Modern lifestyle, the availability of food and lack of exercise all contribute to the problems they face. In this modern lifestyle we tend to drive everywhere complain if we don’t have a TV remote and have to get up off our comfy chairs to change channel and because of our wonderful technology there is a lack of manual physical work which in the past kept all of us lean, fit and healthy. The term Bariatric is a medical term used to describe obese clients these are usually persons who are in excess of 25 stone (159kg), is classified as Morbidly Obese with a body mass index of 40kg/m2 or with a BMI of 35kg/m2 with other additional co – morbidity problems.
Illness or accident historically were the main contributor to becoming Bariatric but as mentioned our lifestyles are now the main factor and the weight gain gradually creeps up and we gain weight over a period of time to a point of being obese without any major alarm bells ringing but then with a blink of an eye the weight gain can accelerate and suddenly from being obese we become bariatric and this is when the manual handling issues to first responders becomes an issue. The problems of obesity fall in to two categories. Firstly there are changes of the anatomy and physiology that affect the obese. These create problems in airway management, ventilation, circulatory access and drug dosage. Then there are the effects of the sheer physical bulk and weight of the person.
By the time the BMI reaches 40 the person’s mobility and health is being affected by their body fat. They will now begin to present problems of extrication once a person exceeds 20 stones they may be pushing the limits of the design load limit of the rescue equipment and the crew/teams will have to be looking to use specialist equipment to be able to safely move this person to protect the casualty and the staff members involved.
In the last 10 years there has been a mixed response from the emergency service providers with your main ones being the ambulance, fire and police as to what level of service they provided this ranged from well-funded, well equipped specialist teams down to the prejudices in the services who were in denial to the issues and problems that the obese/bariatric persons presented this in turn caused inter agency friction. Positively and more recently there is an acceptance of the issues and necessary steps are being taken to be responsible and find solutions to provide professional services and that the same level of service needs to be provided to all sectors of the community from tiny to large and to provide a safe working environment for their employees.