A scoop stretcher, also known as a clamshell or orthopedic stretcher, is a specialized device used by emergency medical services to safely move injured patients. Its primary purpose is to secure a person onto a rigid platform while minimizing any movement of the spine or limbs during the transfer process. This device is designed to maintain the patient in a neutral, supine position to reduce the risk of causing secondary injuries, particularly when trauma is suspected. The scoop stretcher is intended for the initial transfer of a patient from the ground or a confined space onto a more stable transport device.
Patient Scenarios Requiring a Scoop Stretcher
The decision to use a scoop stretcher is primarily driven by the need to maintain spinal motion restriction (SMR) in trauma patients. Any situation where a patient has suffered significant blunt force trauma, such as a motor vehicle accident or a fall from a height, makes the scoop stretcher an appropriate tool. It is indicated for patients with suspected injuries to the cervical, thoracic, or lumbar spine, where even small movements could exacerbate an unstable fracture or cause damage to the spinal cord.
The device is also specifically useful for patients who have sustained fractures of the pelvis or proximal femur, as these injuries are extremely painful and highly unstable. The gentle and symmetrical application of the stretcher helps to maintain alignment of the fractured bones during the lifting process. Utilizing a scoop stretcher is often preferred when a patient is already lying on a flat surface and a traditional log-roll maneuver would be challenging or risky. These stretchers are particularly advantageous in difficult access situations, such as extricating a patient from a vehicle or maneuvering in a narrow hallway. In such confined spaces, the ability to assemble the device around the patient, rather than having to roll or lift them onto a fixed board, streamlines the rescue process.
How the Scoop Stretcher Minimizes Patient Movement
The design of the scoop stretcher is what enables it to minimize patient movement so effectively during the initial lift. It is constructed from two longitudinal halves that can be completely separated from one another. These two pieces are positioned on either side of the patient and then carefully slid underneath the body from opposite directions.
Once the halves are underneath the patient, they are secured together using a locking mechanism at both the head and foot ends. This process gently encases the patient, effectively “scooping” them up without requiring them to be rolled onto their side. Eliminating the need for the traditional log-roll maneuver is the single greatest advantage, as the log-roll can introduce significant and potentially harmful movement to an already compromised spine.
Biomechanical studies have demonstrated that using a scoop stretcher causes significantly less spinal motion during application compared to the movement generated by a log-roll onto a long backboard. The reduction in these forces is paramount for preventing the shift of fractured vertebrae that could compress the spinal cord. The patient remains secured to the device with multiple restraint straps, ensuring stability and alignment of the entire body during the lift and transfer.
When Other Devices Are Required Instead
The scoop stretcher is considered an extrication and transfer device, and it is not recommended for the duration of patient transport to the hospital. Due to its rigid, contoured nature, prolonged time on the scoop stretcher can cause patient discomfort and may increase the risk of pressure sores. Current protocols often advise that once the patient is secured and moved onto the ambulance cot, they should be transferred from the scoop stretcher onto a device better suited for long-term stabilization and comfort. A vacuum mattress is frequently the preferred alternative for transport, as it molds to the patient’s body shape, distributing pressure more evenly than a rigid surface.
There are also specific clinical situations where the scooping action could be detrimental. It is generally contraindicated for patients with severe, open, or highly unstable pelvic injuries where the lateral sliding of the halves could exacerbate bleeding or fracture displacement. Additionally, patients who require immediate and uninterrupted cardiopulmonary resuscitation (CPR) may need to be transferred to a firm, flat surface like a traditional backboard if the scoop stretcher does not provide adequate rigidity for chest compressions.