Lisa Eckart, an EMT with American Medical Response Ambulance, demonstrates the switch that activates a motorized winch to tow patients inside the special bariatric ambulance in Independence, Mo. (David Eulitt/Kansas City Star/MCT) DAVID EULITT

KANSAS CITY, Mo. -- Ambulances are transporting more supersize patients than ever - several a day, including some as large as 800 pounds.

And as the number of morbidly obese Americans goes up, emergency crews are straining their backs and budgets to get them to hospitals.

Especially during a life-threatening emergency, the process requires not only brute strength, but creativity on the fly.

Ambulance workers have enlisted brawny firefighters, makeshift pulleys, tarps, plywood and even a hydraulic-lift truck to get patients up or down stairs, through narrow hallways, out of houses and on the road.

"There's a surprise around every corner," said Jeff Johnson of Johnson County (Mo.) Med-Act. "If somebody's life is on the line, we'll do everything that we can to help that individual. But we also have to be very careful for our own safety."

Although specialty equipment is making the process easier for ambulance workers and more dignified for patients, the devices are expensive and still not widely used.

American Medical Response (AMR) in Independence, Mo., is one of a relatively small number of ambulance providers nationwide to have a bariatric ambulance.

The vehicle features a reinforced floor and shocks, a ramp and a motorized winch to pull a loaded gurney into the back. While AMR's standard cots hold 450 pounds, the bariatric cot can support 850 pounds in the extended position or 1,600 pounds when lowered.

AMR bought the ambulance to handle an increasing number of 350-pound-plus patients who need regular transportation to dialysis or other medical treatments, said operations manager Cam Hendry. But it is also dispatched to other cities when needed for scheduled transports and 911 calls.

In May, AMR recorded more than 60 transports in its bariatric unit. That is double the number from May 2008 and triple the number from January 2008.

In 2007, MAST transported only a couple of patients heavier than 400 pounds each month. This year it has averaged more than 20 such calls per month.

When moving extra-large patients, predicaments abound.

About two years ago, Johnson County Med-Act was called to help an approximately 800-pound man who went into cardiac arrest in the basement of his home, Johnson said.

Medics performed CPR. Firefighters constructed a pulley system using the winch on their truck and a tree in the yard. About 15 people helped pull the man up the stairs and out of the house on a tarp.

Paramedics got the patient to a hospital, although he died a few days later, Johnson said.



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