and Prince George's, Montgomery and Fairfax counties, as well as many smaller departments. So, too, are cots widened to about 30 inches, which provide increased surface area while still being able to pass through most internal doors.

But those improvements are not enough once a patient reaches about 700 pounds, a group that has become a new focus.

Patients that large must be moved with extra staff and in specially rigged ambulances. Some have a ramp and winch that can pull in a 1,600-pound patient on a cot and is built with a chassis the size of a lumber truck.

Local EMS officials can recite the types of challenges driving their discussions:

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