The Practical Application of Emergency Evacuation of Bariatric Patients in an Acute Teaching Hospital

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The Practical Application of Emergency Evacuation
of Bariatric Patients in an Acute Teaching
Hospital

• Presented by - Harvey Stewart Helen Naylor

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HTM 05-03

• States-
• Once a fire has started, has been detected and a
  warning has been given, occupants should be able
  to escape safely, either unaided or with
  assistance but without the help of the fire and
  rescue service.

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Background

• Old Victorian Building
• Steep, narrow metal fire escapes with
  180switchbacks
• Need to be able to successfully evacuate all
  patients unaided by Fire Service

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Process

• Bariatric Working Group - sub group for
  evacuation
• Identify the areas where bariatric patients are
  treated
• Identify areas where it is safe to treat this
  type of patient taking into account the size of
  the patient in relation to the fire exit route
  and door opening.
• Draw up a plan of rooms that are more suitable
  with regard to fire evacuation.
• Any extra fire compensations required were
  identified e.g. 60 minutes fire doors and fire
  compartmentation

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Staff Information

• Providing Dignified Care for Bariatric Patients,
  guidelines for staff
• Developed Bariatric Risk Assessment and Care
  Pathway
• Personal Emergency Evacuation Plan

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Equipment

• Source suitable equipment easier said than done.
  Two were found

Evacuation Jack
Evac Mat
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Equipment Trials

• The first trial was with the Evacuation Jack

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• The second was with the Evac Mat

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Outcome

• Evacuation Jack

• Pros
• Easy to insert under patient
• Quick to inflate
• Integral back support
• Very easy to move
• Minimal manual handling

• Cons
• Quiet wide
• Unflexible to negotiate tight corners
• Difficult to negotiate narrow fire escape

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Outcome cont.
Evac Mat

• Pros
• Easy to insert under patient
• Buckles were quick to connect
• Easy to negotiate tight corners
• Easy to negotiate narrow fire escapes
• Similar process to ski pads already used in Trust
  

• Cons
• More manual handling involved than evac jack
• Not as comfortable for the patient

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Next Stage

• Recommendations for evacuation equipment
  additional fire compensations accepted by Senior
  Management
• Bariatric assessment guidelines accepted by
  Assistant Chief Nurse
• Recommendation of the fire officer with regard to
  the more suitable areas on the wards accepted by
  Senior Management

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• 29 Bariatric Evac Mats ordered, delivered
  strategically placed through out the trust.
• Estates are addressing the extra fire
  compensations required.
• Laminated plan of most suitable room/s placed in
  the fire warden book
• Commence training in the use of the Evac Mat

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Introduction of the Bariatric Evacuation Mat to
the Fire service

• A number of practical training sessions using the
  Evac Mat have been carried out covering all 4
  watches and all local fire stations have been
  involved.

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Other Developments

• Vertical evacuation of patient theatre
• A fire evacuation exercise was carried out to
  evacuate a patient following major surgery
• The patient in relation to weight and size did
  not warrant the use of the bariatric evacuation
  mat.
• The senior surgeon who took charge of the mock
  evacuation decided to use the Evac Mat instead of
  the ski pad not for the size of the patient but
  because of the amount of medical monitors and
  equipment that needed to stay with the patient
  during evacuation.
• The Evac Mat because of its extra size was used
  successfully to evacuate this patient and
  encompass all the equipment safely.

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Other Developments cont.

• Fallen Patient
• Although the Evacuation jack was not suitable for
  fire evacuation the Trust has purchased two
  systems to be used for the retrieval of fallen
  patients.
• It can raise a patient from the floor in either a
  seated or supine position to bed or stretcher
  height.
• Can be used with a spinal board.
• No minimum weight limit maximum weight limit
  862kg (135 stone)

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Suitable Patients Suspected spinal fracture
(can lift patient whilst on spinal board) Any
other suspected fracture Cardiology /
respiratory compromised patients (due to integral
back rest) Bariatric patients Patients with
peripheral vascular disease Patients with
cellulitis / leg oedema where hoisting may cause
skin damage Patients with little / no head
control Neurologically compromised patients
Any fallen patient where hoist access is not
possible
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• Thank you for listening
• Any Questions?