GENERAL CONSIDERATIONS

• Patients who weigh greater than (BMI < 40 kg/m2) are frequently classified as high risk because if the increased medical complications associated with their excess weight.
• In EMS systems, they present the additional problem of movement and transportation.
• These individuals have the right to expect prompt and expert emergency medical care. Therefore, in order to facilitate the care of these individuals without risking the health of EMS workers, the following protocol is established.

EMT/AEMT/Paramedic Standing Order:

• In managing a patient with a weight over (BMI < 40 kg/m2)., at no time should the patient be moved without adequate assistance. EMS personnel may be supplemented by law enforcement or other safety personnel as appropriate.
• Consider the utilization of specialized bariatric transfer services in your area.
• It may be necessary to remove doors, walls, or windows. The situation is no different than extrication from a vehicle, although property damage may be higher. At all times the scene safety and the patient’s life must be the priorities.
• The patient is to be placed on an adequate transfer device designed for this population.
• It is recommended that the patient be loaded onto a cot that is in the lowest position and keep the cot in the low position.
• It is necessary to notify the hospital well in advance of your arrival so that preparations can be made in a timely fashion.
• If individuals in the community are known to fall within this special category it is appropriate to inform them in advance of the type of assistance they can expect from the EMS system, and help them make
• plans well in advance to assist you. Ask the individual to identify themselves and their special needs when calling for EMS assistance.