By Eva Ruth Moravec
The San Antonio Express-News
SAN ANTONIO — In a city some consider the seventh-fattest in the United States, a specialized private ambulance designed to handle patients who weigh up to 1,500 pounds makes about 350 trips a year.
More than 40 percent of Bexar County residents are obese, defined as having a body mass index of 30 or higher, said Dr. Fernando Guerra, director of the Metropolitan Health District. A small percentage of them are categorized as being morbidly obese, Guerra said, with a BMI over 40.
People in both categories have difficulty fitting on standard ambulance stretchers, made to carry up to 700 pounds, and sometimes have to ride on the ambulance floor for lack of more comfortable options.
Last year, Acadian Ambulance Service — Bexar County’s contract medical service - spent more than $120,000 to acquire what it calls a “bariatric ambulance” to transport obese patients in Bexar County and the surrounding area.
Chris Cirillo, Acadian’s vice president of operations in Bexar County, said about two people a day from Bexar, Medina and Frio counties require transport via the specialized ambulance.
“If you are 700 to 800 pounds, before this asset was available, you literally would have been put on a mattress or a tarp and about eight paramedics or firemen would have to drag you out of a house, in front of your neighbors,” he said. “We have specially designed tarps with handles to put them on the stretcher and treat them as we would any other patient.”
Overall, San Antonio Fire Department ambulances last year took about 144 patients each day to area hospitals, while Acadian transports about 50 a day, officials said. There is no extra cost to patients transported in the special ambulance, Cirillo said.
In May, Men’s Health ranked San Antonio the seventh-fattest city in the country, based on publicly available statistics on percentage of overweight residents, percentage of residents with Type 2 diabetes, the percentage of those who haven’t left the couch in a month, money spent on junk food and the number of people who ate fast food nine or more times in one month, according to the magazine’s website.
Acadian’s bariatric ambulance provides regularly priced service and at any agency’s request, Cirillo said. It’s stocked with a hydraulic stretcher that can accommodate a patient whose girth is twice the size as the average patient’s, a ramp, and a winch that pulls the stretcher inside.
Yvette Granato, assistant chief of communications for the San Antonio Fire Department, said the city uses Acadian’s modified ambulance when time permits, but critical patients who don’t fit on the normal stretchers often have to ride on the ambulance floor.
“It’s difficult, because you’re trying to maintain as much of a patient’s dignity as possible,” she said. “But the bottom line is, if they need emergency transport, we’ll do what we need to do.”
Cirillo said SAFD calls Acadian to help with extra-large patients about once a month. While Granato said her agency’s largest patients weigh between 400 and 500 pounds, Cirillo said the bariatric ambulance transports patients mostly between 600 and 800 pounds, but a Bexar County patient weighing about 1,000 pounds once required Acadian’s assistance.
Obese people are at a greater risk for medical complications, Guerra said, and in medical emergencies many require rapid hospitalization. But it might take emergency responders longer to transport them, he said.
“It’s a desperate set of circumstances,” Guerra said. “You can imagine if they need to transport someone via helicopter, it would be almost impossible. There probably is a need for an ambulance service that caters to (the obese).”
When calling 911 to request medical assistance for an overweight person, Cirillo said callers should tell the dispatcher if the patient is overweight so responders can request the bariatric ambulance.
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