New Stretcher Technology

[Kate Connelly]

Hello there! I am an aspiring engineering student. I am in the midst of a design for a new revolutionizing technology to make life for EMS operators a heck of a lot easier! I am in need of feedback from EMS operators, ASAP. What is the most difficult part of operating a stretcher? If your rig has a stryker power lift, what are the pros and what are they cons? Powered stretchers or non powered? What type of jobs are better suited for powered stretchers and which ones are better for non powered stretchers? If you could change anything about the process of using a stretcher, what would it be? What is the biggest stress involved with stretchers? Are there any reoccuring problems you are experiencing with your current stretcher? Any other feedback is GREATLY appreciated. Feel free to leave your most honest opinions. I don't bite.

 

[luke_31]

The weight is the only real issue. When the batteries die the stretcher is very heavy and hard to raise and lower the legs. Honestly the Stryker power load system is already pretty good.

 

[Kate Connelly]

The weight is the only real issue. When the batteries die the stretcher is very heavy and hard to raise and lower the legs. Honestly the Stryker power load system is already pretty good.

Thanks for the quick feedback! Is there any feature in particular you are looking for in a gurney?

 

[CALEMT]

Thanks for the quick feedback! Is there any feature in particular you are looking for in a gurney?

Pretty much a power pro gurney with the weight of a manual gurney.

 

[Kate Connelly]

Pretty much a power pro gurney with the weight of a manual gurney.

Great idea. Noted.

 

[Jim37F]

My last job we used manual Ferno gurneys, the 28-Z Pro Flexx Chair Cot (sorry in advance this is gonna read a lot like an ad, but after using both manual Strykers and this Ferno, I really do like the Ferno sooooo much better lol)

http://www.fernoems.com/en/products...r-Cot.aspx?ec_trk=followlist&ec_trk_data=cots

Basically it was a manual gurney, a lot lighter than the Strykers, that could fold from a flat cot into a seated chair position. The two wheels at the head were fixed while the two at the feet could spin 180°, so you could steer it around easy enough, but it wouldn't roll off in a random direction like the Stryker's with all 4 weels rotating 180.

That meant once in a chair mode you only need one person to wheel the gurney in, it fit into a lot tighter spaces (tight hallways, elevators in older buildings, etc). Makes it a lot easier to roll over small obstacles like curbs, small shallow steps and the like, you could tip it back and just roll down some of those small obstacles, made the life of the EMT at the foot end a lot easier as they didn't have to carry the weight of the patient and gurney all the way over the edge and down, just help keep the cot from dropping to fast.

For most patients (especially ambulatory, or assisted walking) helping them into a chair was a lot easier IME. Then because the way the legs just fold underneath it, you just literally push in/pull out of the ambulance, no need for one guy to hold it up while the other collapses the legs, just line it up and push straight in all the way to the "antlers".

Now for the Cons: when it's flat you cannot adjust the height of the cot (unless you fold the legs so its all the way flat on the ground). That sometimes made things a bit challenging for those patients that you could not walk into the chair mode. Or if the SNF bed didn't adjust up or down either (as many don't seem to), we had no choice but to have to completely pick up the patient (99% using their sheets) to transfer them. Thank goodness we always had a 4 man engine crew to help out in those situations. Plus there was a lot more moving parts, there were horror stories that back in the day a patient got their hand caught in the mechanism while going from chair to flat and got a finger cut off so our dept drilled us into 100% of the time one person always had both patients hands in their lap to prevent such a mishap.

So in answer to the OPs question (finally! right? ) in my mind combine those Fernos with the power cot technology, perhaps so the actuator could raise or lower the overall cot height like on a Stryker without sacrificing the ability of the legs to fold under itself and load without lifting the whole shebang, and add some sort of padding to the sides to eliminate the possibility of the patient getting caught in those pinch points. Since the Ferno is already lighter, I bet adding that mechanism it would still be lighter than the Stryker power cot, really nice if the batteries fail (another reason why I would wanna keep those back saving folding legs lol)

 

[Kate Connelly]

My last job we used manual Ferno gurneys, the 28-Z Pro Flexx Chair Cot (sorry in advance this is gonna read a lot like an ad, but after using both manual Strykers and this Ferno, I really do like the Ferno sooooo much better lol)


Basically it was a manual gurney, a lot lighter than the Strykers, that could fold from a flat cot into a seated chair position. The two wheels at the head were fixed while the two at the feet could spin 180°, so you could steer it around easy enough, but it wouldn't roll off in a random direction like the Stryker's with all 4 weels rotating 180.

That meant once in a chair mode you only need one person to wheel the gurney in, it fit into a lot tighter spaces (tight hallways, elevators in older buildings, etc). Makes it a lot easier to roll over small obstacles like curbs, small shallow steps and the like, you could tip it back and just roll down some of those small obstacles, made the life of the EMT at the foot end a lot easier as they didn't have to carry the weight of the patient and gurney all the way over the edge and down, just help keep the cot from dropping to fast.

For most patients (especially ambulatory, or assisted walking) helping them into a chair was a lot easier IME. Then because the way the legs just fold underneath it, you just literally push in/pull out of the ambulance, no need for one guy to hold it up while the other collapses the legs, just line it up and push straight in all the way to the "antlers".

Now for the Cons: when it's flat you cannot adjust the height of the cot (unless you fold the legs so its all the way flat on the ground). That sometimes made things a bit challenging for those patients that you could not walk into the chair mode. Or if the SNF bed didn't adjust up or down either (as many don't seem to), we had no choice but to have to completely pick up the patient (99% using their sheets) to transfer them. Thank goodness we always had a 4 man engine crew to help out in those situations. Plus there was a lot more moving parts, there were horror stories that back in the day a patient got their hand caught in the mechanism while going from chair to flat and got a finger cut off so our dept drilled us into 100% of the time one person always had both patients hands in their lap to prevent such a mishap.

So in answer to the OPs question (finally! right? ) in my mind combine those Fernos with the power cot technology, perhaps so the actuator could raise or lower the overall cot height like on a Stryker without sacrificing the ability of the legs to fold under itself and load without lifting the whole shebang, and add some sort of padding to the sides to eliminate the possibility of the patient getting caught in those pinch points. Since the Ferno is already lighter, I bet adding that mechanism it would still be lighter than the Stryker power cot, really nice if the batteries fail (another reason why I would wanna keep those back saving folding legs lol)

Amazing response! I am definitely going to keep coming back to this reply for reference in my designs. Thanks so much.

 

[Flying]

Until recently I was in your position, aspiring BME student, looking to create improvements on medical devices that would help folk. I got an EMT certification and joined a local service in the quest to support this goal and ended up moving away from it instead.

I suggest you make arrangements with a local fire/EMS service for the opportunity to observe a shift or tour a station, and try to ask EMS professionals in person. Nothing we say will beat personal observation and experience.

When a patient is moved from home to hospital there are four critical states that body strain is high and injury is a concern during normal operation:
- Moving the patient from environment to stretcher. (Done mostly manually)
- Moving the patient on the stretcher into the ambulance. (Mitigated by stretcher, eliminated by powered lift.)
- Moving the patient on the stretcher from the ambulance. (Mitigated by stretcher, eliminated by powered lift.)
- Moving the patient from the stretcher onto an adjustable hospital bed. (Done mostly manually, but with more people and a controlled environment, not as much of a deal.)

All of this needs to be done with regards to patient and provider safety and comfort. Focus the majority of your efforts in mitigating or eliminating the physical strain on patient and provider here.

ALL of the time periods in between are relatively easy on the patient/provider, but this is not to be ignored, as stretcher ride comfort is a big deal as well (independent suspension systems for the stretcher are more trouble than they are worth unless if you have gobs of money, so don't even think of going that route).

Powered stretchers with a stretcher lift on the ambulance is the way to go for now, as that removes half of our above concerns. The recent development of self-loading stretchers is very interesting as well, though the problem of raising the stretcher to the required height remains.

Make the powered stretchers light, you will address #2 and #3 and do very well. Find a novel way to address #1 and #4 with another system and you will do even better.

Other little thoughts:
- The stretcher should be cleaned with disinfectant wipes after every transport. Make it really easy to clean, please. Reduce any edges, nooks, and crannies that will make it annoying to wipe it down completely. The less annoying, the more people will clean it.
- Same spirit as above, the Strykers have these rubberized handles with a texture that promotes germ collection. A grippable non-porus surface is needed.
- Wheel dimensions are a big deal when trying to optimize the maneuverability of the stretcher and the comfort of the patient on it.
- Gotta have relatively quick and simple maintenance. Stryker struck just the right balance between robustness, weight, and time between stretcher servicing.
- It's gotta somehow fit in an elevator with a 200lb+ patient on it and 4-5 other people in the elevator. Stryker managed it with collapsible bits, you gotta be on par.
- Make it obvious which end is for the head and which is for the foot, sometimes we fuddle about this before placing the person on the stretcher, not a big deal.
- Have one of your project members relax on the floor and with only two people try to lift them 1-2 feet onto a sofa.
- When moving a patient to/from a bed of any kind, there is often an annoying gap caused by the dimensions of the stretcher that the patient had to traverse (best seen for yourself, some video footage of ER handoffs may give insight.) Eliminating that was a dream of mine.\
- CPR needs to be possible on your stretcher mattress.
- Design a cool sticker that outlines what is needed for manual operation of your spanking new powered stretcher. We will be spoiled by it and forget what to do in the event of no power.

Also, look to the UK. They have cool ramps. Just look up videos of the NHS.

 

[Flying]

Another thing to note: The number of providers and their capabilities often is not static.

Look at the Stryker MX-PRO bariatric stretcher. It is manually operated, yet it's designed for the transport of people who weigh 300-900+ lbs?
It is operated on the assumption that you have the space in the ambulance (often is the case, but a specialized truck is preferred) and that you have a large number of people to help lift (local fire department).

Again, your ideal stretcher will not continuously encounter the same environment. Be realistic, do your research, know your customer better than the people selling your product, know your competition's product (Stryker) as well as the people who use it daily.

 

[Kate Connelly]

Another thing to note: The number of providers and their capabilities often is not static.

Look at the Stryker MX-PRO bariatric stretcher. It is manually operated, yet it's designed for the transport of people who weigh 300-900+ lbs?
It is operated on the assumption that you have the space in the ambulance (often is the case, but a specialized truck is preferred) and that you have a large number of people to help lift (local fire department).

Again, your ideal stretcher will not continuously encounter the same environment. Be realistic, do your research, know your customer better than the people selling your product, know your competition's product (Stryker) as well as the people who use it daily.

These tips are GOLDEN. Absolutely, 100% golden. Thank you so much for your insight, it is greatly appreciated. I would love to stay in contact with you- email me at k8connelly@gmail.com. Thanks again.

 

[Kate Connelly]

These tips are GOLDEN. Absolutely, 100% golden. Thank you so much for your insight, it is greatly appreciated. I would love to stay in contact with you- email me at k8connelly@gmail.com. Thanks again.

One more thing, do you know the percentage of ambulances that employ the power lift? Is it too costly? Also, are they available to rent or is that less common?

 

[CALEMT]

I suggest you make arrangements with a local fire/EMS service for the opportunity to observe a shift or tour a station, and try to ask EMS professionals in person. Nothing we say will beat personal observation and experience.

This times a billion.

 

[Tigger]

One more thing, do you know the percentage of ambulances that employ the power lift? Is it too costly? Also, are they available to rent or is that less common?

How do you mean rent? Like the entire system? I haven't heard of Stryker leasing their systems but I suppose it's possible.

I think the cost of the powerload system is the main detractor, with the powerpro cot it's 40k+ system last I heard. We chose not to purchase for that reason and because we were unsure if it would operate on a slant. We instead ordered Ferno iNx cots, which we are still waiting for delivery on. Initial trials were positive though, zero lifting to load the patient and it could be used in our older ambulances with traditional stretcher mounts.

 

[Flying]

How do you mean rent? Like the entire system? I haven't heard of Stryker leasing their systems but I suppose it's possible.

I think the cost of the powerload system is the main detractor, with the powerpro cot it's 40k+ system last I heard. We chose not to purchase for that reason and because we were unsure if it would operate on a slant. We instead ordered Ferno iNx cots, which we are still waiting for delivery on. Initial trials were positive though, zero lifting to load the patient and it could be used in our older ambulances with traditional stretcher mounts.

I was looking for the iNx when thinking of the self-loading systems! Were there any concerns with the lack of side rails or with the attachable wings?

 

[Tigger]

I was looking for the iNx when thinking of the self-loading systems! Were there any concerns with the lack of side rails or with the attachable wings?

It does have siderails, they're like fold down armrests. Our demo did not have the wings.

 

[pineapplenick]

I have been using the Ferno INX cots since July. Here are a few thoughts on them. First, they are heavy, it's not usually a big deal, but there are times when it can be a major pain. If and when the battery dies and you have to go into manual mode, it is truly terrible. This is the one time when having the legs work independently is not beneficial. The side armrests are pointless, they just get in the way. I would so like to have the stryker wings on this cot. Overall the cot is not bad, but I am still not completely sold on it.

 

[Tigger]

I have been using the Ferno INX cots since July. Here are a few thoughts on them. First, they are heavy, it's not usually a big deal, but there are times when it can be a major pain. If and when the battery dies and you have to go into manual mode, it is truly terrible. This is the one time when having the legs work independently is not beneficial. The side armrests are pointless, they just get in the way. I would so like to have the stryker wings on this cot. Overall the cot is not bad, but I am still not completely sold on it.

Do you have the cot mount that also charges the battery?

 

[BlueJayMedic]

We have used the stryker power cot with the powerlift and onboard charging system for a couple of years now in out service and I don't think I have heard of a power malfunction more than five times. They seem to be very reliable and we never have trouble with the weight as we leave it outside of the residence and if the patient is located across terrain, there is usually another bunch of hands available to use alternate means to get the patient to the stretcher. I believe this cot will add years to my career as well as save (as it already has) our company countless tax dollars on paid injury from on duty claims. Can't wait to see what comes out next, I heard talks of us getting the new power stair chairs. If people could only not get jammed between the tub and toilet all the time back injuries would be even more scarce.

 

[pineapplenick]

Do you have the cot mount that also charges the battery?

We did, but found it to be finicky. Now we have an extra battery plugged into a charger in the trucks, and have found it to be a much better system.

 

[Mufasa556]

We have used the stryker power cot with the powerlift and onboard charging system for a couple of years now in out service and I don't think I have heard of a power malfunction more than five times. They seem to be very reliable and we never have trouble with the weight as we leave it outside of the residence and if the patient is located across terrain, there is usually another bunch of hands available to use alternate means to get the patient to the stretcher. I believe this cot will add years to my career as well as save (as it already has) our company countless tax dollars on paid injury from on duty claims. Can't wait to see what comes out next, I heard talks of us getting the new power stair chairs. If people could only not get jammed between the tub and toilet all the time back injuries would be even more scarce.

I'm hulk smash level green with jealousy. I'd be stoked to just have a power Stryker.