Special Considerations for Bariatric Patients

Bariatric patients, individuals who are significantly overweight or obese, have specific needs related to their healthcare and daily living. These needs encompass various aspects of their physical, emotional, and social well-being. Here are some key considerations when caring for bariatric patients:

    Specialized Equipment:
        Bariatric patients often require specialized medical equipment, such as wider hospital beds, heavy-duty wheelchairs, commodes, and patient lifts, to ensure their comfort and safety.

    Healthcare Staff Training:
        Healthcare providers should be trained in proper bariatric patient care techniques, including safe patient handling and transfer protocols. This training helps prevent injuries to both patients and healthcare workers.

    Nutritional Support:
        Bariatric patients may need specialized dietary guidance and support to manage their weight and overall health. Nutritionists or dietitians can work with them to develop appropriate meal plans.

    Mobility Assistance:
        Some bariatric patients may face mobility challenges. Physical therapists can assist in improving mobility and independence through exercise and mobility aids.

    Wound Care:
        Bariatric patients are at higher risk for skin issues, including pressure ulcers. Proper wound care and preventive measures are essential.

    Medication Management:
        Medication dosages may need adjustment for bariatric patients due to differences in metabolism and body composition. Close monitoring is important.

    Psychological Support:
        Many bariatric patients face emotional and psychological challenges. Support from mental health professionals, support groups, and counseling services can be valuable.

    Respect and Dignity:
        Providing respectful and dignified care is crucial. Healthcare providers should avoid stigmatization and ensure the privacy and comfort of bariatric patients.

    Safety Precautions:
        Ensuring that the healthcare environment is free of obstacles and hazards that could pose a risk to bariatric patients is essential.

    Customized Care Plans:
        Care plans should be tailored to each patient's unique needs and circumstances, taking into account their medical history, comorbidities, and goals for treatment.

    Bariatric Surgery Considerations:
        For some severely obese individuals, bariatric surgery may be an option. Care providers should educate patients about the risks and benefits, as well as provide comprehensive pre-operative and post-operative care.

    Social Support:
        Encouraging involvement of family and friends in a bariatric patient's care and recovery can be beneficial.

    Regular Follow-Up:
        Ongoing monitoring and follow-up appointments are crucial to track progress and address any issues that may arise.

Bariatric patients often require a multidisciplinary approach to their care, involving healthcare professionals from various specialties. The goal is to support their overall health and well-being, while respecting their unique needs and circumstances. By providing tailored care and support, healthcare providers can help bariatric patients achieve better health outcomes and an improved quality of life.

 Learn more on how you can use Ruth Lee Bariatric Training Manikins in your facility:

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Twin Tensioned Rope Systems for Rescue

The TTRS are fast becoming the go-to set up for rescue.  But, we must be reminded there are limitations for this system.

Twin-tensioned rope systems, commonly used in technical rope rescue scenarios, offer several advantages but also come with limitations and considerations. Some of the limitations of twin-tensioned rope systems for rescue include:

1. Complexity: Setting up a twin-tensioned rope system can be complex and requires a good understanding of rope rescue techniques and equipment. This complexity can increase the risk of errors, especially in high-stress situations.

2. Equipment Requirements: Twin-tensioned systems typically require more equipment, including multiple anchors, pulleys, and additional rope. This can make the system heavier and more cumbersome to set up and manage.

3. Space Requirements: Setting up twin-tensioned systems often requires more horizontal space compared to single-tensioned systems. In confined or urban environments, this may not be practical.

4. Tension Management: Maintaining equal tension in both ropes can be challenging. If not properly managed, one rope may take more load than the other, potentially leading to an imbalance and increased risk.

5. Load Redistribution: If a load is suddenly applied to one side of the system (e.g., a rescuer falling), there can be a sudden shift in load distribution, which may require rapid adjustments to maintain balance.

6. Knot Passing: Passing knots through pulleys in a twin-tensioned system can be difficult, which can slow down operations and increase the risk of mistakes.

7. Increased Friction: With more pulleys and redirections, twin-tensioned systems can introduce more friction into the system, which can reduce efficiency and make hauling and lowering operations more strenuous.

8. Communication Challenges: Effective communication is crucial in any rescue operation. In twin-tensioned systems, rescuers on each rope may not be able to communicate as easily as in simpler systems, potentially leading to misunderstandings or coordination issues.

9. Additional Training: Operating twin-tensioned systems effectively requires additional training and experience. Rescuers need to understand the principles, equipment, and techniques specific to these systems, which can be a barrier for some teams.

10. Risk of Entanglement: With more ropes and pulleys in play, there is an increased risk of entanglement or jamming of equipment, which can complicate operations and introduce safety hazards.

11. Weight Limitations: The combined load of a victim, rescuers, and equipment may exceed the weight-bearing capacity of the ropes or anchors, especially in complex rescue scenarios.

12. Cost: The equipment needed for twin-tensioned systems can be more expensive than simpler systems, which may be a limitation for organizations with budget constraints.

Despite these limitations, twin-tensioned rope systems can be highly effective in certain rescue situations, particularly when a more complex and versatile setup is required. However, they should be used by trained and experienced personnel who understand how to manage the associated challenges and risks.

See our selection of NFPA-G rated 7/16" ropes:

 Back Injuries in the Nursing Profession

Back injuries in the healthcare industry are relatively common due to the physically demanding nature of the work. Healthcare workers, such as nurses, nursing assistants, and orderlies, often lift, move, and transfer patients, which can put significant strain on their backs. Here are some key points to consider:

1. **Causes of Back Injuries:**

   - **Patient Handling**: The primary cause of back injuries in healthcare is the manual lifting and transferring of patients.
   - **Repetitive Tasks**: Repeatedly bending, lifting, and twisting can strain the back over time.
   - **Awkward Postures**: Healthcare workers often have to work in awkward postures, which can contribute to back problems.
   - **Equipment**: Improper use of patient handling equipment or lack of access to it can also lead to injuries.

2. **Preventing Back Injuries:**

   - **Proper Body Mechanics**: Training healthcare workers in proper body mechanics, including lifting techniques, can help prevent back injuries.
   - **Use of Patient Handling Equipment**: Whenever possible, healthcare facilities should provide and encourage the use of patient lifts, transfer boards, and other equipment.
   - **Team Lifting**: In situations where a patient's weight or mobility requires it, always use a team approach to lifting and transferring.
   - **Ergonomics**: Adjusting workstations, chairs, and other equipment to suit the individual worker's needs can reduce the risk of injury.

3. **Ergonomics in Healthcare Settings:**

   - Proper ergonomics can help healthcare workers maintain good posture and minimize the strain on their backs.
   - Adjustable beds, stretchers, and examination tables can be helpful.
   - Flooring and surfaces should provide adequate traction to prevent slips and falls.

4. **Workplace Safety Regulations:**

   - Occupational Safety and Health Administration (OSHA) in the United States and similar organizations in other countries set guidelines for workplace safety, including regulations specific to the healthcare industry.

5. **Injury Management:**

   - Early intervention and appropriate treatment of back injuries are crucial to prevent long-term complications.
   - Healthcare workers should report injuries promptly and receive medical evaluation and treatment as needed.

6. **Education and Training:**

   - Continuous education and training on safe patient handling techniques and ergonomic principles are essential for preventing back injuries in the healthcare industry.

7. **Policy and Culture:**

   - Creating a culture that prioritizes the safety and well-being of healthcare workers is important. Policies that emphasize safe patient handling and reporting of injuries should be in place.

Preventing back injuries in the healthcare industry is not only important for the well-being of the workers but also for the quality of patient care. By implementing proper training, equipment, and workplace safety measures, healthcare facilities can reduce the incidence of back injuries and create a safer and healthier environment for their staff.

See the Ruth Lee Patient Handling Manikins Here:  Click Here

CREATING REALISTIC AND CHALLENGING EXTRICATION EXERCISES WITH MANIKINS

According to statistics from ‘Statista’, in 2018 there were around 273.6 million cars on the roads in the U.S. It’s no surprise then that there are 17250 accidents that occur on the roads every day. Some are low-impact bumps, but others are more serious, requiring the Fire and Rescue Service to free those trapped inside. In fact, The Department for Transport reported 33,654 road deaths in 2018..

When there has been a serious collision, extricating injured and trapped people can be extremely difficult. Often, vehicles need to be stabilized before teams can even start to think about getting someone out safely, and of course, the safety of both the injured person, and the crew rescuing them is paramount. It goes without saying that training can help teams to construct effective plans for a variety of difficult scenarios and at Ruth Lee we have a range of manikins which will provide different extrication challenges for your team.

DUTY PLUS MANIKIN

If you need a versatile, durable manikin, which will sit upright in a vehicle, can be fitted with a neck brace and will 'act' as a conscious casualty, the NEW Duty Plus manikin is the ideal choice. This manikin is constructed with a plastic spine to help prevent ‘head flopping’, closed cell foam in the back and polyethylene strips which run to the waist/hip area allowing flexibility and a more ‘upright’ position - perfect for sitting in vehicles. Anatomically correct weight distribution to give the ‘feel’ of a conscious casualty, perfect for encouraging correct patient care.

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WATER-FILLABLE BARIATRIC SUIT

What would you do if you were called out to an obese casualty, trapped inside the cab of a Semi? Our new Water-fillable Bariatric suit lets you turn a Ruth Lee Duty manikin into a bariatric. The beauty of this product is that you can position the manikin in place before adding the weight, letting your trainer create more challenging extrication scenarios.

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MULTI-TRAUMA MANIKIN

You attend a serious MVA and the driver has been impaled by an object which has penetrated his window-screen. You can now train your team to prepare for this scenario using the Ruth Lee Multi-Trauma Manikin! With a chest cavity to let you impale the manikin, and detachable limbs to simulate a full or partial loss of limb, this versatile manikin will let you create a very challenging rescue scenario.

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AIRWAY MANAGEMENT MANIKIN

Airway Management Skills are often practiced in a warm classroom - how would your team react completing these skills in a real emergency - Such as underneath an over-turned vehicle? Our Full-Bodied Airway Management Manikin is tough and can be trapped by the arms or legs, allowing you to prepare life-saving strategies for this scenario.

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WHEN THE WORST HAPPENS…WHY EMERGENCY EVACUATION PLANNING IS SO IMPORTANT

No one wants to think about it – but how would your team cope if the worst happened and there was a fire in your Care Home?   It’s likely you would have a large number of residents who are infirm, even incapacitated and in need of assistance to evacuate, some may even be bed-ridden.   In the wake of the Grenfell (UK)  tragedy, buildings which house a large number of residents are coming under closer scrutiny with regards to emergency planning – for good reason.

PREPARING A PLAN

One of the best things you can do to ensure the safety of your residents and staff is to create a detailed and robust emergency evacuation plan. But even the best plan In the world will be ineffective unless your team feel confident they can carry it out.   In a true emergency people can become anxious and flustered, leading to mistakes both in terms of what to do, but also ‘how’ to do it! For example, they may try and lift someone badly, causing injury to themselves or the resident they are helping.

WHY TRAINING IS KEY TO EFFECTIVE EMERGENCY EVACUATION

You should ensure that your staff are able to lift or assist residents safely and efficiently (either manually or by using lifting and transfer equipment) to make sure your home would be evacuated quickly, with no injury to residents or staff. A UK HSE report on the Health and Care Industry in 2014/15 indicated that each year there are 86,000 self-reported non-fatal workplace injuries, with 27% of these involving lifting and handling.  Regular staff training is key to avoiding injury and using training manikins can be very beneficial.  At Ruth Lee, we can provide a range of training manikins which are perfectly suited to Care Home training.

Although traditionally, staff would practice skills on each other, using a manikin means there is significantly less risk of injury (i.e. a dummy won’t get hurt if you drop him!). Another benefit is that the whole team takes part (no volunteer required) – and because we have a range of different manikins, from a 20kg Patient Handling manikin, right the way up to a 260kg bariatric or obese manikin, you can make sure your team are trained to help people of all shapes and sizes! We also provide Full Bodied CPR or Airway Management Manikins to let your teams perfect their life-saving skills. 

ADDING DRAMA – WITH FIRE SIMULATION

If you want to create a training scenario which will be remembered for years to come (for all the right reasons) and truly test your team’s ability to react quickly and rationally in a ‘fire’ situation, you might also consider Fire Simulation.

We know what usually happens in a fire drill – people take their time, grab a coat, ‘down their brew’ – how would they react if smoke was coming down the corridor. Would they behave rationally and safely? Would they rush to help residents and cause injury to themselves or someone in need of help? Fire simulation lets you test and improve your team’s reactions.

SMARTER TECHNICAL RESCUE - WORKING AT HEIGHT AND CONFINED SPACES

Over the years, Emergency Services and Civil Defense teams around the world have greatly improved the skills of their teams to make sure they have the specialist skills required to perform technical rescues such as working at height and confined spaces.

We know that a ‘trial-by-error' approach won’t cut it – your team needs to be confident that they have technical rescue skills which are well embedded through effective and regular training.

 

WORKING AT HEIGHT – TRAINING TO MITIGATE THE RISK

Did you know that statistically, falls from height account for the highest proportion of workplace fatalities in the UK? Even if employers ensure that staff are well trained in using fall arrest equipment, there is also a significant risk of suspension related injuries and consequent fatality and therefore it is imperative that plans are in place to quickly and efficiently rescue the casualty.

The Work at Height Safety Association provide expert advice on the potential risk to casualties who are left suspended, especially those who are unconscious. Specifically, that the longer a casualty is suspended without moving, the greater the chances are of serious consequences developing. Suspension Trauma is a very real risk, which is potentially fatal and training to ensure that workers are quickly rescued is absolutely imperative. 

Therefore, rescuers must be skilled in extricating a casualty from a suspension quickly to make sure that this risk is minimized and training is the best way of achieving this goal. 

 TRAINING MANIKINS FOR WORKING AT HEIGHT

While you may already know and love our standard duty manikin, we have worked with experts in the field of technical rescue to develop manikins to suit specific training scenarios including working at height.

Available in a range of weights, 30, 50 and 70Kg, the Working at Height Manikins are designed to be anatomically correct with regards to weighted proportions and due to additional features, will sit comfortably in a rescue harness without slumping, making it the ideal choice for working at height rescue training.

 

IN A TIGHT SPOT...MANIKINS FOR CONFINED SPACES

Another technical rescue skill which is increasingly in focus is confined space extrication. It is a very specialist skill and depending on the environment of the extrication, potentially hazardous for the rescuer and casualty.

Previously, training for confirmed spaces could be tricky – getting your manikin into the narrow space could be as much of a challenge as extricating it in training! This is why we designed the Confined Space Manikin, which splits into several components to be constructed once the manikin is in position. None of the individual parts weigh more than 25kg meaning that it is easy to carry the individual pieces into the confined space.

In October 2019, we worked with Eight2O Water Alliance to set up a training scenario for their teams. Working in collaboration with South Central Ambulance Service HART Team and specialist technical rescue crews from Oxfordshire Fire and Rescue, a fantastic technical rescue exercise was developed, which was praised by all. 

 The Ruth Lee Ltd range of technical rescue manikins is well worth investigating if you are looking for a more challenging training scenario for your team. Our expert team are able to talk you though the different manikins to make sure that you choose the right man(ikin) for the job.

CARE HOME EVACUATION TRAINING - HORIZONTAL AND VERTICAL EVACUATION AND THE IMPORTANCE OF PEEPS

If you manage a property which houses a large number of residents, many of which have complex needs in terms of their mobility, you will no doubt have considered how best you might evacuate everyone safely in the event of an emergency.

PEEPS (Personal Emergency Evacuation Plans) should be written for any resident who is unable to safely walk unaided, and these must be tailored to the individual’s needs. Each PEEP should give detailed information on this person’s movements during an evacuation and importantly, all members of staff should be aware of these instructions and be confident in their ability to carry them out to the letter.

For example, is the individual able to walk unaided or will they need a lot of support? Complex mobility or neurological needs should to be considered and you might decide that horizontal evacuation is preferred for these residents, at the initial stages of an evacuation at least.

Likewise, if someone is found unconscious, there should be a different procedure in place which is understood by all staff in case on an emergency situation.

 

VERTICAL AND HORIZONTAL EVACUATION

Depending on the style and size of your residence, you may need to consider both vertical and horizontal evacuation procedures.

Vertical Evacuation (using a stairway) is usually the preferred method of exiting a building in an emergency. Simply put, this refers to using the stairs to get everyone who is usually housed above the ground floor out of the building quickly.  However, generally speaking this method is for those who are able to evacuate a building with minimal assistance. Ideally, you should house those with mobility needs on the ground floor, where possible.

However, in some larger premises, the evacuation procedures and plans are designed to allow for horizontal evacuation, where people who are not in imminent danger can delay starting their evacuation.

This means that fire escape routes do not become congested and a danger in themselves.

Horizontal, phased evacuation is the method of moving people away from the area of danger to a safer place on the same floor. This type of evacuation is usually required where a resident cannot use exit stairs to get outside and must remain on a particular floor until assistance arrives. This is one reason why using fire doors properly is so important, as they help to create fire resistant compartments.

However, depending on the fire situation it may ultimately be necessary to attempt a vertical evacuation with these residents too and therefore, a resident’s PEEP should have listed the preferred method of moving that person down a flight of stairs.

 TRAINING FOR EVACUATION

In order to ensure that evacuation procedures run smoothly it is important to conduct regular training. This is in fact a legal requirement and forms part of fire regulations.

Therefore, conducting regular drills, and ensuring that enough staff are competent (to manage shift patterns etc) is vital to ensure compliance with fire regulations. Effective fire routine is dependent on regular training and practice – as with all learning, the more frequently we train, the better we become.

You should write a detailed fire emergency evacuation plan and this should include instruction on the general procedures, instructions for individual PEEPs and details of any training needed for employees.

Remember too that you should think ‘out of the box’ and consider different scenarios. Carry out regular drills using a variety of escape routes, assuming that the normal and most direct evacuation route is not always possible. It is surprising how much this can throw someone off in an emergency.

Practice both horizontal and vertical evacuation techniques and consider ‘worst case scenario’ plans which see those who would normally be covered in a horizontal evacuation, moved vertically.  In this situation, specialist equipment may be needed so this is also the time to make sure that staff are well trained in using evacuation equipment such as Evac Chairs or evacuation board and sledges.

Having to use this equipment for the first time in a genuine emergency is a recipe for disaster and could lead to serious injury to those being evacuated, or the handler.

 

HOW USING MANIKINS CAN HELP YOUR TRAINING

When teaching use of evacuation equipment, we would recommend the use of training manikins, not least because it greatly reduces the risk of injury to either the person doing the lifting and handling or to a volunteer if lifted incorrectly.

At Ruth Lee Ltd we have been providing rescue training manikins for more than 30 years and we have a range well-suited to care home evacuation. This includes our Patient Handling manikin, which will sit upright in a wheelchair if required, and a range of bariatric manikins. It is a sad fact that the population is getting larger and heavier – would you staff be confident to evacuate a heavy resident in a genuine emergency? Consider introducing bariatric training into your routine training schedules.

 REALISTIC TRAINING - FIRE SIMULATION

If you want to create ultra-realistic training, which will be remembered for years to come (for all the right reasons!) you could also consider fire simulation.