Improving Quality of Care for Bariatric Patients

With more and more bariatric patients entering the healthcare system, it is becoming increasingly vital to apply special considerations to ensure these patients receive the treatment they need in a safe environment. Fundamental issues such as the mobilisation and transport of patients can be difficult when dealing with this class of patient. Without adequately and intelligently addressing these issues, both bariatric patients and healthcare professionals increase their risk of injury and harm.

The call for bariatric facilities in ambulances

Ambulance services have been designed with ambulant people in mind. As such, the transportation of patients who don’t fall into this category can prove complex and challenging. According to the Australian Safety and Compensation Council, ambulance representatives have reported that vehicle capacities are limited, standard stretchers do not always provide the necessary support for severely obese patients, and sudden deceleration of the vehicle may cause problems due to the patient exceeding the capacity of the restraints. Furthermore, upon arrival at the hospital, issues such as sloped or ridged ambulance bays may impede trolley movement.

Past solutions and current dilemmas: providing dedicated bariatric vehicles

Paramedics have cited the difficulty of transporting and treating bariatric patients as one of the key pain points of the role. In response, some Australian states including South Australia, New South Wales and Victoria have introduced dedicated bariatric vehicles to their ambulance fleets. However, the cost of providing and operating these specialise vehicles can be prohibitive in some areas. Bariatric ambulances are limited to major city centres only, which means that incidents that occur in remote locations require planned transport solutions. This places bariatric patients at greater risk in the case of an emergency, where even air transportation is limited by load capacity.

Other services have invested in specialised equipment for transporting bariatric patients, including air jacks, patient slides and powered stretchers. While this sounds promising, such equipment often requires a power source to operate — something that isn’t always available at the point of patient collection. Furthermore, if the patient is collected from his or her home, restricted space can prevent the use of the equipment.

Training and educating staff in providing healthcare for bariatric patients

The treatment of bariatric patients differs significantly from that of your standard patient. Healthcare professionals should be aware that if a patient’s weight might exceed 170kg, it is necessary to dispatch a second ambulance crew to the call location. Utmost respect must also be given to the patient’s dignity; in some cases, fire services are called to assist with patient movement, however this is not recommended as it can attract unwanted attention and put the patient’s dignity at risk.

Attempts have been made by state governments to improve the training of staff in the use of bariatric equipment, but little progress has followed: the lack of available equipment means that experience remains limited. 

The healthcare industry continues to battle with barriers to adequately care for bariatric patients, but at least the issue is being acknowledged and new solutions worked on. ​