A stretcher is used to carry a seriously ill or injured victim. There are a number of stretchers available, e.g. the standard stretcher, the pole-and-canvas stretcher, the Utila folding chair, the trolley bed, the Neil Robertson stretcher, and the paraguard stretcher.
A stretcher should be rigid enough to carry casualties with suspected spine fracture without having to add boards to it. To ensure that a stretcher is capable of taking the weight of a victim, it should be tested before it is used. A person should lie on it and then others should lift it up, one end at a time first, then both the ends at the same time.
Types of Stretchers
Type Features
Standard (Furley) It consists of a canvas bed, poles, handles, stretcher traverses, and runners. The traverses are jointed such that the stretcher can be opened and closed. In closed state the poles lie close together with the canvas bed folded on top. This is then kept in position by two transverse straps. If slings are carried then they are laid along the canvas held by the straps.
To open the stretcher place it on its sides with its runners towards you, and the studs or buckles securing the straps uppermost. Unfasten any straps. Push the traverses fully open with your heel and place the stretcher on its runners.
To close the stretcher turn the stretcher on its side with its runners towards you and the studs or buckles which secure the straps uppermost. Push the joints of the traverses inwards with your heel to open them. Push the poles together pulling the canvas out from between them. Fold the canvas over the poles and secure them with the straps.
Folding stretcher It is a lighter version of the standard stretcher. It has light metal poles with telescoping handles and a plastic or canvas bed. There are two types available. One folds like the standard stretcher, and the other folds in half in the center and occupies less space. Pole and canvas It is one of the most commonly used stretcherstretchers. It consists of a plastic or canvas sheet measuring 200 cm in length and 50 cm in width. There are two long poles. The canvas can be folded and slid under the victim where he lies. The poles are passed through the sleeves of the sheet to form the stretcher. Spacer bars are placed over the ends of the poles to keep them apart and maintain the firmness of the stretcher.
Scoop (orthopedic) It is used to transfer a victim to an ambulance stretcher in the same position in which he is found, as is required when a fracture of the spine is suspected. Its length can be adjusted to suit any height of the victim.
Place the stretcher to the victim’s side and adjust its length. Dismantle the two ends of the stretcher and slip each half under the victim from each side. Join the two sections again. Place the head pad and secure it. Lift up the stretcher with the victim on it and place it in the ambulance. Then dismantle it and remove it from under the patient, if it is required to move other victims. Otherwise it can be kept under the victim until he is taken to a hospital bed.
Trolley bed It is found in many ambulances. It is a fully adjustable stretcher bed with wheels and is made of a light metal. A canvas stretcher is laid on the stretcher bed and two blankets are placed on top.
It is made of bamboo and light canvas. It is caused to lift casualties in the upright position through small hatches like pothole entrances and manholes, or to lower victims from a height in mountain accidents. There is a rope at the base to hold the victim’s feet like stirrups and a strap at the top for securing the victims’s head. The upper flaps are wrapped around the victim’s chest and secured with two short straps. The arms are secured with the long strap. The lower flaps are strapped around the lower limbs. There is a ring at the head end for hoisting the stretcher up. There is a ring at the foot end, to which a rope is attached for guiding the stretcher.
Paraguard stretcher: It is similar to the Neil Robertson stretcher and is used in similar situations. It is lighter, more durable and more convenient to use than the Neil Robertson stretcher. It can be folded up and carried on the back. It can bend in the middle to help negotiate obstacles.
Improvised stretcher: Two poles can be passed through the sleeves of two or three coats turned inside out. Then the coats are buttoned up. The poles may be kept apart by strips of wood tied to the poles at each end of the stretcher.
□ PREPARING A STRETCHER
1. One blanket method : place a blanket diagonally over the stretcher so that there are two opposing corners at the ends of the stretcher. After placing the victim on the stretcher, bring the point of the top blanket at the foot of the stretcher up over the victim’s feet and tuck a small fold between the ankles. Fold the point of the blanket at the head around the head and neck. Bring the right side of the blanket over the casualty and tuck it in. Then repeat the procedure with the lift side of the blanket.
2. Two blanket method : place the first blanket lengthwise across the stretch with one edge covering half the length of the handles at the head end, leaving a little more of it on one side of the stretcher than the other. Fold the other blanket lengthwise into three and place it on the stretcher with the upper edge about one third of the way down the stretcher, leaving adequate length for folding over the feet. After placing the victim on the stretcher bring the fold of the top blanket over the victim’s feet and tuck a small fold between his ankles to prevent their rubbing together. Bring the folds of the blanket over the feet and legs and tuck them in. Turn the upper corners of the first blanket in. Bring the shorter side over the victim and tuck it in. Then repeat the procedure with the long side of the blanket.
□ CARRYING A LOADED STRETCHER
When the casualty has been placed on the stretcher the bearers should take up their positions at each end of the stretcher. At least two trained persons are required. The person in charge of the victim should remain at his head. If bystanders are available they should be asked to help. The general rules for carrying a stretcher are as follows.
1. The head should be kept higher than the feet, unless the victim is in shock.
2. He should always be carried feet first, except in the following situations.
• When carrying a victim to the side or foot of a bed.
• When going downstairs or hills when the victim’s lower limbs are injured or there is hypothermia.
• When going upstairs or hills when the lower limbs are not injured.
• When loading a victim into an ambulance.
Carrying a Stretcher
Situation Technique
Four bearers Secure and grasp the handles with their your hands, palms inwards, keeping your backs straight.
Rise together when the order ‘rise’ is given.
Hold the stretcher with the arms extended and keeping it level.
With the order ‘advance’ walk simultane¬ously but out of step to avoid bouncing.
On reaching the ambulance lower the stretcher to the ground evenly, with the casualty’s head nearest the ambulance.
When crossing uneven ground, secure the victim to the stretcher with broad bandages or a harness before you start. Keep the stretcher as level as possible by each bearer adjusting the height of the stretcher individually.
Four bearers, only a Stand at the side of the stretcher facing short distance to be inwards. Grasp the poles with one hand and covered place the other about 75 cm from the end of the stretcher. Then move sideways.
Four bearers, Avoid crossing a wall, if possible. If not, place crossing a wall the stretcher on the wall, with the front runners beyond the wall. After the front bearers cross the wall one at a time while the others steady the stretcher, lift it up and advance until the back end of the stretcher is close to the wall. Let the other bearers cross the wall. Then resume carrying the stretcher.
Four bearers, moving Stand on either side of the stretcher facing from one level to each other across the stretcher. Lift the another stretcher so that it is at level with the top of the elevation. Place its front end on the elevation. Let one bearer get up on to the elevation and receive the stretcher while the others pass it forward. Then let another bearer climb up the elevation. Move the stretcher forward until the rear runners are on the bank. Then let the rear bearers ciimb up the elevation. Resume carrying the stretcher.
Two bearers Stand in between the two handles of the stretcher at either end of the stretcher. At the order ‘lift’, lift the stretcher up together, keeping the upper limbs straight. With the order ‘advance’, start walking simultaneously. While placing it down bend down simultaneously and put it down slowly
□ HOW TO LOAD AN AMBULANCE
1. A few ambulances have flat built-in beds with grooves to take the runners of a standard stretcher. Four persons should do this together. One person should stand inside the ambulance to guide the stretcher. The other three should stand on both sides and one end to lift the stretcher.
2. If there are two berths to be loaded, always load the left one first.
3. While loading a trolley bed into an ambulance, two bearers should stand at the ends of the trolley bed, raise the trolley bed to the required height, and carry it head first into the ambulance.
□ HOW TO UNLOAD THE STRETCHER
The victim is unloaded from the stretcher after transportation to the desired place like the hospital or his home. The methods applied for the unloading are the same as of loading, except that the order is reverse.
1. He is picked up by four persons holding the four corners of the bed sheet or blanket on which he is lying, and placed on his bed. Then the sheet is folded in around the person in all sides and drawn out from under him.
2. If he is not lying on a bed sheet or blanket, then he is lifted up with their hands below his head, waist, chest, hips and legs.