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Use of simulation to improve fire department standard operating procedure for bariatric patient extrication
  1. Brad Gable1,
  2. Michael Duncan2
  1. 1 Center for Medical Education & Innovation, OhioHealth, Columbus, Ohio, USA
  2. 2 Worthington Fire Department, City of Worthington, Worthington, Ohio, USA
  1. Correspondence to Dr Brad Gable, Center for Medical Education & Innovation, Ohio Health, Columbus, OH 43214, USA; Brad.Gable2{at}

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The removal of a victim from a burning building is inherently dangerous. This assignment can become even more difficult depending on the type of fire, the structure’s characteristics, the resources available and the victim themselves. One aspect of the victim that can make rescue more challenging is their size. Bariatric patients pose unique challenges to the firefighters that have to rescue them. As the prevalence of obesity in the USA continues to rise, the frequency with which firefighters encounter this situation will increase as well. Simulation education is a staple of paramedic and firefighter training. Previous literature has described simulation training for paramedics in the medical care of bariatric patients.1 However, to our knowledge this is the first description of a change to a fire department’s standard operating procedure as a result of simulation training.


Our training took place in March of 2016. The training was developed jointly between OhioHealth and Worthington Fire Department (WFD). We developed a simulated scenario where firefighters would respond to a structure fire (house fire) and encounter several victims, one of which was an unresponsive bariatric patient.

Equipment: To increase the realism of the simulation, firefighters and paramedics were asked to use their actual equipment to respond to the simulated fire scenario. This included: personal protective equipment (turnout/bunker gear), self-contained breathing apparatus, fire hoses (lines) and engines/medics/ladders. Environment: The WFD had a home donated to them for training purposes, and the simulation was conducted in situ. With the goals of the …

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  • Contributors Both authors contributed to the planning and execution of the simulation. Additionally, both authors participated in the planning and the reporting of the work described herein. Both BG and MD participated in the design and education of the work described. BG was responsible for the literature search. BG and MD contributed to the content of the article, its content and review. BG will act as the guarantor.

  • Competing interests BG is employed by OhioHealth for work in Graduate Medical Education. Additionally, BG is employed by Mid-Ohio Emergency Services as an emergency department physician. MD is employed as a firefighter/paramedic for the city of Worthington, Ohio.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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