Two obese patients remained in hospital for weeks because there was no way to transport them home, a report calling for action to improve the safety of obese patients in Otago District Health Board facilities says.
The patients had been transported to hospital by St John ambulance when they were in an acute condition, but the service had cited weight and physical dimension as the reason they could not safety undertake the transfers home, the report said.
It did not name the hospital or hospitals involved.
The report, written by professor of paediatrics and child health Barry Taylor, nurse director Adele Knowles and project co-ordinator Raymond Jones, follows a project which looked at how the board should deliver services for the obese.
The 10-strong project team decided there were some immediate risks to be remedied and that the safety of overweight, obese and morbidly obese patients in board facilities needed to be the priority for action.
The report, which will go before the board's community and public health advisory committee today, noted that the standard St John stretcher could accommodate a maximum weight of 180kg and was 45cm wide.
There had been instances where St John had not been able to undertake a routine inter-hospital transfer due to a particular patient's weight or physical dimensions.
Alternative transport was found, but the risks associated with this non-standard method were great.
Fire service staff were sometimes called to help.
St John district operations manager for coastal Otago David Jasperse said the instances in the report were not regular occurrences, but predictions about obesity rates suggested the service would eventually be dealing with more obese people.
In the ambulances, the drop-leg stretchers which fitted into a plinth inside the vehicle had reduced the floor space, common to earlier designs, and this made it more difficult to transport very large people.
Mr Jasperse said staff could sometimes be putting themselves at risk to ensure a patient requiring urgent treatment could be transported to hospital.
That involved a different responsibility for the service than taking them home after treatment.
As well as concerns for staff safety, there was the dignity of the patient to consider.
If the person was not mobile, there was the question of how they would get back into their home, something which placed an unfair expectation on ambulance staff and possible risk to the patient, especially if any lifting was required.
One of the report's recommendations was that a request be made to the Southern Region Emergency Care Co-ordination Team to review the provision of care services for obese patients with special focus on patient transportation, rural hospitals' and community services' ability to manage obese patients and fire service involvement as the "last line of rescue".
