Treating and transporting a bariatric patient can require coordination with outside agencies, as well as specialized lifting and monitoring equipment. Bariatric patients have the right to expect professional and timely emergency care, with consideration given to their unique assessment challenges, and providers have the obligation to deliver such care without risking their own health. Learn more in this EMS1 Special Coverage series, Bridging the gap in bariatric patient care: Pathophysiology, assessment and transport solutions.
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EMS providers are increasingly challenged to provide care for bariatric patients – generally considered patients’ whose weight exceeds 350 pounds – and a comprehensive approach is necessary to ensure patient and provider safety.
EMS agencies need to serve bariatric patients with the right equipment and processes, using effective, patient- and provider-safe principles and delivery. Bariatric patients have the right to expect professional and timely emergency care, with consideration given to their unique assessment challenges, and providers have the obligation to deliver such care without risking their own health.
We surveyed EMS1 readers to determine how well EMS providers are equipped and trained for moving, assessing and treating bariatric patients.
We received more than 200 responses from paramedics (54%), EMTs (39%) and A-EMTs (7%).
Here are three takeaways from the survey about how well EMS is equipped and trained to assess, treat and transport bariatric patients.
1. Deficiencies in bariatric EMS training, equipment pose a safety danger
Despite the fact that bariatric patients make up more than 10% of calls for 58% of respondents, only 32% noted they are equipped with specialized bariatric patient transportation equipment on every call.
Another 31% of respondents noted they are only equipped with specialized equipment on some of their calls, while the largest number of respondents – 38% – noted they do not carry specialized lifting equipment at all.
When asked what area of bariatric patient assessment, treatment or transportation they wished for additional training in, the top choice was how to safely lift bariatric patients – the skill most critical to prevent provider injury – over patient assessment, treatment and interaction skills.
Put directly, 62% of respondents replied they do not feel equipped with training and equipment to safely transport bariatric patients.
2. Clinical training on comorbidities, complications needed
In addition to provider safety concerns, our bariatric training survey revealed a gap in clinical training for assessing and treating bariatric patients. Over the past 12 months, 70% of respondents received just one hour or less of bariatric-related training of any kind (45% received no training at all).
Bariatric patients have pathophysiological differences in addition to size that may require specialized equipment for taking and monitoring vitals with accuracy. Availability was split amongst respondents, with 50% noting they have access to specialized assessment equipment at least some of the time, while the other half of respondents do not. Only 20% of respondents, however, have been trained to use that specialized equipment in the past year.
About 50-80% of respondents replied they have never received training in assessing vital signs, common comorbidities and presentations, airway management and post-surgical complications specific to bariatric patients.
Though transportation takes considerable consideration when treating bariatric patients, understanding that being overwieght is often secondary to the patient’s primary complaint and training in common comorbidities and considerations can give providers an edge when it comes to diagnosis and beginning treatment.
3. Additional opportunities for bariatric training
The additional providers, specialized assessment equipment and bariatric specific patient handling devices required to safely assist a larger patient take finesse to deploy while preserving the patient’s dignity. As EMS1 Editor-in-Chief Greg Friese, MS, NRP, writes, “all patients, regardless of their size or chief complaint, need to be treated with respect and dignity.”
Yet only 20% of providers noted they had been trained in how to comfort and put bariatric patients at ease during their transportation in the last year. This presents an opportunity to include provider communication and courtesy in initial and refresher training on patient handling.
And finally, one more area to consider when developing a training plan: work with other municipalities and disciplines. Transporting bariatric patients often requires a team effort. Practicing with those who will aid you – or whom you will be called to aid – will allow everyone involved to familiarize themselves with the equipment each department has available, and to streamline approach, resulting in smoother, safer operations in the field.