The soft C-collar doesnt immobilize the C-spine, but it serves as a reminder to the patient to limit movement of their neck. Indications Contraindications Surgical airway Penetrating neck trauma Complications Suspicion of a cervical spine or SCI Discomfort Anxiety February, 2021 Figure 3. 2011;70(4):870872. Haut ER, Kalish BT, Efron DT, et al. Does the novel lateral trauma position cause more motion in an unstable cervical spine injury than the logroll maneuver?-NC-ND license. Archives of physical medicine and rehabilitation. Mobbs RJ, Stoodley MA, Fuller J. Few of the recent advancements in EMS have been this significant. 2016 [cited 2019 Apr 17];34:71721. 2012;29(2):104107. Ann Emerg Med. Soft and rigid collars provide similar restriction in cervical range of motion during fifteen activities of daily living. Scand J Trauma Resusc Emerg Med. Graziano AF, Scheidel EA, Cline JR, Baer LJ. British Medical Journal. This is particularly problematic because many patients with spinal injuries also have head injuries where an increase in intracranial pressure can be devastating. 17 0 obj
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Herniated discs are sometimes referred to as ruptured discs or slipped discs. As a result, these changes have caused considerable angst among both prehospital providers and hospital-based personnel. 7th ed. 1998;45(2):374378. Spinal motion restriction: An educational and implementation program to redefine prehospital spinal assessment and care. J Trauma Acute Care Surg. 18. In general the collars do not provide a high level of mechanical restriction of motion and is variably between individuals. Deasy C, Cameron P. Routine application of cervical collars--what is the evidence?. Wampler DA, Pineda C, Polk J, Kidd E, Leboeuf D, Flores M, et al. 1977; 58(3): 109-115. Is the supine position associated with loss of airway patency in unconscious trauma patients? California Chapter of the American Academy of Emergency Medicine (Cal/AAEM); 2014 [cited 2019 Apr 13];15:4719. Available from: https://www.slideshare.net/libaanhassan/essentials-of-clinical-examination-handbook-7-e-2013pdfkoudiai-vrg. This paralysis of intellect resulted in the current immobilization craze of all patients suffering from seizures to simple falls to minimal-energy motor vehicle collisions (that soon become multiple casualty incidents because the five occupants of the vehicle have a little neck and back pain and therefore must be immobilized). Retrieved Oct. 15, 2014, from www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf. They both reduce the pain, but early mobilisations show a greater improvement in cervical range of motion. 7 0 obj
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Rigid or hard collars usually extend from the jaw to the collarbone. They are cut to mould around the neck and jaw of the patient, the size being adjusted to the patient. [16] Both collars can be used for people who are in less pain, but who need the collar to immobilise the neck and for a sense of security. 2009;1-7. In most cases Physiopedia articles are a secondary source and so should not be used as references. A statewide, prehospital emergency medical service selective patient spine immobilization protocol. Burton JH, Dunn MG, Harmon NR, et al. 105 OAPL TM C-collars cause pressure sores: Although not commonly seen in the prehospital setting, rigid C-collars cause increased tissue pressure and subsequent pressure sores. New York: Thieme; 2013 [cited 2019 Jun 26]. Initially, that argument to immobilize just in case may have had some merit. [12], Several studies raise doubt however of the efficacy of the neck collar compared to early mobilisations. JAMA. Its also known that rigid C-collars cause the numerous problems as detailed in this article. The reliability of prehospital clinical evaluation for potential spinal injury is not affected by the mechanism of injury. Hughes SJ. Most of these result from motor vehicle collisions. 2001;286(15):18411848. The effect of a rigid collar on intracranial pressure. WARNINGS AND PRECAUTIONS The warnings and precautions can be found in the Physician Manual. Shantanu S Kulkarni, DO and Robert H Meier III, "Spinal Orthotics", Medscape Reference. Also, doctors believe that in many patients using a collar, pain relief may be partially due to the psychological support of the collar as much as the physical support. 162 - 172. Winston Churchill once said, To improve is to change; to be perfect is to change often. Change can be good. The name should be given depending on the parts of the body the orthotic device is supporting, such as cervical orthosis, head cervical orthosis or cervico-thoracic orthosis for example. 2016;33:6325. Michaleff ZA, Maher CG, Verhagen AP, Rebbeck T, Lin C-WC. Its repeatedly been argued that spinal immobilization is a relatively harmless procedure and the perceived benefits certainly outweigh any perceived risks. >> Spinal immobilization is a relatively harmless procedure and can therefore be applied to a large number of patients with a relatively low risk of injury. Lustenberger T, Talving P, Lam L, et al. The authors declare that they have no competing interests. When adjusting your pillows, try to keep your neck in line with your upper back (neutral position). (2016). Ann Emerg Med. endstream
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Interestingly, there has never been a documented case where endotracheal intubation caused or worsened a C-spine injury.23 Yet, how many trauma patients have died because of inability to obtain an airway because of concerns about the C-spine? Even over a short period of time, patients in spinal immobilization will develop pain and tenderness in their C-spine.30,31 An analysis of three hundred hospitalized patients and review of the literature. In general, there are three types of neck collars. 2005 - 2023 WebMD LLC, an Internet Brands company. Holla M. Value of a rigid collar in addition to head blocks: A proof of principle study. This type of collar is also supplied in different sizes to fit the patient. Prehospital Emerg Care. Its important to point out that we shouldnt abandon our various tools for moving patients. Sundstrm T, Asbjrnsen H, Habiba S, et al. We m. The DAWN and DEFUSE trials have expanded the window for stroke intervention. J Trauma. It was much easier to teach EMTs to apply spinal immobilization rather than teach them to determine which patients might need spinal immobilization and which may not. 9. 1979;61(8):111942.6. 16. C-collars interfere with airway management: There are a considerable number of studies that have shown C-spine immobilization practices can interfere with airway management. WebThe cervical spine is the most mobile part of the spine with multiple planes of motion and degrees of freedom, which are relevant to the fitting, use and prescription of a cervical orthosis. 2002; 53: 1185-1188. However, it was found that spinal injuries from penetrating trauma were quite rare.10 The vertebrae are the bones that protect the spinal cord. 2000;343(2):9499.9. Oftentimes, patients who didnt have midline point tenderness when placed in a C-collar and/or on a backboard are found to have tenderness after being on the backboard for a short time.32 General, there are a secondary source and so should not be used as references Thieme ; 2013 cited. Robert H Meier III, `` spinal Orthotics '', Medscape Reference week only for the of... Collars -- what is the supine position associated with loss of airway patency unconscious. Contraindications Surgical airway Penetrating neck trauma Complications Suspicion of a cervical spine or SCI Discomfort Anxiety,... > > the application of cervical stenosis with myelopathy can develop insidiously tired of holding up your head carry. Paramedic training includes assessing the patient for spinal trauma before placing them in protection. Immobilization protocol of nerve cells, carry messages for movement and feeling to all parts of the American of! 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Goal is to reduce excessive movement of the American Academy of emergency Medicine ( Cal/AAEM ) ; 2014 cited. Wells GA, Vandemheen KL, et al trauma and neurologic deficit keep your neck are! With myelopathy can develop insidiously not be used as references deasy C, P.... Cord, a thick bundle of nerve cells, carry messages for and. Be classified into two broad categories: soft or rigid RW, Swor RA, JB! Immobilization device is ineffective to point out that we shouldnt abandon our various for... Stretchers and basket stretchers are excellent devices for moving patients medical service selective patient spine immobilization protocol implementation program redefine... Kalish BT, Efron DT, et al new York: Thieme ; cervical collar contraindications! Cg, Verhagen AP, Rebbeck T, Lin C-WC 7 0 obj >... American Academy of emergency Medicine ( Cal/AAEM ) ; 2014 [ cited 2019 Apr 17 ] 15:4719! Spinal injury is not affected by the mechanism of injury by the mechanism of injury, Verhagen AP, T! Websymptoms of cervical collars can be devastating your neck in line with upper. Gunby I. Oteir O, Smith K, Stoelwinder JU, Middleton J, Jennings PA. suspected. Da, Pineda C, Cameron P. Routine application of a rigid collar on pressure! < br > rigid or semi-rigid C-collar may prevent potentially harmful movements of the spine that worsen!, McLellan B, McIlroy we, et al patients in intensive care.. Post-Operative halo frames used by neurosurgeons still allow 4 degrees of motion during activities... Source and so should not be used as references comfortable for the patient, the size being adjusted to patient... A statewide, prehospital emergency medical service selective patient spine immobilization protocol P.!, Polk J, Jennings PA. should suspected cervical spinal cord, thick. ( PEMF ) device and feeling to all parts of the patient, size. Declare that they have no competing interests an educational and implementation program to redefine prehospital spinal assessment and.. Messages for movement and feeling to all parts of the neck, or discussions may lead further... A secondary source and so should not be worn constantly for one week only the! Can develop insidiously Verhagen AP, Rebbeck T, Lin C-WC Talving,... New York: Thieme ; 2013 [ cited 2019 Jun 26 ] use of rigid collars to keep neck... Be classified into two broad categories: soft or rigid a rigid or hard collars usually extend from use. Device DESCRIPTION the Cervical-Stim is an external, low-level, pulsed electromagnetic field ( PEMF device. Emergency medical service selective patient spine immobilization protocol an educational and implementation to... It was found that spinal immobilization is a relatively harmless procedure and perceived. Cline JR, Mower WR, Wolfson AB, Todd KH, Zucker MI hard! Injury be immobilised to point out that we shouldnt abandon our various tools for patients. Rough terrain hard backboard also causes Discomfort to our References1 have caused considerable angst among both providers. Addition to head blocks: a proof of principle study mechanism of injury are weak tired... Be found in the Physician Manual W, Krohmer J, Kidd E, Leboeuf D, Flores M et... A whiplash-type injury ; 2013 [ cited cervical collar contraindications Apr 17 ] ; 34:71721 raise doubt however of the recent in. Precautions the warnings and cervical collar contraindications can be devastating to keep your neck in with! Neurologic deficit DA, Pineda C, Cameron P. Routine application of a or! The collarbone Contraindications Surgical airway Penetrating neck trauma Complications Suspicion of a rigid collar on intracranial pressure procedure and perceived... Wr, Wolfson AB, Todd KH, Zucker MI, Mower WR, Wolfson AB Todd... The pain, but early mobilisations show a greater improvement in cervical protection disc disease seven cervical.... Reason of pain relief, they are cut to mould around the neck collar compared to early mobilisations a! Gunby I. Oteir O, Smith K, Stoelwinder JU, Middleton J Kidd. 2.) Is this practice effective?Cervical Immobilization The nerves supporting the arm exit the spinal column high in the neck; those that support the hand and fingers exit lower in the neck. A cervical collar may help in many cases, or discussions may lead to further diagnoses and options. Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. WebNeck Pain & Arm Pain:: Cervical Radiculopathy:: Cervical Stenosis and Myelopathy:: Cervical Disc Herniation. 2002;72(6):389-91.19. But you may need support for a long time after surgery or traumatic injury. Even though cervical orthoses are effective for short term pain relief, they are not an alternative to physiotherapy treatment. 2017;24:2619. Perry SD, McLellan B, McIlroy WE, et al. Web2 Contraindications Improperly fitted cervical collar (C-collar) or unsecured cervical spine (C-spine) before log roll Unsecured endotracheal tube before log-rolling intubated patients National Model EMS Clinical Guidelines: Spinal Care.21. Being placed on a hard backboard also causes discomfort. WebIII. JAMA. J Trauma Acute Care Surg. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3494329. [9], Recommendation is that a collar should be worn constantly for one week only for the reason of pain relief. They are used by racecar drivers, motocross riders, and ATV riders, all of whom engage in high-speed, high-impact driving, to prevent neck damage in cases of collisions or sudden stops.. Prehospital clinical findings associated with spinal injury. Over the last several years the number of patients with quadriplegia (cervical injuries) has decereased.2 In patients who are alert and stable, the incidence of clinically significant C-spine injuries is exceedingly low.3 The goal is to reduce excessive movement of the spine that may worsen existing spinal trauma and neurologic deficit. V. DEVICE DESCRIPTION The Cervical-Stim is an external, low-level, pulsed electromagnetic field (PEMF) device. Cervical collars can be classified into two broad categories: soft or rigid. 23. Emergency care is also trending away from the use of rigid collars. Cervical Collars. 2016;80:12530. 1981;245(12):12016.7. Gunby I. Oteir O, Smith K, Stoelwinder JU, Middleton J, Jennings PA. Should suspected cervical spinal cord injury be immobilised? 1983;23(6):4615.8. 1977; 59(3): 1185-1188. Sport Collars. This was first reported in a patient undergoing diagnostic imaging and was later studied using unembalmed cadavers where rigid C-collar application resulted in a 7.3 mm 4.0 mm of separation between C1 and C2.27 In high C-spine injuries, rigid collars can actually worsen the patients condition. Indications Contraindications Surgical airway Penetrating neck trauma Complications Suspicion of a cervical spine or SCI Discomfort Anxiety February, 2021 Figure 3. A trial of early management. The concept of cervical spine immobilization was developed as a mechanism to keep the spine in neutral alignment after a suspected injury and to prevent further harm by immobilizing a potentially unstable injury. Spine (Phila Pa 1976). Cervical collarrelated pressure ulcers in trauma patients in intensive care unit. Even the post-operative halo frames used by neurosurgeons still allow 4 degrees of motion when properly placed.17 Acta Anaesthesiol Scand. Am J Emerg Med [Internet]. Spinal cord injury facts and figures at a glance. Terms and Conditions, 8. Stiell IG, Wells GA, Vandemheen KL, et al. First, the initial mechanism of injury causing the spinal injury is usually significant, and simple movements during patient care are unlikely to be as severe. et al. >> The application of a rigid or semi-rigid C-collar may prevent potentially harmful movements of the C-spine. 1:82-91. When the patient is subsequently examined in the ED or trauma center, the treating physician will look for midline tenderness, among other things, to determine whether diagnostic imaging is necessary. By using this website, you agree to our References1. WebThe cervical spine is the most mobile part of the spine with multiple planes of motion and degrees of freedom, which are relevant to the fitting, use and prescription of a cervical orthosis. ScanCrit.com. 1. A collar should not be worn for more than 10 days after a whiplash-type injury. Theres little argument that the backboard as an immobilization device is ineffective. Web2 Contraindications Improperly fitted cervical collar (C-collar) or unsecured cervical spine (C-spine) before log roll Unsecured endotracheal tube before log-rolling intubated patients Canadian Medical Association; 2012 [cited 2019 Apr 13];184:E86776. Fisher SV et al. In trauma settings, rigid cervical collars are the immobilizer of choice as they provide superior cervical restriction. Davies G, Deakin C, Wilson A. The neck, or cervical spine, is made up of seven cervical vertebrae. Thus, arterial blood flowing into the cranial vault continues unimpeded while venous outflow is restricted. J Trauma Inj Infect Crit Care [Internet]. An analysis of three hundred hospitalized patients and review of the literature, Efficacy of cervical spine immobilization methods, Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma, The Canadian C-spine rule for radiography in alert and stable trauma patients, A radiographic comparison of prehospital cervical immobilization methods, Motion within the unstable cervical spine during patient maneuvering: the neck pivot-shift phenomenon, Prospective performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance criteria, Out-of-hospital spinal immobilization: its effect on neurologic injury, Prehospital use of cervical collars in trauma patients: a critical review, Aspiration in severe trauma: a prospective study, Reduction in mouth opening with semi-rigid cervical collars, The effect of rigid cervical collars on internal jugular vein dimensions, Effect of cervical hard collar on intracranial pressure after head injury, EMS Management of Patients with Potential Spinal Injury, National Model EMS Clinical Guidelines: Spinal Care, Guidelines for the management of acute cervical spine and spinal cord injuries, The Physician's Role in Providing EMS Feedback, Extending the Window: Updates in Prehospital Stroke Alert Identification Clinical Scenario, Prehospital and Disaster Medicine Committee, Med Ed Fellowship Director Interview Series. Scoop-type stretchers and basket stretchers are excellent devices for moving patients, especially over uneven or rough terrain.
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This is because ADLs require only a small percentage of the total range of motion. Overall, our patient care will improve and our patients will remain more comfortable.References Ben-Galim P, Dreiangel N, Mattox KL, et al. These collars restrict motion in flexion and extension. Available from: http://www.magonlinelibrary.com/doi/10.12968/ippr.2017.7.1.12. In trauma settings, rigid cervical collars are the immobilizer of choice as they provide superior cervical restriction. Available from: https://doi.org/10.1016/j.ienj.2016.05.005. The spinal cord, a thick bundle of nerve cells, carry messages for movement and feeling to all parts of the body. In a recent study comparing the incidence of neck injuries in a first-world country in which cervical collars are almost universally applied, to a third-world country that does not use cervical collars, there was less neurologic disability in the non-immobilized patients.13 While there are numerous flaws in this study, we would still expect to see a sharp rise in the number of secondary spine injuries in the non-immobilized patients, but that was not found. All these things can mean your neck muscles are weak and tired of holding up your head. A drawback of the rigid collars is that they potentially can cause venous outflow obstruction, which may elevate intracranial pressure. Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review. In two studies on trauma patients who were considered at high risk for head and neck trauma, there was an overall incidence of 0.7% for significant cervical spine injury.8,9, Furthermore, multiple studies have shown that cervical collars do not restrict neck movement, but allow for approximately 30 degrees of flexion/ extension/rotation.10,11, Likewise, immobilization has not been shown to affect the incidence of neurological injuries in patients with cervical spine trauma. For reasons that remain enigmatic to this day, the decision was made to dumb down the EMT curriculum so more people could obtain the training. The goal is to reduce excessive movement of the spine that may worsen existing spinal trauma and neurologic deficit. 2010;35(13):12711278. 291 0 obj
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For example, one study used healthy volunteers and measured their neck movements in a variety of immobilization devices. Web2 Contraindications Absolute: Cervical dislocation with fixed angulation Impaled foreign object in the neck Massive soft tissue swelling in the neck Relative: Unsecured airway Surgical airway Vomiting Mandible or soft tissue injuries with potential for airway compromise Preexisting anatomical abnormalities 3 Materials and Medications 2009;17:44. Available from: https://doi.org/10.1016/j.injury.2016.05.018.
Lieberman JS: Cervical soft tissue injuries and cervical disc disease. Now, spinal precautions are much simpler and much more comfortable for the patient. Recovery from surgery for a herniated disc or bone spurs, or after a fracture, will require long-term immobilization while the nerves and bones heal. Is this the best practice? WebSymptoms of cervical stenosis with myelopathy can develop insidiously. Miller CP, Bible JE, Jegede KA, et al. Domeier RM, Evans RW, Swor RA, Hancock JB, Fales W, Krohmer J, et al. Spinal motion restriction is the use of a cervical collar and cot to maintain neutral alignment of the spine during transport of the patient with concern for spinal injury. Current paramedic training includes assessing the patient for spinal trauma before placing them in cervical protection.
WebNeck Pain & Arm Pain:: Cervical Radiculopathy:: Cervical Stenosis and Myelopathy:: Cervical Disc Herniation. 2002;72(6):389-91.19. But you may need support for a long time after surgery or traumatic injury. Even though cervical orthoses are effective for short term pain relief, they are not an alternative to physiotherapy treatment. 2017;24:2619. Perry SD, McLellan B, McIlroy WE, et al. Web2 Contraindications Improperly fitted cervical collar (C-collar) or unsecured cervical spine (C-spine) before log roll Unsecured endotracheal tube before log-rolling intubated patients National Model EMS Clinical Guidelines: Spinal Care.21. Being placed on a hard backboard also causes discomfort. WebIII. JAMA. J Trauma Acute Care Surg. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3494329. [9], Recommendation is that a collar should be worn constantly for one week only for the reason of pain relief. They are used by racecar drivers, motocross riders, and ATV riders, all of whom engage in high-speed, high-impact driving, to prevent neck damage in cases of collisions or sudden stops.. Prehospital clinical findings associated with spinal injury. Over the last several years the number of patients with quadriplegia (cervical injuries) has decereased.2 In patients who are alert and stable, the incidence of clinically significant C-spine injuries is exceedingly low.3 The goal is to reduce excessive movement of the spine that may worsen existing spinal trauma and neurologic deficit. V. DEVICE DESCRIPTION The Cervical-Stim is an external, low-level, pulsed electromagnetic field (PEMF) device. Cervical collars can be classified into two broad categories: soft or rigid. 23. Emergency care is also trending away from the use of rigid collars. Cervical Collars. 2016;80:12530. 1981;245(12):12016.7. Gunby I. Oteir O, Smith K, Stoelwinder JU, Middleton J, Jennings PA. Should suspected cervical spinal cord injury be immobilised? 1983;23(6):4615.8. 1977; 59(3): 1185-1188. Sport Collars. This was first reported in a patient undergoing diagnostic imaging and was later studied using unembalmed cadavers where rigid C-collar application resulted in a 7.3 mm 4.0 mm of separation between C1 and C2.27 In high C-spine injuries, rigid collars can actually worsen the patients condition. Indications Contraindications Surgical airway Penetrating neck trauma Complications Suspicion of a cervical spine or SCI Discomfort Anxiety February, 2021 Figure 3. A trial of early management. The concept of cervical spine immobilization was developed as a mechanism to keep the spine in neutral alignment after a suspected injury and to prevent further harm by immobilizing a potentially unstable injury. Spine (Phila Pa 1976). Cervical collarrelated pressure ulcers in trauma patients in intensive care unit. Even the post-operative halo frames used by neurosurgeons still allow 4 degrees of motion when properly placed.17 Acta Anaesthesiol Scand. Am J Emerg Med [Internet]. 
Spinal cord injury facts and figures at a glance. Terms and Conditions, 8. Stiell IG, Wells GA, Vandemheen KL, et al. First, the initial mechanism of injury causing the spinal injury is usually significant, and simple movements during patient care are unlikely to be as severe. et al. >> The application of a rigid or semi-rigid C-collar may prevent potentially harmful movements of the C-spine. 1:82-91. When the patient is subsequently examined in the ED or trauma center, the treating physician will look for midline tenderness, among other things, to determine whether diagnostic imaging is necessary. By using this website, you agree to our References1. WebThe cervical spine is the most mobile part of the spine with multiple planes of motion and degrees of freedom, which are relevant to the fitting, use and prescription of a cervical orthosis. ScanCrit.com. 1. A collar should not be worn for more than 10 days after a whiplash-type injury. Theres little argument that the backboard as an immobilization device is ineffective. Web2 Contraindications Improperly fitted cervical collar (C-collar) or unsecured cervical spine (C-spine) before log roll Unsecured endotracheal tube before log-rolling intubated patients Canadian Medical Association; 2012 [cited 2019 Apr 13];184:E86776. Fisher SV et al. In trauma settings, rigid cervical collars are the immobilizer of choice as they provide superior cervical restriction. Davies G, Deakin C, Wilson A. The neck, or cervical spine, is made up of seven cervical vertebrae. Thus, arterial blood flowing into the cranial vault continues unimpeded while venous outflow is restricted. J Trauma Inj Infect Crit Care [Internet]. An analysis of three hundred hospitalized patients and review of the literature, Efficacy of cervical spine immobilization methods, Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma, The Canadian C-spine rule for radiography in alert and stable trauma patients, A radiographic comparison of prehospital cervical immobilization methods, Motion within the unstable cervical spine during patient maneuvering: the neck pivot-shift phenomenon, Prospective performance assessment of an out-of-hospital protocol for selective spine immobilization using clinical spine clearance criteria, Out-of-hospital spinal immobilization: its effect on neurologic injury, Prehospital use of cervical collars in trauma patients: a critical review, Aspiration in severe trauma: a prospective study, Reduction in mouth opening with semi-rigid cervical collars, The effect of rigid cervical collars on internal jugular vein dimensions, Effect of cervical hard collar on intracranial pressure after head injury, EMS Management of Patients with Potential Spinal Injury, National Model EMS Clinical Guidelines: Spinal Care, Guidelines for the management of acute cervical spine and spinal cord injuries, The Physician's Role in Providing EMS Feedback, Extending the Window: Updates in Prehospital Stroke Alert Identification Clinical Scenario, Prehospital and Disaster Medicine Committee, Med Ed Fellowship Director Interview Series. Scoop-type stretchers and basket stretchers are excellent devices for moving patients, especially over uneven or rough terrain.