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A stretcher, 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. In American English, a wheeled stretcher is referred to as a gurney. The name comes from a horse-drawn cab patented in the USA by J. Theodore Gurney in 1883 which bore a similarity to early wheeled stretchers.
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Stretchers are primarily used in acute out-of-hospital care situations by emergency medical services (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 c.1380. Simple stretchers were common with militaries right through the middle of the 20th century.
Classification
EMS stretchers used in ambulances 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, or for patients with suspected spinal injury who must be transported on a spinal board. The feet can be raised to what is called the Trendelenburg position, indicated for patients in shock.
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
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 within the ambulance in order to prevent movement during transport. 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.