The Impact of Obesity on Patients in a Prehospital Setting: A Narrative Review

Abstract

Objective

Obesity is a growing epidemic with significant implications on all aspects of health care, including prehospital care. As body mass index increases, the risk of comorbidities increases, as do potential challenges in the prehospital setting. In addition, there are concerns about clinician injuries when moving and transporting patients. This narrative literature review aimed to identify how obesity influences medical care in the prehospital environment.

Methods

A literature search regarding obesity in the prehospital environment was performed using PubMed, Web of Science, and Embase until January 2026. Data were extracted in a qualitative manner to form this narrative review, with comparisons made with in-hospital literature.

Results

From 3,753 articles, 55 studies were included with 6 themes identified based on frequency of occurrence: endotracheal intubation (n = 12); alternative airway management (n = 2); cardiac arrest management and outcomes (n = 22); triage, scene time and transportation (n = 5); nonairway interventions (n = 2); and the challenges of moving patients (n = 12). There were conflicting results in the effect of obesity on cardiac arrest outcomes and prehospital intubation. Scene times are likely to increase with obesity, and triage remains problematic given that injury burdens are difficult to assess in the prehospital setting. Obesity presents additional challenges, such as ensuring adequate chest compressions, moving, transferring, and intravenous access.

Conclusion

Patients living with obesity are seen regularly in the prehospital setting, and consideration of their requirements is recommended. This population may benefit from specific guidelines to optimize airway management, cardiac arrest management, and triage decisions, ensuring optimal ongoing care.