[Out-of-hospital management characteristics of severe obese patients]. / Particularités préhospitalières de la prise en charge des patients obèses sévères et morbides.

ABSTRACT

OBJECTIVES: Assessment of prehospital management difficulties in morbid obese patients. Registration in several emergency departments for medical devices usable for morbid obese patients. STUDY DESIGN: Descriptive clinical study and regional survey. PATIENTS AND 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. CONCLUSION: 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.