The wider waistlines that weigh down the average American translate to increased costs and challenges for hospitals that treat severely overweight patients. Many facilities find standard equipment ill-suited to address the transportation needs of bariatric patients, and increasingly, caregivers are being injured on the job when moving obese patients.

In fact, a recent Wall Street Journal article indicates an alarming increase in the number of Americans who are morbidly obese -- that is, 100 pounds or more overweight. Approximately 1 in 80 men weighs more than 300 pounds, a 50 percent jump between 1996 and 2000, according to the Journal. One of every 200 women weighs more than 300 pounds, marking an astonishing 67 percent increase.

Consequently, it's no surprise that patient transport equipment manufacturers nationwide are reporting a steady increase in the demand for bariatric equipment, products specifically designed for obese patients. The equipment runs from wheelchairs to special lifts.

For instance, companies like Liko Inc., Franklin, MA, are introducing special product lines to accommodate the increasing number of bariatric patients who are admitted to hospitals. Hans Sivardsson, president of Liko, says more clients are ordering ceiling lifts or freestanding overhead lifts to accommodate bariatric patients. The need to tame the cost of Workers' Compensation claims linked to back injuries trumps the cost of purchasing new equipment, he says.

"What's driving our business is Workers' Comp issues. You can buy an awful lot of lifts for the cost of an average comp claim," Sivardsson says. He estimates the cost of the typical back injury can reach $40,000 to $50,000, including Worker's Compensation payout, sick days and the cost of replacing the injured employee.

Pia Johansson, director of sales and marketing for Largo, FL-based Stretchair, a manufacturer of chairs that convert to stretchers, agrees. Two factors concern many clients: meeting the needs of bariatric patients and protecting caregivers, she says. Johansson reports an upswing in the number of bariatric products sold to Stretchair customers and a growing interest in ergonomic equipment.

The following represent a cross-section of products available on the market:

* The Liko Ultra Twin overhead lift system employs two lift motors for increased lifting capacity, patient comfort and versatility. Able to accommodate patients up to 880 pounds, the lift system is available as a freestanding unit or for permanent mounting. The freestanding system features a sturdy, lightweight aluminum overhead lift frame that can be assembled without tools. The frame is adjustable to operational heights ranging from 88.5 inches to 104 inches, and can be lowered to the transport position of 67 inches to move the patient from room to room. Liko also offers slings for heavyweight girth accommodations.

* Stretchair's MC-800 oversized patient transfer system functions as a chair, bed or stretcher. The easy-to-clean product features pressure-reduction foam, removable cushions, nylon covering, hydraulic assist, central braking and eight-inch carpet casters. The Stretchair MC-800 can accommodate patients weighing up to 800 pounds. A linear actuator enables the user to stop the chair in any position. In the chair position, the MC-800 is 20 inches from the ground, and automatically moves to 31 inches in the stretcher position, allowing for easy patient transport and transfer from one flat surface to another.

* Archbold, OH-based Gendron's Bariatric Transport Stretcher is designed to safely transport and transfer patients weighing up to 1,000 pounds. An extra heavy-duty reinforced stretcher frame, litter top, fowler back rest and side rails provide maximum stability. A manual fowler backrest comes standard; a hydraulic, foot-pedal controlled fowler backrest is also available.

The stretcher comes with a beechwood powder coat finish and a full-perimeter non-marring bumper rail. Dimensions are: litter top, 29 3/8 inches high, 80 1/4 inches long, and 37 inches wide; overall bumper-to-bumper width, 40 inches; overall length, 80 1/4 inches.

Designed to reduce the risks associated with patient handling, the AIR PAL is used to transfer patients from bed to stretcher to other areas of the hospital. The AIR PAL is part of a line by Patient Transfer Systems, Center Valley, PA. The patient air lift uses a lightweight portable air supply that is attached to and inflates the mattress. The air "lifts" the patient as it is released through the perforated underside. The patient is literally transported on a cushioned film of air, allowing one or two staff members to perform a move that once required four to eight.

From Wheelchairs of Kansas, Ellis, KS, the BCW Advantage wheelchair supports patients up to 600 pounds and offers a heavy-duty frame and double X-brace for support. The wheelchair also features heavy-duty vinyl reinforced upholstery, four-point telescoping for strength, removable desk-length padded armrests, 24-inch composite mag wheels, and six-inch solid rubber front casters, according to the company. Seat widths are available from 22 inches to 30 inches.

The CQ Electric Transport Chair (ETC), by Abilene, TX-based ConvaQuip Industries Inc., allows healthcare staff to transport bariatric patients without the bodily stress and exertion associated with manual wheelchairs. A control lever allows the caregiver to safely move a patient up to 650 pounds. Design features include a leather-like, padded automotive-style seat and lap belt, flat-free tires and casters, flip-up armrests, swing-away footrests, a storage area to transport patient belongings during admittance and discharge, and a garment hook that doubles as an I.V. pole. The ETC has a steel frame for maximum durability.

The MAGNUM II Bariatric Patient Care System, by Batesville. IN-based Hill-Rom Services Inc., can reduce the need for patient transfers since it serves as a combination bed, chair and transporter. A Hi Lo function positions the patient for clinical procedures. Upper body X-rays, using the radio lucent surface and X-ray cassette holder, can be performed without transferring the patient. The MAGNUM also features a built-in scale, adjustable side rails, corner posts to accommodate standard traction or I.V. poles, and heavy-duty locking casters for transport.

RELATED ARTICLE: Transporting around the campus.

When it comes time for hospitals to provide transportation for patients and guests within campuses that can stretch for miles, hospitals usually face a "build or buy" decision. In this case, the choice involves purchase/lease of a van or some such large vehicle or bringing in a vendor to handle the transportation responsibilities. Either way, the vehicle used to haul patients and guests can often be a Ford.

Models like the Dedicated CNG E-350 Wagon combine environmental friendliness with functionality. The vehicles, which operate on natural gas, offer a wheelchair access door and lift.  Medical Supplies.