How many of you out there remember a time when ambulance cots were nothing more than aluminum tubes with what seemed like welded grocery cart wheels? And that the ability to perform a dead lift by you and your partner was the only way your patents were going to be wheeled into a locked position of your hearse … er, ambulance. Jeez! You are old.
Now that your vertebrae from C1 to L5 has the consistency of peanut brittle, isn’t it nice to know, just prior to receiving your first disability check, that your generation of ambulance drivers paved the way for today’s back-saving cot technology?
They’re called gurneys, prams, litters, stretchers, cots or even trolleys by the British—who also, by the way, invented the double-decker stretcher. Whatever you choose to call them, they represent the foundation of our work. I know many of you resent that portrayal of our profession, but let’s be honest here. Portable ambulance beds symbolize what we do—transport the sick, injured and annoying.
Maybe we resent how movies and TV series (specifically cop programs) often portray our profession, using the stretcher as the principal backdrop in its depiction of EMS. Whether the patient is alive or dead, the ambulance crew entering these scripted scenes never once introduce themselves to anyone around them, never asks any questions, never applies any skills or never uses firefighters to lift the body. They just silently come in and pick up the body, with the cameras primarily focusing on stretcher use—specifically creating scenes in which it’s loaded with the patient or corpse (seriously?) into the ambulance.
The ambulance then leaves the scene—often only after the cop gives the medics permission by slapping the palm of his hand twice on the back windows of the rear doors.
Maybe that’s why my scene times are so long. I religiously wait to hear that consensual whack from an officer certified in the art of basic CPR before putting the rig in drive.
Maybe this is why we paid little attention to gurney technology and backbone preservation. We wanted to prove our worth with equipment that truly symbolized our potential to become worthy of highly profitable Medicare/Medicaid reimbursements.
Thank goodness some folks out there—specifically Dick Ferneau and El Bourgraf—were looking out for our spines while we were too busy looking out for our egos. These two party animals happened to be watching their secretary iron a dress for her daughter. As you can imagine, this turned them on … to the idea of developing an adjustable stretcher that could be raised and lowered similar to an ironing board.
They didn’t stop there. They not only went on to develop multi-level, adjustable stretchers; scoop stretchers; stair chairs; and roll-in, hydroelectric stretcher technology, but they also helped fold the secretary’s laundry.
I truly appreciate their insight in creating more than one method of moving patients from point A to point B (Unless point B is on divert, in which case point C would be your appropriate destination … until diverted to point D, then E, then F, then G).
They foresaw the need for multiple means of patient transport, because we often need to move progressively from one transfer device to another. The patient may be placed on a wheel-less backboard, scoop, stair-chair or butt bag (basket stretcher), which we hopefully navigate for only a short distance before securing them to a portable gurney. The gurney is then wheeled a short distance where the primary (wheeled) cot is placed on yet another wheeled device (ambulance).
Yeah, baby. We’ve come a long way from the early days of crews who didn’t properly latch the cot at a level where they wanted their patient to be. This was always a real crowd pleaser and a great method of converting a patient out of v-tach … or more often the case, putting them in v-tach.
Old medics also remember when stretchers didn’t have tailored comfort or flair to their design. Today, stretchers have substance and style. Our wheeled tubular frames are now aerodynamically sleek and come in a variety of colors and fragrances. They can position themselves at any angle or elevation and can withstand the astronomical weight of patients not seen since … since your last shift. I have no doubt Theodore Gurney, the patented inventor of the horse-drawn ambulance cab, would be proud from whence we came regarding EMS patient transport.
Until next time, don’t forget to rotate your gurney’s tires every 1,000 miles, and keep those cot chains readily available during winter months. JEMS
his article originally appeared in August 2011 JEMS as “Stretch & Bear It: The back-breaking evolution of the cot.”