Albany Times Union Article - New Guilderland ambulance can aid patients weighing over 600 pounds

      EMS crew demonstrate a bariatric ambulance's features. A powerful winch pulls the extra large stretcher up the metal ramps

GUILDERLAND — Senior Paramedic Supervisor Jay Tyler remembers vividly a 911 call years ago before he came to Guilderland.

An 800-pound woman fell on her back, couldn't get up and was suffocating. Her breasts and fat from her chest shifted onto her throat—and windpipe— and face. She was young but not strong enough to lift her own weight to save herself. She lay trapped in a hallway in her home.

That 911 call now sees a harbinger of a hidden health problem of people so ashamed of their morbid obesity that they hide from the outside world. First responders often don't know someone weighing more than 500 pounds lives in their town until the person suffers a crisis. Like all emergency medical services, Guilderland has a list of "special needs" residents who need to be checked on during heat waves and snowstorms. Morbid obesity is not considered a special need and Tyler wonders if that should change.

Guilderland advanced life support services supervisor Donald Doynow told the Town Board in early June that he waited over an hour for a bariatric ambulance from another town to help a morbidly obese person. Guilderland's average ambulance response time is 12 minutes at night, seven by day.

This month, Guilderland bought a bariatric ambulance that it will share with Albany County. The ambulance has a stretcher that can carry 1,000 pounds, a rig, a hydraulic lift and a chain winch that can pull a 900-pound patient on a stretcher up iron ramps into the ambulance.

About 25.5 percent of New Yorkers are obese — the Capitol Region's obesity rate is 29.4 percent— according to the Trust for America's Health. Morbid obesity is an extreme. It applies to those more than 100 pounds overweight. Guilderland averages 17 calls to 911 daily but doesn't tally those related to obesity. But Tyler said calls from people weighing 500 to 800 pounds are increasingly common.

"The Albany County civil service requirements (for ambulance crews) put you in good shape to help a 300-pound patient, but 500 pounds and over pose some unique challenges," Tyler said.

Paramedics must be able to lift one end of a stretcher weighted with 150 pounds twice above their heads, carry 125 pound barbells while walking backwards and carry heavy sacks up three flights of stairs without pausing. A morbidly obese patient requires more than strength from his rescuers.

"At 500 pounds, a person's body configures itself in unexpected ways," Tyler said. ""If they slouch or fall into the wrong position, the weight can make it hard for them to breathe."

Stretchers break. The ambulance team may need help lifting a 500-pound-plus patient into the ambulance. If patients can't be brought through hallways and out of a house, the fire department may be called to extract them through a window.

The bariatric ambulance has a sturdy stretcher with a power lift. A flick of a button brings it from the ground to the ambulance crew's waists. A winch can be attached to the stretcher so the chain pulls it and the patient up iron ramps into the bigger than average ambulance.

"A bariatric ambulance is much easier to move around in and helps us provide quality care," said Guilderland paramedic field supervisor Sean McGaughnea. "They are designed to fit the larger stretcher."

Now that Guilderland has an ambulance for the morbidly obese, Tyler hopes those who need help will call.  He's met patients who said they were too embarrassed to phone 911 or didn't believe saving their lives was worth bothering EMS. He remembers helping a man who was around 600 pounds man who apologized for the strain his girth placed on the paramedics. He told Tyler, "Please don't go to too much trouble. I really don't think much about living any more."

Tyler's response is always; "I believe your life is valuable enough for us to save."