Dr Brendan O’Hare1, Dr Nathan White, Dr John Glasheen, Mrs Renee Bolot, Dr Lynton Hargreaves
1Lifeflight Retrieval Medicine, Brisbane, Australia
Introduction
The caseload of bariatric retrieval in the Australian setting has not yet been described in the literature. Management of this high-risk patient population in the prehospital and retrieval environment is associated with added clinical and logistical difficulties. Strategies are required to mitigate risk to patients and retrieval teams, including the use of appropriate manual handling techniques and devices.
Methods
A retrospective analysis of all bariatric aeromedical retrieval cases from July 2109 until August 2021. Because LRM does not routinely record patient height, we used body weight >120kg as a surrogate for obese BMI. Demographic data is described, as well as the clinical priority of the cases, the transport platforms used, and critical care interventions provided.
A comparison of difficulty of intubation in this patient population with the wider retrieval population by reporting both the overall and the first attempt intubation success rate. Procedural complications, clinical adverse events and logistical difficulties encountered in the bariatric retrieval cohort are also described.
Results
Results showed patients in the bariatric group had 14.8 rate of suffering an adverse clinical event, and 1.7 rate of intubation.
Airway data also demonstrated an increased number of attempts and worsening airway grade at increasing weights, particularly over 130kg
Conclusions
This descriptive study demonstrates a higher rate of complications among bariatric patients in the prehospital environment in Queensland and will be of interest retrieval agencies and clinicians to aid with strategic planning of aeromedical services, assessment of necessary equipment, and to inform the design of targeted education programmes.