Why do we love the stretcher in the United States?

StCEMT

Forum Deputy Chief
2,823
1,543
113
I dont know about everywhere.... I used the stair chair twice tonight, but I will also often bench people when appropriate. Some nights that's not at all, others it's damn near everyone. I'm not carrying people around for their minor ailments that don't truly warrant the use of an ambulance anyway.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
284
45
28
So. Pasadena area. House on top of a hill. 45 steps up to the front door. Driveway at the side had a hard switchback which was also the turn around area and always had a car or two in it so no turn around. Drive the unit up to the back of a house you would park on about a 10 degree angle and have to back down all the way to the street.
Entering the front of the house the narrow staircase was immediately to your right with not quite 3 feet from end of staircase to front wall. Patient, regular customer, lived upstairs. On the bright side she only weighed about 80 lbs.
Stair chair? We needed sky hooks.
 

luke_31

Forum Asst. Chief
942
312
63
So. Pasadena area. House on top of a hill. 45 steps up to the front door. Driveway at the side had a hard switchback which was also the turn around area and always had a car or two in it so no turn around. Drive the unit up to the back of a house you would park on about a 10 degree angle and have to back down all the way to the street.
Entering the front of the house the narrow staircase was immediately to your right with not quite 3 feet from end of staircase to front wall. Patient, regular customer, lived upstairs. On the bright side she only weighed about 80 lbs.
Stair chair? We needed sky hooks.
There anything you’ve not done or do you just feel the need to comment on everything.
 

ffemt8978

Forum Vice-Principal
Community Leader
9,944
764
113
There anything you’ve not done or do you just feel the need to comment on everything.
This forum is about sharing knowledge and experience, so members are free to comment on any topic they feel like provided our rules are followed.
 

DrParasite

The fire extinguisher is not just for show
5,407
1,519
113
So. Pasadena area. House on top of a hill. 45 steps up to the front door. Driveway at the side had a hard switchback which was also the turn around area and always had a car or two in it so no turn around. Drive the unit up to the back of a house you would park on about a 10 degree angle and have to back down all the way to the street.
Entering the front of the house the narrow staircase was immediately to your right with not quite 3 feet from end of staircase to front wall. Patient, regular customer, lived upstairs. On the bright side she only weighed about 80 lbs.
Stair chair? We needed sky hooks.
What the heck are you talking about? Seriously, I have no idea what you were trying to say.

With the situation you describe, you have several options: either stairchair the person from her location to the street where your ambulance is waiting, or stairchair her from her location out the front door to the waiting stretcher, then wheel her to the ambulance,

a non-ambulatory patient is almost always safer when transported over horizontal ground via the stretcher (esp if it's not all the way up). this is safer for the crew as well, as they aren't carrying the patient. A stairchair is a carrying device, which can be used for limited transportation if the ground is not horizontal.

but if they can safely ambulate, there is nothing clinically inappropriate about having them walk to the ambulance.
 

NomadicMedic

Pot or Kettle? Unsure.
11,437
6,010
113
How many of you have worked at a place where it’s highly encouraged to put people on the stretcher and move them so the Medicare claim isn’t denied?

I’ll wait.
 

akflightmedic

Forum Deputy Chief
3,633
2,196
113
How many of you have worked at a place where it’s highly encouraged to put people on the stretcher and move them so the Medicare claim isn’t denied?

I’ll wait.

0 times.

If they need wheels, they get wheels. If they do not need wheels and it is safe to ambulate, they ambulate. If I happen to have the stretcher there already and they can walk, I will usually just go ahead and give them the wheels.
 

ffemt8978

Forum Vice-Principal
Community Leader
9,944
764
113
How many of you have worked at a place where it’s highly encouraged to put people on the stretcher and move them so the Medicare claim isn’t denied?

I’ll wait.
The private I worked at was like that...or at least the billing clerk was.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
284
45
28
What the heck are you talking about? Seriously, I have no idea what you were trying to say.

What the heck are you talking about?

"Why do we love the stretcher in the United States?"​

When transport crosses the line into extrication, you use, and do, whatever works. Unless of course there is some policy/mandate in place.

But to answer @MMiz question, the answer becomes obvious when you look at the broader picture. Stretcher origin, 'modern use' originated mainly from the military on battlefield. This can be clearly seen in many third world countries this present day. Ambulances commonly pick-up trucks with camper shells, the stretchers standard military canvas grab and runs.
In the ambulance service I started in we had several of those canvas stretchers growing mold in the back of the barn. The early newer iterations of stretchers were made of steel and, let's just say, presented a hazard to both patient and ambulance attendant alike.
Over the years various countries produced their own versions of patient transport devices, along with certain standards of patient care. (Whack the patient out with a half grain of Morphine ring any distant bells?")
So the evolution of patient transport in the US followed it's own guidelines. I recall aluminum stretchers that had warnings of patient weight must not exceed 200 lbs. Some wonderful stretchers with folding legs that could easily take your fingers off. All sorts on interesting iterations on the theme.
And then viewing patient transport in other countries, the US has always been a little behind the times and tended to be stuck in ruts. Profits with equipment suppliers weighed in heavily while in socialized medicine countries the trend went towards what was best for both patient and attendants without regard for cost.
 

CCCSD

Forum Asst. Chief
870
499
63
“...socialized medicine countries the trend went towards what was best for both patient and attendants without regard for cost.”

I‘m DYING!!!🤣🤣🤣🤣🤣🙄🙄🙄
 

RedBlanketRunner

Opheophagus Hannah Cuddler
284
45
28
I‘m DYING!!
F i n a n c i a l + R e s o u r c e s. 1+1= ?

Shows in many countries in Europe. Privately owned ambulance services cannot compete with state funded or subsidized operations when it comes to purchasing equipment and very often, levels of trainings.
Also, and it should go witthout saying, quality of equipment in the US varies significantly from locale to locale, depending on available funds.
 
Last edited:

RedBlanketRunner

Opheophagus Hannah Cuddler
284
45
28
Returning to the original question about stretchers. I would venture a guess that building codes factor in here. The US maintains accessibility requirements where in England and many countries in Europe, accessibility falls short of standards. A friend of mine's brother has a large construction business in England that only does renovations on older structures, often concentration on staircases and landings. Very narrtow staircases, little or even no landings, and other oddities like 6 foot or less ceilings are very common, especially in the outlying areas and grandfathered older constructions. That all adds up to stair chairs can be used just about anywhere but stretchers, not so much.
 

OceanBossMan263

Forum Crew Member
74
23
8
I'm going to take a wild guess that at some point in the past, lawyers got involved, and from that point the stretcher was pushed to prevent patients from walking.
 

NateJack745

Forum Probie
29
14
3
Over the past few weeks I've watched quite a few episodes of the British TV show Ambulance on YouTube.

On the TV show I rarely see patients carried out of their homes on stretchers. Instead, nearly every time the patient is walked to the ambulance or strapped on to a stair chair-like chair with four wheels.

During my active years in EMS we always lugged in the stretcher. Up stairs, through doorways, and into tiny rooms.

I see that Stryker's recent model stair chairs come standard with four wheels and tracks. Is anyone using them? Why don't we use something similar in the United States?
We carry that model of stair chair. It doesn’t get used much. It’s a shame. It’s a great tool.
 

ZombieEMT

Chief Medical Zombie
Premium Member
375
28
28
I once worked for a service that said every patient gets a stretcher, regardless of condition, complaint or preference. Additionally, they also never transported a second patient if needed. Every MVC and fall received a collar. I am no longer there but have been told they still have similar practices.

I am okay with stable patient walking and sitting, vs use of the stretcher. If they do not need or want it, then no need for the extra week. With that being said, I am more likely to use a stretcher than some of my coworkers. In todays time of power stretchers and power loads, its not as much of an effort to use the stretcher.
 

Top