Ambulances use specialized equipment to move and support patients outside of a medical facility. This apparatus is a complex piece of medical technology that allows emergency medical services (EMS) personnel to safely transfer and treat patients in a moving environment. The device must provide a secure platform while accommodating medical procedures and integrating safely with the ambulance structure. Understanding the terminology and technology behind this equipment reveals its central role in modern pre-hospital care.
The Correct Terminology: Cot, Stretcher, or Gurney?
The wheeled device used to carry patients in an ambulance is most accurately referred to as an “ambulance cot” or a “stretcher.” While often used interchangeably, “stretcher” is the most accepted term in medical literature and official documentation. EMS crews commonly prefer “cot” for the wheeled, adjustable devices used for routine transport.
The public or hospital settings frequently use the word “gurney,” particularly for wheeled carts in emergency departments and hallways. However, “gurney” is less common among pre-hospital emergency care providers. The device’s fundamental purpose is to provide a stable, adjustable surface that can be easily loaded into an ambulance and maneuvered across various terrains. These devices are purpose-built for durability and compatibility with specialized vehicle locking systems, distinguishing them from standard hospital beds.
Manual Versus Powered Cot Systems
Modern ambulance cots are categorized by their lifting mechanism: manual or powered. Traditional manual cots rely on the physical strength of two EMS providers to lift and lower the patient, using an X-frame or H-frame mechanism. These systems remain reliable and are often lighter, but they require significant physical exertion, posing a risk of musculoskeletal injury to providers.
Powered cot systems utilize a battery-powered hydraulic or electromechanical system to raise and lower the patient at the touch of a button. This automation drastically reduces the physical strain on emergency personnel, who face high rates of back injury from repetitive lifting. The benefit of these systems is the reduction in manual lifting, which has been shown to decrease crew injuries by as much as 40 percent in some services.
These systems can handle bariatric patients, with many models capable of unassisted lifting for patients weighing up to 700 pounds. Powered cots often integrate with an automatic loading system, eliminating the need for personnel to lift the cot into the ambulance. Studies have also shown that powered systems provide a smoother experience for the patient, exhibiting significantly lower vertical acceleration and vibration during lifting and loading compared to manual cots.
Securing the Patient and the Cot
Securing both the patient and the cot is a regulatory mandate governed by safety standards to ensure stability during high-speed transit and sudden braking. The patient is secured to the cot using a multi-point restraint system, typically a five-point harness. This system includes straps across the chest, hips, and knees, along with two over-the-shoulder restraints.
These straps are designed with metal-to-metal quick-release buckles and are fabricated from strong, easily cleanable materials like nylon. The over-the-shoulder straps prevent the patient from being ejected forward during a frontal impact or rapid deceleration. Proper restraint ensures the patient remains centered and secure, mitigating the risk of injury from movement or tipping.
Separately, the cot must be securely locked into the floor of the ambulance patient compartment using a specialized fastening system. This locking mechanism, often called a latch or receiver, prevents the cot from moving laterally or longitudinally during transit. Current safety standards, such as those set by the Society of Automotive Engineers (SAE J3027), require this system to limit the forward movement of the cot and patient to a maximum of 14 inches in the event of a crash. This dual-layer of security is a fundamental component of safe emergency transport.