Obese patients in disaster situations

classicdame, MSN, EdD · Sep 3, 2007

Airway management may be a challenge, as well as IV access. Check with local EMS or go online to a website dedicated to EMS. I remember hearing local EMS talk about why it was important to discover whether or not a person had had bariatric surgery. Had something to do with airway management. Sorry, I don't have details. What I did remember was to assess the abdomen for surgery scar, even if pt is no longer obese. Seems it has something to do with damaging the stomach.

Sorry I don't have more

OC_An Khe · Sep 3, 2007

Are you talking about a Katrina like disaster or a more local one like a fire in the facility? Just a thought, but if you are in a true disaster situation, triage principles need to be accounted for. Can you get everyone out? Do you evacuate the easiest first thereby probably moving more patients out of danger or the hardest first with the possibilty of moving less out of danger.?

lamazeteacher · Sep 4, 2008

I am making a Grand Rounds presentation for the surgeons at my hospital in mid October and with my background and expertise, they have asked me to present the issues of the obses population in disaster situations. I am focusing on home preparedness, communication of needs and evacuation issues.
I would love to hear from anyone who has dealt with this isuues, has or knows or a facility/agency that has a plan on this topic or any information you can share. I have a solid base for the article from peronal experience as well as multiple trainings and certifications, but always like to hear from pthers.
This most likely will roll into an article that the Bariatric Nurses Association has asked me to write.
Please contact me using the private messaging system
Thanks so much....\
LynneFFRN
RN, BSN, MBA, CNA, c-MSEM
Master Exercise Practitioner
Federal Homeland Security and Incident Command Instructor
Mass Fire Academy Instructor

How fabulous you are to access this resource!You could contact American Red Cross (ACS)chapters' Disaster Services nurses who assisted in the Katrina effort. New Orleans' penchant for fattening food consumption would have made the residents there highly likely candidates for obesity! I'd sure like to look at the records of any medical examiner's assessment of the size of the deceased persons, and I'll bet they were mostly overweight to morbidly obese, or they would have been more mobile, getting out to their roofs where they could be rescued.As an ACS Nurse volunteer on the Disaster Services Committee, I'm reaching back to my experiences working in shelter infirmaries during the aftermath of earthquakes and fires.None of the early arrivals at the shelters were in the least overweight! We had a group of 90 year+_ladies from an assisted living facility there by the time I reached the workstation, and they were all skinny. The San Francisco Delta Hotel fire in '94 brought many mobile folks to us, but they were somewhat overweight....... some had hypertension, needing BP checks and medications filled.....A friend of mine is friendly with a diabetic 400+ pounder who lives surrounded by her junk in a small apartment, which inhibits access to her. She's bedbound, and has no Hoyer lift at home. She would resist any assistance, as the state of the mess embarasses her. My friend is the only one she'll allow in! e.g. Her TV has only yellow hues since lightening struck her building months ago. We got a used TV for her, but we aren't physically able (due to advanced age) to carry it into the place, as things on the floor would have to be moved and she won't allow that. This demonstrates that she has given up the only mentally stimulating activity she has (other than telephone calls), due to self consciousness and self criticism.Obviously no firefighter's lift is possible for these folks, in a disaster situation, and the desperation of those for whom rescue possibility is limited to nonexistant, that inhibits their "flight" response.This is an extremely important population for a "focus group" of professionals. The Diabetes Association would be another resource, as people with morbid obesity are usually diabetic and needed early intervention and medical care years before their weight exceeded 250 pounds. I'm not saying the rescue of these individuals is only possible through eradicating their disease, but I'm a believer in prevention...... and planting mental "seeds". I admire your efforts.