Presented by :- Harvey Stewart & Helen Naylor

1. The Practical Application of Emergency Evacuation of Bariatric Patients in an Acute Teaching Hospital Presented by :- Harvey Stewart & Helen Naylor Better Medicine Better Health

2. 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.’ Better Medicine Better Health

3. Background • Old Victorian Building • Steep, narrow metal fire escapes with 180°switchbacks • Need to be able to successfully evacuate all patients unaided by Fire Service Better Medicine Better Health

4. 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 Better Medicine Better Health

5. Staff Information • Providing Dignified Care for Bariatric Patients, guidelines for staff • Developed Bariatric Risk Assessment and Care Pathway • Personal Emergency Evacuation Plan Better Medicine Better Health

7. Equipment Evacuation Jack Source suitable equipment easier said than done.Two were found Evac Mat

8. Equipment Trials The first trial was with the Evacuation Jack

13. The second was with the Evac Mat

21. 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 Better Medicine Better Health

22. 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 Better Medicine Better Health

23. 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 Better Medicine Better Health

24. 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 Better Medicine Better Health

25. 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. Better Medicine Better Health

26. 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. Better Medicine Better Health

27. 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) Better Medicine Better Health

28. 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 Better Medicine Better Health

29. Thank you for listening Any Questions? Better Medicine Better Health