This report originally appeared in the August 2010 issue of DOTmed Business News

The hospital's wake-up call was admitted to the critical care area. The patient, a 42-year-old man, quickly fell into a coma, becoming unresponsive to the medical staff buzzing around him. At that point, moving the comatose man proved to be a challenge.

The normal body mass index (BMI) range for a man the patient's height is somewhere between 18 and 25. When this individual was rushed through the hospital's doors, he had a BMI of about 91 and weighed 700 pounds.
"That was our largest patient to date," says Marylou Muir, a retired nurse with 30 years of experience, who was on shift when the patient was admitted to the Health Sciences Centre in Winnipeg, Canada. "It certainly tested all the equipment, whether the width ratings and the weight ratings were going to be compatible for this patient, so we had lots of challenges," she says.

The man was admitted to the facility three years ago, and the hospital didn't have the proper equipment to handle a patient of his size. Six people were needed to merely turn him. Other elements of patient management - everything from intubation to routine hygiene care - called for more medical staff and well thought-out safety considerations.

The man spent 95 days in critical care. At one point during his stay, his bed broke down.

"When you have one bed and the bed breaks, what do you do?" asks Muir.

While the bed was undergoing repairs, the medical team placed the man in an alternative device, which due to its design, was not the most effective way of managing the patient.

The staff also had difficulty transferring the patient to a power chair using the floor lift device. Finding the correct angle between the device, the patient and the swing proved to be another challenge.

"You're forever coming up with new problems, it seems," says Muir. "And each patient is certainly a learning experience when they're that size and level of immobility."

Today, the hospital is ready to accommodate morbidly obese patients. Muir says the improvements in technology over the past several years make it possible to effectively manage the bariatric population.

If one lesson can be derived from Muir's extensive experience, it's that the influx of bariatric patients poses unprecedented hurdles to health care providers, challenges that cannot be ignored. Currently, she sits on the board of directors for the National Association of Bariatric Nurses in the United States and works as a private bariatric patient management consultant.

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