For decades, a preoccupation with body weight has been ingrained in the American psyche. Over the years, Jane Fonda, Richard Simmons, Tony Little, and the Tae-Bo Guy have been tapping into this obsession and telling the public that happiness and a whole new life awaits for those who are willing to work up a sweat, drop a few pounds, and tone those legs and upper bodies. Even celebrities have jumped on the bandwagon, shilling for exercise equipment, gym memberships, and diet programs.

Nonetheless, the weight loss industry is not just a money making machine; it is addressing a need. The last few years have ushered in what Time Magazine last year dubbed “America’s Obesity Crisis.” A report from the Center for Disease Control and Prevention (CDC) caused quite a buzz last spring when it announced that 400,000 deaths per year were linked to obesity. While a more recent CDC study, based on newer data, claims that number may have been a bit exaggerated (by nearly 300 percent!), it did confirm that there is a growing number of health risks related to being significantly overweight. In addition to diabetes, hypertension, and heart disease, recent findings have linked the likelihood of dementia, including Alzheimer’s disease, to those who are overweight and obese throughout midlife.

Was the “obesity epidemic” sold to us last year overblown? What is an ideal healthy body weight? What diet and exercise programs are the safest and most effective for weight loss? The medical and scientific communities may long ponder and argue over these questions, but the fact is that Americans are indeed getting larger. And this is posing a problem for the healthcare personnel that are required to treat, transport, and care for them as patients.

As wider and heavier patients find themselves in need of medical attention and hospital stays, some of the older, time-tested hospital equipment such as chairs, beds, OR tables, scales, and patient transfer equipment that was designed around “average-size” patients, is proving inadequate. This in turn has opened up a new market for patient handling products that address the special needs of larger patients and the facilities that care for them. A number of medical product manufacturers are stepping up to meet those needs with high capacity patient handling equipment designed to keep both the patients and healthcare personnel safe throughout the facility.

Patient Handling Inside the OR...

Hill-Rom Company’s LIFTEM MARK IV Portable Lift can lift and move a 700-pound patient, while ensuring the safety of both the patient and staff

Skytron is one company that was in the forefront, releasing their Hercules 6500HD surgical table in 1994. This table offered 1,000-pound lifting capability and 850-pound articulation, while providing optimal imaging of larger, heavier patients. Earlier this spring, the company launched their newest table to serve the bariatric market. The Hercules 6700B surgical table combines the best features of the 6500HD and the 6600 Series General Purpose surgical table.

The Hercules 6700B surgical table can lift a 1,200-pound and articulate up to 1,000 pounds. It is also designed to lower to 23 inches from the floor, providing surgeons greater comfort when working over larger patients. Both back and leg sections are removable, and optional 36-inch carbon fiber back/leg sections are available for obstruction-free imaging amplification for upper or lower body procedures. The table top can be quickly widened to 30 inches with one piece specialty pads for wider patients. The table also features auto beach chair and return-to-level functions as well as optional Infrared (IR) Wireless Remote Control.

Skytron also offers the UltraSlide 3600B surgical table with 23-inch Top Slide and full table functions. This table lifts 1,000 pounds, articulates 800 pounds, and lowers to 24 inches off the floor. The 23-inch Top Slide capability quickly clears the table base to optimize C-arm access and can provide up to a 57-inch imaging window. This also provides extra leg room for both standing and seated surgeons. In addition to the exceptional imaging capabilities of the 3600B table, it offers many of the same features of the Hercules 6700B.

Skytron’s Hercules 6700B surgical table can lift up to 1,200 pounds and articulate 1,000 pounds.

Another leader in the bariatric surgical table market is STERIS Corporation. In addition to marketing a fine line of high-capacity general and specialty surgical tables, they also offer a number of table accessories designed to accommodate larger, obese patients. What is essentially the company’s flagship table is the Amsco® 3085 SP General Surgical Table. It is currently among the most widely used tables in North America and offers a generous weight capacity of 1,000 pounds. It has an extensive line of accessories for accommodating bariatric procedures and virtually any other surgical service. STERIS’s latest acquisition, though, eclipses the Amsco 3085 SP in weight and articulation capacity, offering broader options to surgeons treating bariatric patients.

The Cmax™ General Surgery Table (the Cmax name highlights the table’s extensive C-arm access) was specifically designed to accommodate both current and future surgical procedures and device technologies. It provides an 1100-pound weight capacity for prone and supine positions and a 900-pound capacity for patient articulation. Its unique intelligent hand control displays both patient and table status, while the auto-limit sensor prevents table articulation conflict and suggests corrective measures. The Cmax's powered longitudinal slide provides 86 inches of full-body imaging without the need to change patient orientation, and the powered removable leg section increases surgeon access to the perineal area and can act as a patient transfer device. This is especially helpful in dealing with larger patients that can be a problem to move.

The AIRPAL Patient Air Lift gently raises and glides patients weighing up to 1,200 pounds on a frictionless air surface for easy lateral transfer.

Among the problems that STERIS’s table accessories address is that obese patients are not only heavy, but usually very wide as well. While a number of tables can tolerate the weight of bariatric patients, many of them struggle to accommodate the girth. STERIS’s Bariatric Table Extensions (a set of eight extensions) are sized specifically for 3080 and 3085 SP Tables and have no pinch points or obstructions. They extend the normal 20-inch table width to a continuous 28-inch wide surface, with standard side rails that accommodate most other accessories. These table extensions are rated at the same 1000-pound weight capacity as the Amsco 3085 SP surgical table.

The STERIS bariatric accessory line also includes Bariatric Power-Lift Stirrups, which have gas spring assists that ease the lifting of the heaviest legs and support patients as heavy as 800 pounds; an extremely strong Bariatric Foot Extension that connect to the side rails of the Bariatric Table Extensions; a Bariatric Fluid Collector, a Bariatric Reverse Trendelenburg Strap, and a variety of storage options for bariatric accessories.

Even on a surgical table that can accommodate their weight and girth, bariatric patients run other risks during lengthy surgeries, such as developing pressure ulcers. Action Products has been supplying hospitals with pads and positioners to minimize pressure sores for over 15 years. The pads and positioners are made of the company’s soft AKTON dry polymer. This polymer functions much like a gel, but offers a longer life and will not leak, flow, or bottom out—a crucial component in avoiding pressure sores on bariatric patients. There are over 100 reusable, radiolucent Action pads and positioners available to protect patients of all weights and sizes, including head donuts, armboard pads, positioning straps, ulnar protectors, foot pads, and more.

Of course, the problems inherent in holding, moving, and positioning large and obese patients extend beyond the OR and into other areas of the facility as well. Pre- and post-op accommodation of bariatric patients must be addressed as well.

The Maxi-Rest bariatric bed is part of Gendron’s “Total Solutions for Bariatric Patient Care.”

Hill-Rom Company offers a variety of innovative systems and devices to help move heavy patients while ensuring the safety of both the patient and staff. The LIFTEM® MARK IV Portable Lift features a patented ergonomic lift design that is capable of lifting and moving patients weighing up to 700 pounds without physically moving the lift. The patient transfer is regulated by the pendant control, so the lift does all the work, rather than the nurse. This portable device comes with an optional scale for weighing patients, and has an integrated safety-control system to ensure patient safety.

Lateral patient transfer systems are also available from Hill-Rom. The AIRPAL® Patient Air Lift gently raises and glides the patient over a frictionless air surface, easing the transfer from bed to stretcher and back. The AIRPAL can accommodate patients up to 1,200 pounds and the fast and easy transfer helps reduce the risk of injury, while keeping the patient comfortable. The Barton I-660 Transfer/Chair is designed to allow a single caregiver to safely and easily laterally transfer patients up to 660 pounds. It quickly and easily converts from the prone stretcher position to an upright mobile chair, while a fully adjustable headrest with side support, a fold-away foot rest, and a central brake-and-steer system help increase patient comfort and safety.

Gendron, Inc. has an extensive offering of unique products aimed toward the bariatric market. Offering what they call the “Total Solutions for Bariatric Patient Care,” the company offers something to meet virtually every special need of the bariatric patient across the facility. Their product line includes bariatric beds, lifts, chairs, seating, walkers, wheelchairs, commodes, transfer products, stretchers, and much more.

Scale-Tronix offers a wide variety of wheelchair scales, stand-on scales, bed scales, and other weighing systems designed to accommodate bariatric patients.

Among the most recent additions to the Total Solutions is the Extra Care™ Bariatric Beds. The Extra Care Beds are conveniently adjustable, allowing the width to be narrowed to 39 inches for doorway pass-through and patient mobility, yet extending to provide a full 54-inch wide sleep surface. The bed provides unobstructed patient access and a stable platform, so physicians can even perform minor procedures on patients in the bed.

Of course, one of the first diagnostic steps in treating a bariatric patient is ascertaining his/her weight. Traditional old stand-on scales with the sliding weights usually can’t accommodate larger, obese patients, and may be uncomfortable if not impossible for them to use. Fortunately, Scale-Tronix, Inc. offers a number of scales in a variety of configurations to ensure safe, accurate, and easy weighing of bariatric patients. Offering weighing systems, wheelchair scales, stand-on scales, and bed scales that boast capacities up to 1,000 pounds and enlarged weighing platforms, Scale-Tronix scales provide ease of use for the patient and the nursing staff. Certain models even include hand-rails and ultra-low stable weighing platforms to increase not just the patient's safety, but also peace of mind.

While it cannot be said that the steady and increasing growth of Americans in size and weight is a good thing, there are a number of steps that can be taken personally and medically to keep things largely under control. A good, reasonable diet and an exercise regimen are usually enough to keep the slightly pudgy on a healthy track, but for those who need additional help; it’s nice to know there are doctors, and facilities, that can handle them.