Some of my favorite EMS products are those tried and true devices that we sometimes overlook. I think we overuse the long spine board as a patient mover. It’s really not a stretcher; it is a full body splint.
The problem is that we often use it for too many other things.
I’ve met many who use the backboard as a portable stretcher, to move people from inside the house and over rough ground. This is actually kind of dangerous. Most backboard straps alone are not designed for challenging lifting angles. The patient will be more secure when they are wrapped in a flexible stretcher. Here are some examples.
1. The Flexible Stretcher
The first of these is the Reeves Stretcher. It is best described as a heavy duty coated tarpaulin style fabric that encircles the patient. Inside the two fluid resistant fabric layers there are narrow slats or boards, which provide longitudinal stability.
Around its perimeter are many handholds, both on the sides and ends. This makes it easy to get extra hands onboard when you need it. The patients weight creates a conforming U-shape in the center and the integrated straps secure the patient inside.
In places like Philadelphia they use these things every day. They are fast, effective, and safe to use moving patients down narrow stairways in narrow houses.
The Deluxe version upgrades the plastic buckles for seat-belt grade automotive buckles. It also adds extra slats in the middle to beef up the payload.
Ferno offers a similar product called simply the Ferno Flexible Stretcher. It’s a couple of inches longer. It offers another great solution for moving people on uneven terrain where a wheeled stretcher can’t work.
Use of the Flexible Stretcher seems to be somewhat regional. They are huge in the Northeast but maybe less popular in some other regions. Maybe it’s because as you go west buildings are generally newer, with bigger doors, stairways and elevators. But they are some of the fastest tools for getting someone out of a tight back room or down stairs safely that cannot sit up.
2. The Scoop Stretcher
The next great tool is the orthopedic or scoop stretcher. This is another old-school patient handler that is used more in some areas and less so in others.
I remember seeing scoops in Connecticut mounted to the ceiling of the ambulance, above the cot. You could just drop them on your wheeled stretcher and carry them in.
The original idea was a rigid break-apart device. You undo the head and foot ends to gently insert each half under the shoulders, hips, and legs. This design allowed a casualty to be gently moved without excessive movement.
The whole idea is to pick someone up and then put them down somewhere else without moving them very much. They do this very well. One of the best applications of the scoop stretcher is when it is used with a vacuum mattress.
It’s only a little more work to do something beautiful. You lift the patient, place them on a vacuum mattress, and evacuate the air in the mattress to secure the patient. You then use put the scoop under the vacuum mattress to move them onto the cot, and onto the ER bed. It is an elegant spinal solution, one commonly used in Europe.
Those following best practices in spinal immobilization will find reference to this technique. If you want to move a severely injured patient in the most careful and considerate way, this is how it’s done.
They spend most of their transport time on a conforming vacuum mattress. They are much more comfortable and warmer. The primary exam in the ER goes much smoother because their sources of pain are less caused by what you did to them then by what happened to them.
There are some great newer versions. One is the newer plastic covered scoops like the Ferno EXL.
This modern orthopedic stretcher has an aluminum core covering in smooth plastic. It not only makes it easier to slide under the patient, but it also doesn’t feel as cold to touch.
It is beautifully finished with no rough spots or edges. The center mechanism is the proven push-button latch at head and feet. It can be quickly length adjusted to fit most EMS patients.
It eliminates the need for a log-roll maneuver, which significantly decreases movement to the spine. The EXL is made from X-ray translucent, lightweight, high-impact composite materials. The two hinged, interlocking pieces allow operators to bring the two halves together beneath the patient and gently scoop them up.
I also love the Hartwell CombiCarrier II. This modernized scoop is really a combination scoop and backboard. It is reinforced plastic with a flat back and easy to use latch. It is rugged, fast, and incredibly effective.
3. The Vacuum Mattress
The first vacuum Mattress I was exposed to was the Germa, from Sweden. In Europe, a vacuum mattress is a common alternative to the spine board. It conforms to the anatomy, is comfortable and retains heat. Lying on a rigid spine board for any amount of time is frankly, miserable.
I spent a couple hours on a rigid spine board after my parachuting accident. Yep, my L2 was blown up into a hundred tiny pieces. But an hour lying on the board made me feel much worse. It was miserable.
A vacuum mattress is much more comfortable, because it conforms to the contours of your spine. I wish we used them a lot more in the USA. They could make a huge difference. If we used the scoop and vacuum mattress together we could move patients more gently and transport them more comfortably.
One of the most popular here is from Hartwell Medical. It is effective, affordable, and comfortable.
These are my three favorite patient handling tools. Having a variety of solutions is much better than relying on just one. Yes, this means you take an extra step or two. But it ensures quality care and helps manage patients in severe pain without making it any worse. Isn’t that why we do EMS?
