Thursday, May 29, 2014

the morbidly obese in the ER

Let me preface this by saying: I could lose a few pounds....

Is it just me or are the number of morbidity obese 350 lbs and up patients increasing?  I swear we get 5-6 a shift nowadays. We have one lift in the department.  It is WAAAAYYYY over on the other side of the ER in an area we don't visit much.

There are so many really big people coming into the hospital these days that we have someone in charge of having the products we need to take care of this population.  Bigger chux, depends, gowns.  We have a bed in the ER that doesn't have to be pushed manually, it has controlled to have it move itself.  There are "bariatric beds" in the hospitals.

Upstairs they have lifts for just about every bed, meaning the nurses aren't going to break their back.  In the ER, one.  If they have to go on a bedpan, its a team effort. 

When I see the medics come in with a big person, I wonder how they got them onto the cart. I worry they will hurt themselves.  Sometimes they have to call the fire department to help.

This is modern emergency medicine. Its something that has to be dealt with.  We see it more and more. Its not easy.


Anonymous said...

Interesting! The tittle really got my attention and made me want to read this.

Anonymous said...

And sometimes they get mad when I don't try to pick them up by myself. Sorry, one back, one 141lb nurse here...350lbs of you. I will lose. Of course I don't say this!

Anonymous said...

nursing schools should field football teams. best way to scoop up all the 7 foot 18 year olds.

Anonymous said...

We have lifts in about every other room in our ED (we are fancy, I know) but they often will only lift up to a certain weight. Ours only lifts weights up to 600lbs :-( That usually doesn't help the patients we are worried about.

Anonymous said...

The McDonald generation, would you like fries with that?

Doc Rugrat said...

I used to work in a hospital where we would send morbidly obese patients to the local veterinary college for CTs (forget MRIs). There is no nice way to tell someone you are sending them to the zoo scanner because they don't fit in the people scanner.

Anonymous said...

But why do we have to be so 'nice' and not tell them they don't fit into the scanner. Or that I cannot see their baby with my ultrasound because the XDR the companies make does not have low enough megs to get through their fat.
Can't I just say, you are so flippin' fat that all I know is that there is something in your uterus. It could be a fetus, it could be a polyp. I just can't get through your fat to see if the kid has a defect in the spine, or the heart, or sometimes if it even has a head. So don't expect me to know if it has a cleft palate, or a spinal defect.
Report should read: fetus present. Details unknown.
And then, to really p*ss me off, you tell me that your friend has such a nice picture of her baby, you can see the fingers, and the nose, and everything! Well, honey, I bet your friend weighs 135lb soaking wet.
Endocrine disorder, my eye! I've seen fat people eat. Two ginormous full plates of food to my every 1/2-full plate of food. A biggie french fry plus hamburgs when I have a veggie wrap.
Yah, there's a reason I'm so skinny. I look after myself. And then I wreck my shoulder pushing on your fat pannus, just to have you complain about the image you're seeing. I'm surprised you even managed to get pregnant. Just how the h@ll did you accomplish that anyway?

Anonymous said...

I'm laughing about the pregnancy comment!
One of the hospitals I work at have rooms for these big people. 48 inch wide doors, beds able to support 700 lbs. Toilets that are ginormous--if a regular pt. gets the room a liner has to be in the toilet or they will fall in. And there are scads of these patients today. I started 35 years ago and these folk were almost unheard of.

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