[Out-of-hospital management characteristics of severe obese patients].
OBJECTIVE
Assessment of prehospital management difficulties in morbid obese patients. Registration in several emergency departments for medical devices usable for morbid obese patients.


METHODS
Descriptive clinical study and regional survey.


METHODS
During one year, all morbid obese patients managed by the prehospital emergency mobile unit (PEMU) were recorded. Pre hospital medical management and hospital admission difficulties were systematically recorded and analyzed. A regional survey was also performed in clinical and radiological departments, which are likely to receive these patients in emergency situations.


RESULTS
During the period of study, 92 patients were managed by the PEMU. Medical difficulties were numerous: impossibility to measure arterial pressure in 8 patients, difficulties in peripheral line placement for 12 patients, difficult airway management in 5 of 25 (20%) patients requiring tracheal intubation. The handling of obese patients needed additional rescuer in 27 (33%) patients transported to hospital. The regional survey showed that many obese patients could not profit from several specialized diagnostic and therapeutics devices because of their weight restriction.


CONCLUSIONS
Management of morbid obese patients in the context of the out-of-hospital emergency medicine is frequently associated with specific and major technical difficulties. Numerous diagnostic and therapeutic devices are not currently adapted to the most severe overweight patients.
Jbeili
C
C
Département d'anesthésie-réanimation chirurgicale et Samu-Smur, 94, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Penet
C
C
Jabre
P
P
Kachout
L
L
Schvahn
S
S
Margenet
A
A
Marty
J
J
Combes
X
X
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D004630:Emergencies; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation*; D009767:Obesity, Morbid / Q000534:rehabilitation*; D010045:Outpatients