The nationwide obesity epidemic is putting a strain on local emergency medical responders, pinching their backs and knees as well as their ability to give patients good care.
Though there’s a lack of hard data, emergency medical service officials say they are assisting many more overweight patients now than 10 or 20 years ago.
“We handle 200- to 300-pound people all day long, and 400 pounds is not all that uncommon,” said Van Prater, chief paramedic at LifeStar Ambulance Service Inc., one of the three ambulance companies in Sangamon County. “We have 500- or 600-pound patients as often as once a month.”
A study released last week by researchers at the U.S. Centers for Disease Control and Prevention, Duke University and RTI International says annual increases in obesity rates may be slowing, but 42 percent of Americans are expected to be obese by 2030, compared with 31 percent in 2010.
Moreover, the percentage of Americans classified as severely or morbidly obese is projected to at least double — from about 5 percent in 2010 to more than 11 percent in 2030. Severe obesity generally is defined as more than 100 pounds overweight.
“The public is getting bigger,” said Greg Surbeck, assistant chief of the Springfield Fire Department. “We see a lot more large people.”
Hidden problem
Assisting severely obese people can create challenges for EMS personnel, Prater said. But he said he hasn’t seen those challenges result in delays or other complications that have harmed local patients.
The most obvious challenge is the manpower needed to lift someone out of a house or into an ambulance, according to Mike Nichols, operations manager for America Ambulance Service.
Ambulance crews in Springfield generally consist of one paramedic and a driver who is an emergency medical technician. More people often are needed to lift morbidly obese patients.
“A two-man crew cannot lift someone who weighs 1,100 pounds,” said Prater, adding that LifeStar has handled a patient of that size.
Tending to the health needs of obese patients can be difficult too, he said.
“Sometimes something as simple as taking a pulse or a blood pressure on that kind of person can be tough,” Prater said. “When you try to set up an IV, you have to go through more flesh and fat to find a vein.”
Diverted crews
During medical emergencies — when a patient has complained of shortness of breath, chest pain or other concerns that prompted a “911” call — Nichols said ambulance crews usually can get help moving patients from firefighters who have been dispatched to the scene.
But in non-emergencies, such as when a patient is being discharged from the hospital and needs to go home or to a nursing home, firefighters aren’t always there. America sometimes has to dispatch several ambulance crews in those cases, Nichols said.
In theory, pulling a crew out of service to assist with an obese patient could create a delay in responding to a true emergency, he said. But that hasn’t happened, at least not yet for America, he said.
Springfield firefighters sometimes are called to homes when a severely obese person has fallen and can’t get up on his or her own, Springfield Fire Chief Ken Fustin said.
“We’ve had them from 400 to 900 pounds,” he said.
Volunteer and non-full-time fire departments receive similar requests.
“We do ‘lift assists’ once or twice every couple of weeks,” said Louie Rogers, chief of Riverton Fire & EMS.
If the patient doesn’t need hospitalization, firefighters will help them get up with a special tarp that has grips for two or three people on each side, Fustin said.
Firefighters also will assist ambulance paramedics. But the fire department now requires ambulance companies to exhaust their own resources in non-emergency situations before firefighters will help.
Associated injuries
Seven firefighters from the 218-member Springfield force have been injured since 2009 while lifting patients, and the department has to focus on emergencies, Fustin said.
“We need to be available for emergency calls to the citizens of Springfield,” Fustin said. “We can’t let ourselves be tied up assisting a for-profit ambulance company when they have their own resources.”
Prater said injuries associated with moving heavy patients can leave ambulance companies short of personnel.
For that reason, Tracy Daugherty, operations manager for Medics First, the third local ambulance company, said the company this year began turning down most non-emergency requests to transport patients weighing more than 400 pounds.
Hydraulic and other equipment can be a big help, but “at some point in every call, someone needs to be lifted,” said Glenn Luedtke, chairman of the EMS safety course committee for the National Association of Emergency Medical Technicians.
The growing size of patients “is definitely a problem for us, and it’s not going to go away,” said Luedtke, a retired EMS director in Sussex County, Delaware. “When you’re getting up around 300 pounds, you’re getting beyond what a normal crew could handle.”
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