Updated Oct. 30, 2017
By Dan White and EMS1 Staff
I sometimes have fond remembrances of the 56-pound ambulance stretcher. But 30 years ago, our patients were, on average, of much lighter weight. Between 1970 and 1990, the average American increased high-fructose corn syrup consumption by 1,000 percent, up to over 50 gallons per person each year. The consequence has been an obesity epidemic.
Over these same years, our industry was forced to respond with heavier ambulance stretchers to bear the increasing loads. In the 80s, we began to use cots with head-end wheels for easier loading. Then with the AntBoxx in the 90s, we were first introduced to power-assisted cots. Now, 10 years later, we have fully power-operated stretchers.
Today’s modern manual ambulance stretcher is twice as strong as anything from the 1970s. A modern powered stretcher today can weigh almost 140 pounds and lift more than five times its own weight. Selecting a new stretcher is one of the most potentially contentious equipment decisions you can make. It’s also one of the most expense items on your required equipment list.
Here are the top six points to consider when making a stretcher purchase:
1. Research your stretcher purchase
Do a lot of homework long before looking at your first new stretcher. Do you run a high call volume? Are you in a mostly suburban, urban or rural environment? A department running a lot of EMS in a high-call volume, urbanized environment wants a lightweight cot that’s fast. They will also be heavily influenced by department history and culture. One aspect of this I’ve noticed is preferences for H- or X-frame type stretchers.
Once a busy service with a stable workforce gets its hands on an H-frame cot, you will have to pry it out of its cold, dead, lifeless fingers. If you try, you better have the facts to back it up. Injuries to staff or patients should be carefully examined. In older eastern cities with tight halls and narrow entrances, a fast and maneuverable lightweight cot makes sense. Out west, the buildings are 100 years newer, with wider halls and doors. In these situations, the advantages of a taller X-frame could be far greater than the weight penalty.
The better known X-frame or self-loading cot now comes in a variety of brands, price-ranges, and even colors. I believe the biggest advantage of the X-frame is that it’s inherently safer. The highest or “load” position is high enough for roll-in loading. The center of gravity is lower, so particularly on rough terrain they handle better. They are a little less physically demanding, which could be important for your particular workforce. In departments with lower call volumes, PRN or volunteer staff, that safety catch hook and head end U-bar will translate into fewer patients getting dropped.
2. look into stretcher maintenance and service programs
Take a careful look at maintenance and service programs and pricing. One of the most important aspects of any cot purchase is how you will get it fixed when it breaks. You may have noted I said “when it breaks,” not if. Stretchers are very expensive to ship, and agencies cannot afford to be without even one for long. Only the best-heeled departments can afford to keep numbers of spare cots available. This makes timely and regular service paramount. If you have a current provider of regular stretcher maintenance, he or she could prove to be a valuable resource. Tell them you are in the market for a new cot and why. They may have valuable experience regarding any potential purchase.
If you don’t already have a regular maintenance program for your patient handling equipment there is no time like the present. Keep in mind the more high-tech the stretcher, the more important regular service will be. These things require regular care just like any other piece of high-technology clinical equipment. A well-documented ongoing maintenance program saves money in the long run. It’s important for you to compare the potential down-time, periodic maintenance, and the as-needed repair costs.
3. Go to a show
Send an emissary to EMS Today or EMS EXPO. The two big national EMS Conferences are a great place to see all the latest stretchers in one room. Prepare a half dozen pointed questions focused on revealing points of interest. Spending one day at one of these national conferences will instantly bring you up to date on the latest in patient handling technology.
4. Google is your friend
Do a web search on models of specific interest. With all the new EMS message boards and online communities, the internet provides a great opportunity to learn about a lot of stretchers. It’s easy to find out which models have had problems in other departments, and which ones have worked out great. The opportunity to learn from others experiences can be an invaluable resource.
5. Take your stretcher for a test drive
Once you have narrowed down to the best type of cot for your situation, take it for a test drive. Ask for a loaner to try it out and put it on one unit. Any field evaluation needs to be documented. Develop a very brief questionnaire and have each crew rate the product. If you are comparing cots, it is far easier to quantify your impressions with field data. It’s also critical to have the support of all your staff when making a transition to a new stretcher. If they don’t feel like part of the decision to make the change, you may find them unhappy with it later.
6. Change is easier for some more than others
With any new cot change, expect some complaints, but keep a record of them. Should functional problems arise, it makes it easier to provide your maintenance technician a written record. Frankly, as a piece of mission-critical medical technology, every cot should have its own individual file. But with any huge change in equipment, expect a few complaints. Change is just easier for some more than others. The motor mechanics of what we do every day develops into ingrained habits. When you introduce fundamentally new ways of executing basic motor skills, some folks will have a challenge adjusting. This is really very normal, so expect it.
Ambulance stretchers have come a very long way since the days of Johnny & Roy. They are far stronger, safer, and more feature-rich than ever before. They are also heavier and much more expensive. But it’s the single most used piece of equipment of every ambulance. How well or poorly it works and protects the health of your workforce and patients have a powerful impact on your ability to serve. The quality of today’s modern ambulance stretcher has benefited from intense development and rapid evolution. If you have not evaluated the current new models on the market, now is a great time to start.
Reasearch new stair chairs
Look at your own loss/injury records and talk with your own crews. Find out how many times stairs – especially flights of stairs – are an issue and how many times they produce injury or pain. All stair chair manufacturers offer chairs with a track device that allows the chair with patient to ‘glide’ down stairs, eliminating the need to totally lift and carry the patient’s weight. More often than not, injury is produced by repetition. Eliminating the need to carry the weight of a patient down stairs is reducing the number of repetitions performed by EMTs and medics.
Stretchers and stair chairs are designed to last for years. Many of the design improvements are intended to improve upon safety and to reduce injury. Over the life of this equipment, the injury reduction potential may well be worth the investment. It’s an investment in our people.
Any other suggestions? Anything we missed in the list above? Leave a comment below or email products@ems1.com with your feedback.
