Research shows that the number of Americans classified as morbidly obese is growing twice as fast as the number of Americans who are simply obese or overweight. According to the American Obesity Association, morbid obesity afflicts approximately 9 million adult Americans, twice the number of individuals suffering from Alzheimer's and equal to the population of the state of Virginia. According to researchers, the rate of morbid obesity has increased in the last decade from 1 in 200 adult Americans to 1 in 50.

The rise in this segment's numbers brings special challenges for fire and EMS departments. For instance, the Fresno (Calif.) Fire Department responded in May to a medical call for a non-breather at an old residential hotel in a run-down area. When crews arrived, they found the victim — a 51-year-old man who weighed more than 800 pounds — already deceased.

The engine company returned to service, and Capt. Mile Alforque contacted Bttn. Chief Richard Cabral to advise that the coroner probably would request the fire department's assistance in removing the body.

Cabral encourages his captains to advise him immediately when they foresee a situation. Based on Alforque's information, Cabral contacted Fresno's USAR team, which is well-versed in the use of pulleys and low-angle rescues, as well as breaching and breaking through building construction.

Once on scene, Cabral implemented the department's Incident Command System and contacted multiple agencies for assistance. A USAR team and tactical unit responded with rescue and breaching equipment. Cabral also called for a public information officer to handle the increasing media presence and a safety officer to monitor firefighters' heavy lifting and possible strain. Police officers helped evacuate hotel residents, and police and public works restricted access to the area surrounding the hotel. A representative of the coroner's office was present to approve the method of removal, and a mortuary van was there to transport the body.

“This was not an emergency event,” Cabral said. “We were in recovery mode and we didn't want to injure a firefighter's back or knee. I wanted a safety officer to ensure we were taking care of the personnel.”

Specialized Equipment

The body was in a 10-foot by 10-foot room on a double bed, off of a doorway that led to a narrow hallway on the second floor. A single bathroom was located down the hallway. The crew had to determine whether to breach the exterior wall and remove the victim by forklift and pallet from outside, or enlarge the doorway, tightly wrap the body and move it down the hallway to the stairs, and then slide it down the stairwell. USAR team member Chuck Leach suggested constructing a Z-rig system to help the crew slowly lower the body down the stairs.

“We communicated with the hotel owner, and he agreed we could do whatever we needed to remove the body,” Cabral said.

One crew began working on a makeshift litter or sled — a 4-foot by 8-foot sheet of 9/16-inch-thick business-grade plywood with cutouts for straps. The crew measured the width of the body and decided to wrap the victim in a salvage cover, using straps to reduce the width.

The USAR crew removed the room's contents and breached the wall with the door. After removing the wall debris, multiple firefighters then rolled the wrapped body into the 42-inch-wide hallway, and then slid the victim 40 feet down the wooden floor to the top of the stairwell. As the victim had been dead for several hours, the crew requested a fan for odor control.

“The Z-rig was a 4×4 across the door with a pulley and a brake, and with an anchor and pulley at the head of the stairs,” Cabral said. “We slid the body onto the stairs and let the brake stop the litter and body. We allowed gravity to do its thing and lower the body down the stairs.”

Cabral said that he was particularly proud that the firefighters could perform the recovery in a dignified manner. Aware that the media was waiting outside, firefighters made sure the body was covered and secured.