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Abstract

Objectives Identify the factors that affect the risks and the adoption of risk control measures during the care of bariatric (morbidly obese) patients by paramedics and fire fighter first responders in Australia.

Methods Focus groups were conducted in neutral locations in two Australian state capitals; a suburban region of Melbourne which straddled the rural and metropolitan boundaries; and a large regional Victorian town.

Results Carers of bariatric patients are exposed to manual handling injury risk throughout the journey that bariatric patients take within the healthcare and funeral systems. In focussing on paramedics and fire service first responders, as key groups within that journey, it was found that the risks are significant but are not quantifiable. The injury risk is influenced by the nature and design of the range of environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term "bariatric" and gaps in the information flow during the bariatric patient journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions.

Conclusions There is a lack of knowledge about how to safely manage the unique needs of bariatric patients. It appears that few streamlined systems have been established for patient management, and many cases are managed as if they are an isolated experience. There is little documentation of systems or case studies and thus very little sharing of the knowledge. Improvements in manual handling risk control for carers requires greater inter and intra-industry collaboration, which in turn requires an agreed definition of "bariatric".

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