When emergency medical services (EMS) personnel move a patient into an ambulance, the equipment used often generates public confusion regarding its proper name. While many people refer to it generically as a stretcher or gurney, the official and most common professional term is the ambulance cot. This device is engineered specifically for patient transport, balancing the need for patient comfort and stability with the rigorous demands of pre-hospital emergency care. The cot serves as the primary means of moving and securing a patient during high-speed transit to a medical facility.
The Official Terminology and Variations
In the emergency medical services field, the primary patient transport device is consistently referred to as an ambulance cot or simply a cot. This term distinguishes it from a basic stretcher, which typically refers to a non-wheeled device requiring manual lifting by two or more people. A cot is defined by its integrated wheel system, allowing a single operator to move a patient over flat terrain, though loading into the ambulance still requires assistance. The word “gurney” is often used interchangeably by the public, but it generally refers to similar wheeled carts used within a hospital setting.
The distinction between a cot and a stretcher lies mainly in the presence of wheels and the intended use. A simple stretcher, such as a canvas or pole stretcher, is designed for moving patients over short distances or in environments where wheels are impractical, such as rough terrain or up stairs. Conversely, the ambulance cot is a robust, wheeled device designed to be the patient’s primary surface from the pickup location all the way into the ambulance and the emergency department bay. Modern ambulance cots are regulated to ensure they meet standards for patient weight capacity, securement inside the vehicle, and durability.
How the Main Cot Functions: Loading and Safety Systems
The operational efficiency of the ambulance cot centers on its loading and safety mechanisms, which have evolved significantly from older manual systems. Traditional manual cots require EMS providers to physically lift the patient and the cot’s weight into the ambulance, relying on a set of telescoping legs that fold and unfold during the process. This method requires significant physical effort from the crew, often involving lifting hundreds of pounds multiple times a day. Such repetitive strain has led to a high rate of back and shoulder injuries among EMS personnel.
To mitigate this risk, modern ambulances increasingly use powered cots, which utilize hydraulic or electric systems to raise and lower the patient and cot automatically. These power-lift systems allow the EMS crew to guide the cot rather than lift it, significantly reducing the physical strain and risk of injury.
Regardless of whether the cot is manual or powered, a robust locking mechanism is employed to secure the cot firmly to the ambulance floor during transport. This mechanism often involves a specialized retention system, sometimes referred to as an “antler” or a “hook,” that locks the cot frame into a plate mounted to the vehicle’s chassis. Once secured, the cot is prevented from shifting or becoming dislodged, even during rapid acceleration, braking, or turning. The patient is then secured to the cot itself using multiple straps across the torso and legs, ensuring they remain immobilized on the surface throughout the journey. This dual-layer of securement protects the patient from movement-related injury during high-speed emergency transport.
Specialized Equipment for Patient Movement
While the ambulance cot is the workhorse for most patient transport scenarios, specialized equipment is employed when the main cot is impractical or impossible to use.
Stair Chair
The stair chair is specifically designed for navigating tight hallways, small elevators, and staircases where a full-sized cot cannot maneuver. This chair-like device allows the patient to be moved in a seated position, often utilizing specialized tracks or wheels to slide safely down stairs with controlled friction. It is reserved for patients who are stable and can tolerate being upright.
Scoop Stretcher
The scoop stretcher is often used for patients with suspected spinal injuries or trauma. This device is composed of two longitudinal halves that can be separated, positioned on either side of the patient, and then “scooped” underneath them without the need to log-roll or otherwise manipulate the patient’s spine. By minimizing patient movement, the scoop stretcher helps prevent secondary injury before the patient is transferred onto the main cot or a rigid backboard.
Basket Stretcher
For technical or wilderness rescues, a basket stretcher, or Stokes basket, is employed. It features a durable, enclosed frame that protects the patient from external hazards. The basket shape allows the patient to be securely contained and hoisted or lowered over difficult terrain using ropes and specialized rigging. These different devices ensure that EMS providers have a means to safely and effectively move a patient from any environment to the waiting ambulance cot.