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A stretcher, gurney, litter, or pram is an apparatus used for moving patients who require medical care. A basic type (cot or litter) must be carried by two or more people. A wheeled stretcher (known as a gurney, trolley, bed or cart) is often equipped with variable height frames, wheels, tracks, or skids. Stretchers are primarily used in
acute Acute may refer to: Science and technology * Acute angle ** Acute triangle ** Acute, a leaf shape in the glossary of leaf morphology * Acute (medicine), a disease that it is of short duration and of recent onset. ** Acute toxicity, the adverse eff ...
out-of-hospital care situations by
emergency medical services Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...
(EMS), military, and search and rescue personnel. In medical forensics the right arm of a corpse is left hanging off the stretcher to let paramedics know it is not a wounded patient. They are also used to hold prisoners during lethal injections in the United States.


History

An early stretcher, likely made of wicker over a frame, appears in a manuscript from . Simple stretchers were common with militaries right through the middle of the 20th century.


Gurney

Generally spelled ''gurney'', but also ''guerney'' or ''girney''. The first usage of the term for a wheeled stretcher is unclear, but it is believed to have been derived from Pacific Coast slang. Its use in a hospital context was established by the 1930s.


Classification

EMS stretchers used in
ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
s have wheels that makes transportation over pavement easier, and have a lock inside the ambulance and straps to secure the patient during transport. An integral lug on the stretcher locks into a sprung latch within the ambulance in order to prevent movement during transport. Modern stretchers may also have battery-powered hydraulics to raise and collapse the legs automatically. This eases the workload on EMS personnel, who are statistically at high risk of back injury from repetitive raising and lowering of patients. Specialized bariatric stretchers are also available, which feature a wider frame and higher weight capacity for heavier patients. Stretchers are usually covered with a disposable sheet or wrapping, and are cleaned after each use to prevent the spread of infection. Shelves, hooks and poles for medical equipment and intravenous medication are also frequently included. Standard stretchers have several adjustments. The bed can be raised or lowered to facilitate patient transfer. The head of the stretcher can be raised so that the patient is in a sitting position (especially important for those in respiratory distress) or lowered flat in order to perform
CPR Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore sponta ...
, or for patients with suspected spinal injury who must be transported on a
spinal board A spinal board, is a patient handling device used primarily in pre-hospital trauma care. It is designed to provide rigid support during movement of a person with suspected spinal or limb injuries. They are most commonly used by ambulance staff, ...
. The feet can be raised to what is called the
Trendelenburg position In the Trendelenburg position, the body is lain supine, or flat on the back on a 15–30 degree incline with the feet elevated above the head. The reverse Trendelenburg position, similarly, places the body supine on an incline but with the head ...
, indicated for patients in
shock Shock may refer to: Common uses Collective noun *Shock, a historic commercial term for a group of 60, see English numerals#Special names * Stook, or shock of grain, stacked sheaves Healthcare * Shock (circulatory), circulatory medical emergen ...
. Some manufacturers have begun to offer hybrid devices that combine the functionality of a stretcher, a recliner chair, and a treatment or procedural table into one device.


Basic stretchers

* Simple stretchers are the most rudimentary type. They are lightweight and portable, made of canvas or other synthetic material suspended between two poles or tubular aluminum frame. Many are stored as disaster supplies and are often former military equipment. * The folding stretcher, also known as a ''top deck'' or ''collapsible stretcher'', is similar in design to the simple stretcher, but features one or more hinged points of articulation to allow the stretcher to be collapsed into a more compact form for easier handling or storage. Some models may even allow the patient to sit upright in a Fowler's or Semi-Fowler's position. * The Roberson orthopedic stretcher or ''
scoop stretcher The scoop stretcher (or clamshell, Roberson orthopedic stretcher, or just scoop) is a device used specifically for moving injured people. It is ideal for carrying casualties with possible spinal injuries. A scoop stretcher has a structure that ...
'' is used for lifting patients, for instance from the ground onto an ambulance stretcher or onto a
spinal board A spinal board, is a patient handling device used primarily in pre-hospital trauma care. It is designed to provide rigid support during movement of a person with suspected spinal or limb injuries. They are most commonly used by ambulance staff, ...
. The two ends of the stretcher can be detached from each other, splitting the stretcher into two longitudinal halves. To load a patient, one or both ends of the stretcher are detached, the halves placed under the patient from either side and fastened back together. With obese patients, the possibility exists of accidentally pinching the patient's back when closing the stretcher, so care must be made not to injure them when carrying out this procedure. * The ''
litter Litter consists of waste products that have been discarded incorrectly, without consent, at an unsuitable location. Litter can also be used as a verb; to litter means to drop and leave objects, often man-made, such as aluminum cans, paper cups ...
'', also known as a rescue basket or ''Stokes basket'', is designed to be used where there are obstacles to movement or other hazards: for example, in confined spaces, on slopes, in wooded terrain. Typically it is shaped to accommodate an adult in a face up position and it is used in search and rescue operations. The person is strapped into the basket, making safe evacuation possible. The litter has raised sides and often includes a removable head/torso cover for patient protection. After the person is secured in the litter, the litter may be wheeled, carried by hand, mounted on an ATV, towed behind skis, snowmobile, or horse, lifted or lowered on high angle ropes, or hoisted by helicopter. * A ''Reeves Sleeve'', SKED, or "flexible stretcher" is a flexible stretcher that is often supported longitudinally by wooden or plastic planks. It is a kind of tarpaulin with handles. It is primarily used to move a patient through confined spaces, e.g., a narrow hallway, or to lift obese patients. Reeves stretchers have six handholds, allowing multiple rescuers to assist extrication. * The ''WauK board'' is also designed for use in small spaces. The patient is secured to the board with straps. It has two wheels and a foldable footrest at one end, allowing the patient to be moved by one person, much as with a
hand truck :''"Hand truck" may also refer to Pallet jack.'' A hand truck, also known as a hand trolley, dolly, stack truck, trundler, box cart, sack barrow, cart, sack truck, two wheeler, or bag barrow, is an L-shaped box-moving handcart with handles at o ...
for moving cargo. It can also be used at a variety of angles, making it easier to traverse obstacles, such as tight stairwells.


Wheeled stretchers

For ambulances, a collapsible wheeled stretcher, or gurney, is a type of stretcher on a variable-height wheeled frame. Normally, an integral lug on the stretcher locks into a sprung
latch A latch or catch (called sneck in Northern England and Scotland) is a type of mechanical fastener that joins two (or more) objects or surfaces while allowing for their regular separation. A latch typically engages another piece of hardware on t ...
within the ambulance in order to prevent movement during transport, often referred to as antlers due to their shape. It is usually covered with a disposable sheet and cleaned after each patient in order to prevent the spread of infection. Its key value is to facilitate moving the patient and sheet onto a fixed bed or table on arrival at the emergency department. Both types may have straps to secure the patient.


Other types of stretchers

* The Nimier stretcher (''brancard Nimier'') was a type of stretcher used by the French army during
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
. The casualty was placed on their back, but in a "seated position", (that is, the thighs were perpendicular to the abdomen). Thus, the stretcher was shorter and could turn in the
trenches A trench is a type of excavation or in the ground that is generally deeper than it is wide (as opposed to a wider gully, or ditch), and narrow compared with its length (as opposed to a simple hole or pit). In geology, trenches result from erosi ...
. This type of stretcher is rarely seen today.


See also

*
Battlefield medicine Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first ...
*
Camp bed A camp bed is a narrow, light-weight bed, often made of sturdy cloth stretched over a folding frame. The term camp bed is common in the United Kingdom, but in North America they are often referred to as cots. Camp beds are used by the military in ...
* Casualty movement *
Hospital bed A hospital bed or hospital cot is a bed specially designed for hospitalized patients or others in need of some form of health care. These beds have special features both for the comfort and well-being of the patient and for the convenience of he ...
*
Litter (rescue basket) A litter is a stretcher or basket designed to be used where there are obstacles to movement or other hazards: for example, in confined spaces, on slopes, in wooded terrain. Typically it is shaped to accommodate an adult in a face up position and ...
*
Spinal board A spinal board, is a patient handling device used primarily in pre-hospital trauma care. It is designed to provide rigid support during movement of a person with suspected spinal or limb injuries. They are most commonly used by ambulance staff, ...
*
Trolley (disambiguation) Trolley may refer to: Vehicles and components * Tram, or trolley or streetcar, a rail vehicle that runs on tramway tracks * Trolleybus, or trolley, an electric bus drawing power from overhead wires using trolley poles ** Trolleytruck, a trolleyb ...


References


External links

{{Human-powered vehicles Medical transport devices Beds Medical equipment Ambulances Hand barrows