References

Allen R Hi-tech megambulance to ferry morbidly obese patients.: Adelaide; 2010

Standard Operating Policy. Transport of Bariatric Patient. SOP2012–002.: Ambulance Service of New South Wales; 2012

Procedure: Health Safety and Wellbeing, Manual Handling Procedure. PRO/PAC/019.Melbourne: Ambulance Victoria; 2012a

Work Instruction: Complex Patient Ambulance Vehicle (CPAV) Use.Melbourne: Ambulance Victoria; 2012b

Work Instruction: Equipment and resources for complex manual handling cases.Melbourne: Ambulance Victoria; 2012c

Bachman K Roundtable discussion: Weight stigmatization and bias. Bariatr Nurs Surg Patient Care. 2008; 3:(1)7-15

Baptiste A Roundtable discussion: Care giver injury and safe patient handling. Bariatr Nurs Surg Patient Care. 2007; 2:(1)7-16

Boatright J Transporting the Morbidly Obese Patient: Framing an EMS Challenge. J Emerg Nurs. 2002; 28:(4)326-9

Byard RW, Bellis M Significant increases in body mass indexes (BMI) in an adult autopsy population from 1986 to 2006–implications for modern forensic practice. Journal of Forensic and Legal Medicine. 2008; 15:(6)356-8

Cook D Obesity: the human and financial burden. Journal of Paramedic Practice. 2013; 5:(8)

Cowley S, Leggett S Manual handling risks associated with the care, treatment and transportation of bariatric patients and clients in Australia. International Journal of Nursing Practice. 2010a; 16:(3)262-7

Cowley S, Leggett S Manual handling risks associated with the transportation of bariatric patients in Australia. Journal of Emergency Primary Health Care. 2010b; 8:(2)

Cowley S, Leggett S Manual handling risks associated with the care, treatment and transportation of bariatric (severely obese) patients and clients in Australia. Work. 2011; 39:(4)477-83

Policy Directive: Critical Care Tertiary Referral Networks & Transfer of Care (Adults).Sydney: Department of Health NSW; 2010

Future prevalence of overweight and obesity in Australian children and adolescents, 2005–2025.Melbourne Victoria: Department of Human Services, Melbourne Public Health Branch, Rural and Regional Health and Aged Care Services; 2008

Fife C, Benavides S, Otto G Morbid Obesity And Lymphedema Management. Lymph Link newsletter. 2007; 19:(3)1-3

Gallagher S The challenges of bariatric care. Extended Care Product News. 2005; 101:(5)18-25

Promoting healthy weight: about overweight and obesity.Canberra: Department of Health and Ageing; 2009

Grant P, Newcombe M Emergency management of the morbidly obese. Emerg Med Australas. 2004; 16:(4)309-17

Green S, Gillett A Caring for patients with morbid obesity in hospital. Br J Nurs. 1998; 7:(13)785-92

Hignett S, Chipchase S, Tetley A, Griffiths P Risk assessment and process planning for bariatric patient handling pathways. Research Report RR573.Norwich: Health and Safety Executive; 2007

Humphreys S Obesity in Patients and Nurses Increases the Nurse's Risk of Injury Lifting Patients. Bariatr Nurs Surg Patient Care. 2007; 2:(1)3-6

Jung J Obesity: The new majority. Case Manager. 2004; 15:(6)51-4

Lipperman G, Preira G Accommodating the bariatric resident. Nursing Homes: Long Term Care Management. 2002; 51:(10)

Martin PJ, Harvey JT, Culvenor JF, Payne WR, Else D Victorian nurses back injury prevention project: Evaluation report.Melbourne: Victorian Government Department of Human Services; 2004

Muir M, Heese GA, McLean D, Bodnar S, Rock BL Handling of the bariatric patient in critical care: a case study of lessons learned. Crit Care Nurs Clin North Am. 2007; 19:(2)223-40

Nelson A Evidence-based guidelines for patient assessment, care planning and care giving practices in safe patient handling and movement. In: Nelson A New York: Springer Publishing Company; 2006

Nelson A, Baptiste A Evidence-Based Practices for Safe Patient Handling and Movement. 2004; 9:(3)

Nelson A, Baptiste A Evidence-based practices for safe patient handling and movement. Clin Rev Bone Miner Metab. 2006; 4:(1)55-69

Health at a glance 2011: OECD indicators.Paris: OECD; 2011

Public Health England. Morbid obesity. 2013. http//www.noo.org.uk/NOO_about_obesity/morbid_obesity (accessed 28 August 2013)

Pasco JA, Brennan SL, Kotowicz MA Morbid obesity in women on the rise: an observational, population-based study. BMC Public Health. 2013; 13:(1)

Pellatt G The safety and dignity of patients and nurses during patient handling. Br J Nurs. 2005; 14:(21)1150-6

Rush A Assessing clients for the correct hoist or sling: A practical guide. Int J Ther Rehabil. 2004; 11:(4)179-82

Rush A Use of specialized equipment to mobilize bariatric patients. Int J Ther Rehabil. 2005; 12:(6)269-72

Thomas S, Rickabaugh B Bariatric Nurse Coordinator: Carving Out a New Role in Bariatrics. Bariatr Surg Patient Care. 2008; 3:(1)63-72

Whipple K Maximizing Healthcare Provider Safety While Rehabilitating the Bariatric Patient. Bariatr Surg Patient Care. 2008; 3:(1)41-5

Manual handling guide for nurses.Gosford: WorkCover NSW Health and Community Services Industry Reference Group; 2006

Global strategy on diet, physical activity and health.Geneva: WHO; 2003

Impact of increasing obesity on primary health carers: an Australian perspective

01 September 2013
Volume 5 · Issue 9

Abstract

Increasing levels of obesity in Australia are having a direct impact on those associated with primary care and patient transport.

Whether the patient movement is undertaken in the uncontrolled environment of the home or the controlled environment of the hospital, design features generally limit the use of equipment and the application of safe handling procedures.

Ambulance and fire services are increasingly developing policies and procedures that address the movement of obese and morbidly obese (bariatric) patients and the purchase and use of equipment. Yet the efficacy of these procedures is hampered by the absence of a standard definition of the term ‘bariatric’. Various definitions of ‘bariatric’ are applied in different sectors and risk-based approaches rather than those based on weight, body dimensions or BMI may be more useful.

Substantially more work is required to inform the development of intervention strategies that will lead to significant and sustained risk reduction. Further work is also needed to quantify the frequency of bariatric patient movement within the emergency services across Australia. A clear representation of the journey and the interfaces between the agencies and carers and their respective roles would assist with defining the problem and understanding the solutions.

Growing levels of obesity in many westernised countries are having a direct impact on health care systems. The impact is felt to a high degree among primary carers and emergency services personnel.

In the past 20 years obesity prevalence has increased by half in the United Kingdom and the United States and more than doubled in Australia and New Zealand. Some 20–24% of adults in the United Kingdom and Ireland and Australia are obese (Organisation for Economic Co-operation and Development, 2011).

A proportion of the obese population become morbidly obese (bariatric), i.e. have a body mass index (BMI) 40 kg/m2 or more. Between 1993 and 2011, the prevalence of morbid obesity in England was consistently higher among women (increasing from 1.4% in 1993 to 3.2% in 2011) than among men (increasing from 0.2% in 1993 to 1.7% in 2011) and the prevalence of morbid obesity in England is predicted to rise over the next 20–30 years (Public Health England, 2013). In South Eastern Australia, the prevalence of morbid obesity among women increased from 2.5% to 4.2% during the decade between 1993–7 and 2004–8 (Pasco et al, 2013) and Australia is now ranked as one of the fattest developed nations (Government of Australia, 2009).

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed