LEARNING OBJECTIVE: Recognize the different patient-moving devices and lifting techniques that can be used in patient rescues.

In an emergency, there are many ways to move a victim to safety, ranging from one-person carries to stretchers and spineboards. The victim's condition and the immediacy of danger will dictate the appropriate method. Remember, however, to give all necessary first aid BEFORE moving the victim.

Stretchers
The military uses a number of standard stretchers. The following discussion will familiarize you with the most common types. When using a stretcher, you should consider a few general rules:

Use standard stretchers when available, but be ready to improvise safe alternatives.

When possible, bring the stretcher to the casualty.
Always fasten the victim securely to the stretcher.
Always move the victim FEET FIRST so the rear bearer can watch for signs of breathing difficulty.
STOKES STRETCHER.-The Navy service litter most commonly used for transporting sick or injured persons is called the Stokes stretcher. As shown in figure 3-27, the Stokes stretcher is essentially a wire basket supported by iron rods. Even if the stretcher is tipped or turned, the casualty can be held securely in place, making the Stokes adaptable to a variety of uses. This stretcher is particularly valuable for transferring injured persons to and from boats. As mentioned before, it can also be used with flotation devices to rescue injured survivors from the water. It is also used for direct ship-to-ship transfer of injured persons. Fifteen-foot handling lines are attached to each end for shipboard use in moving the victim.

The Stokes stretcher should be padded with three blankets: two of them should be placed lengthwise (so that one will be under each of the casualty's legs), and the third should be folded in half and placed in the upper part of the stretcher to protect the head and shoulders. The casualty should be lowered gently into the stretcher and made as comfortable as possible. The feet must be fastened to the end of the stretcher so that the casualty will not slide down. Another blanket (or more, if necessary) should be used to cover the casualty. The casualty must be fastened to the stretcher by means of straps that go over the chest, hips, and knees. Note that the straps go OVER the blanket or other covering, thus holding it in place.

ARMY LITTER.-The Army litter, shown in figure 3-28, is a collapsible stretcher made of canvas and supported by wooden or aluminum poles. It is very useful for transporting battle casualties in the field. However, it is sometimes difficult to fasten the casualty onto the Army litter, and for this reason its use is somewhat limited aboard ship. The litter legs keep the patient off the ground. The legs fit into the restraining tracks of a jeep or field ambulance to hold the litter in place during transport.

MILLER (FULL BODY) BOARD. 3/4The Miller Board (fig 3-29) is constructed of an outer plastic shell with an injected foam core of polyurethane foam. It is impervious to chemicals and the elements and can be used in virtually every confined-space rescue and vertical extrication. The Miller Board provides for full body immobilization through a harness system, including a hood and two-point contact for the head (forehead and chin) to stabilize the head and cervical spine. The board's narrow design allows passage through hatches and crowded passageways. It fits

Figure 3-27.-Stokes stretcher.

Figure 3-28.-Opening an Army litter.

within a Stokes (basket) stretcher and will float a 250-pound person.

IMPROVISED STRETCHERS.-Standard stretchers should be used whenever possible to transport a seriously injured person. If none are available, it may be necessary for you to improvise. Shutters, doors, boards, and even ladders may be used as stretchers. All stretchers of this kind must be very well padded and great care must be taken to see that the casualty is fastened securely in place.

Sometimes a blanket may be used as a stretcher, as shown in figure 3-30. The casualty is placed in the middle of the blanket in the supine position. Three or four people kneel on each side and roll the edges of the blanket toward the casualty, as shown in figure 3-30A. When the rolled edges are tight and large enough to grasp securely, the casualty should be lifted and carried as shown in figure 3-30B.

Stretchers may also be improvised by using two long poles (about 7 feet long) and strong cloth (such as a rug, a blanket, a sheet, a mattress cover, two or three gunny sacks, or two coats). Figure 3-31 shows an improvised stretcher made from two poles and a blanket.

CAUTION: Many improvised stretchers do not give sufficient support in cases where there are fractures or extensive wounds of the body. They should be used only when the casualty is able to stand some sagging, bending, or twisting without serious consequences. An example of this type of improvised stretcher would be one made of 40 to 50 feet of rope or 1-1/2-inch firehose (fig. 3-32).