Foley: Mountain Rescue teams are in the transportation business
If our subject is unable to exit the backcountry under their own power it’s our job to provide a free, safe ride to the nearest trailhead. We’ll use whatever resources we can muster to accomplish that task – ATVs, snowmobiles, horses, helicopters. Once we used a dog sled.
Sometimes none of these energy and time saving resources will work due to terrain, weather or availability. It then comes down to elemental human powered search and rescue tactics, usually involving one of our most basic tools, the Stokes litter.
The Stokes basket stretcher (now commonly called the Stokes litter) was invented by Rear Admiral Charles Stokes and was first demonstrated at the 1904 St. Louis World’s Fair. In 1906 the Stokes litter was adopted for use by the United Sates Army and Navy, primarily aboard hospital ships and transports. One big step up from an ambulance stretcher, which is like a cot with handles, the Stokes was especially useful when moving patients in the tight confines of a Navy ship.
Quoting from a Navy Medicine Blog: “The Stokes Stretcher could immobilize the injured parts, allow for the carrying of a patient with minimum direct handling of extremities and, according to its inventor, offer some ‘comfort and a sense of security.’”
Stokes went on to serve as Surgeon General from 1910 to 1914 before retiring in 1917.
The original Stokes litter was basically a basket of wire supported by iron rods. The patient could be secured in the Stokes litter and remain stable no matter the position of the litter. The metal frame allowed for the litter to be handled by multiple persons and also provided a place to attach ropes or straps to assist in moving the litter in confined spaces, on or off ships or on difficult terrain.
A hundred years later the Stokes litter is still in use by military and civilian search and rescue organizations. Modern Stokes litters are made from modern materials, but the form is essentially unchanged. Instead of “chicken wire” the basket is made of plastic mesh, formed plastic or fiberglass and the frame is tubular metal. Special use litters for search and rescue are collapsible, are outfitted with floats or are designed to slide on ground surface.
Grand County Search and Rescue (GCSAR) has several different litters in each of our rescue vehicles. The primary litter we would use for trail or technical evacuations is a Stokes tapered litter that splits into two parts for ease of carrying into the backcountry. The frame is made of titanium with a plastic mesh basket and plastic slats for support. It is load rated at 2500 pounds meeting safety requirements for high angle rescue or helicopter hoisting and only weighs 16 pounds. The cost of one of these state of the industry litters is nearly $3,000.
Another option that we use, especially in the winter, is a two-part collapsible basket litter made by the same company that makes ski patrol rescue toboggans. The basket is made of a composite material that allows the litter slide on snow and ice and the stainless steel frame has been tested and rated for technical use. They now make a carbon fiber and titanium model that runs in the $2500 range that saves about 4 pounds over our $1200 base model.
Either of these litters can be attached to what is called a litter wheel. Similar to what hunters use to carry big game, the litter wheel is a real back saver when it comes to a long trail carry. Even though they weigh more than the litter and are difficult to haul in they can reduce the number of rescuers required to carry a subject by at least half. Litter wheels cost about $1,000 and usually break into two parts for transport.
The third option that we have for human powered patient transport is what’s called a SKED stretcher. A SKED is basically a sheet of thick plastic with holes and straps that becomes a rigid litter when the patient is packed inside. The advantages of a SKED are low cost at about $700, low weight at about 13 pounds and easy deployment. They slide on snow and are also rated for technical work. We have found that a SKED will not protect a c-spine injury very well without a backboard or other secondary splint and is not as comfortable for the patient.
Mountain Rescue teams will undoubtedly continue to use the litter as the primary patient transfer device because it provides a stable platform for patient care, is adaptable to wide variety of environments and provides safety features for both rescuers and patient.
Greg Foley is a member of Grand County Search and Rescue and has been a mountain rescue volunteer for 36 years. He can be reached by email at firstname.lastname@example.org. The GCSAR website can be found at grandcountySAR.com or on Facebook/GCSAR.
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