As Patients Grow Larger, MedStar Adapts

By Marty Sabota


The obesity epidemic is growing, which means patients needing ambulances are getting bigger, too.
Accordingly, ambulance service MedStar is getting a big overhaul.  MedStar, which serves 15 Tarrant County cities, is converting its older Ford chassis to a heavier-duty Chevy chassis, according to Matt Zavadsky, MedStar associate director for operations.


"It's a growing problem," Zavadsky said of the increase in the number of calls to transport obese patients. "And it's one that's not going away anytime soon."


Zavadsky said about 80 percent of the fleet of 54 ambulances has been upgraded, with changes to be completed by year's end. The new chassis costs about $7,000 more than the previous chassis.


"In addition to the remounting, where we put the old box on the new chassis, we also purchased seven additional ambulances for the fleet last year due to the call volume growth and the staffing growth," Zavadsky said.  Zavadsky said the space or "box" area in which patients ride will not be affected.


Although MedStar doesn't keep statistics on patients' weight, Zavadsky said that the trend nationwide toward obesity holds true in North Texas as well. Last year, MedStar logged 220 calls requiring bariatric equipment, for obese patients.  He said one patient weighed close to 1,000 pounds.


"It's the biggest since I've been here," Zavadsky said. "It took lots of equipment and quite a while."


Dramatic increase
More than a quarter of American adults are obese, according to Karen Hunter, a spokeswoman for the U.S. Centers for Disease Control and Prevention.


"During the past 20 years, there has been a dramatic increase in obesity in the United States," Hunter said. "It's pretty disturbing when you see that most states have an obesity prevalence."  Zavadsky said MedStar is responding to those statistics.  MedStar's new gross vehicle maximum weight is 12,300 pounds, compared to the 11,500 pounds maximum previously.  That means the ambulances can carry an additional 800 pounds.


It's an important figure, which takes into consideration the equipment, the paramedics and emergency medical technicians, the patient and a family member or other acquaintance.


"The switch to the heavier-duty chassis is both because of making enough capacity for the patients and for the equipment that we carry," Zavadsky said. "As medical technology changes, we need to add more equipment to the ambulance, and that adds to the weight."


He said all of their ambulances, which are modular dual axle, can cost $130,000 without equipment, and equipment can tack on an additional $30,000 to $50,000.  "A cardiac monitor alone costs $20,000," he said.


Zavadsky said other changes are being made to accommodate people who, through the years, have become wider, heavier and even taller.  The company has several strong winches to move plus-sized patients in and out of the ambulance. A larger stretcher can carry patients up to 850 pounds.


Strap extenders can be attached to existing buckles to hold the patients securely, "just like you have on an airplane -- the same type of principle," Zavadsky said. 


EMT safety
MedStar spokeswoman Suzy Miller said the company is proud of its new equipment and "is always looking for what's on the horizon."


"The world seems built for what's average," Miller said. "However, MedStar has a responsibility to care for the safety and dignity of all our patients, even when one size doesn't fit all."


In addition to obvious benefits, the larger ambulances offer a smoother ride.  The changes are not only helping the patients, but the paramedics and EMTs as well.  Zavadsky said that heavier patients just add to the dangers of their profession.


"Emergency medical workers have a high workers comp rate," he said. "They suffer from back injuries, knee injuries, needle sticks and a host of other problems. It's a very dangerous profession."


MedStar will not charge an additional fee to offset the upgrade.  "We don't feel that's appropriate," Zavadsky said.