section7 equipment A short history of stretchers by Peter Bell Don’t get carried away – but if you do, rest assured that the stretcher which supports you has a long history of development underpinning it. This is a chronological advances in casualty care, and a nobody achieved the same view of some of the consequential rapid evolution of measure of lasting success as stretcher design. Dunant.1,2,3 origins of, and the The St John Ambulance influences upon the The Red Cross and the Association was created, in 1877, evolution of stretchers St John Ambulance by members of the ancient British used for mountain Association Order of St John of Jerusalem with rescue; some the support of the Royal Humane information about Two main participants drove the Society (founded 1774). Their those involved at the progress of this humanitarian function was to help those involved phase – The Red Cross, who in the increasing number of design stages; and a provided humanitarian aid, and the industrial accidents. They few technical notes. St John Ambulance Association, established first aid lectures and The evolution of mountain who deployed first aid skills and demonstrations in large railway stretcher design inevitably runs equipment. Both these centres and mining districts, in the parallel with the evolution of organisations continue to function first instance provided by two mountain rescue. It is difficult to to the present day and hopefully Aberdeenshire military officers, Henri Dunant separate one story from the other; will do so long into the future. Surgeon-Major Peter Shepherd of however, the focus here is upon Henri Dunant founded the Red the Royal Herbert Military Hospital, stretchers themselves and their Cross movement, together with Woolwich, London, and Colonel various designers, rather than the parallel Red Crescent Francis Duncan. Shepherd upon those who have used them, movement, in 1863. Born in conducted these first classes in or indeed the folk who’ve had Geneva, on 8 May 1828, he was the hall of the Presbyterian school need of them. appalled by the suffering of in Woolwich. In common with nearly every thousands of men, on both sides, Soon after, in 1887, the St John advance, progress is usually left to die due to lack of care after Ambulance Brigade was formed influenced by a need to solve a the Battle of Solferino in 1859. He as a uniformed organisation to problem identified in an existing also went on to initiate the first provide a first aid and ambulance facility. The rescue stretchers now Geneva Convention (twelve service. First aid teaching also available to teams have thus nations) in 1864. continued to be provided by the evolved from the earlier and more In 1901, he was awarded the Association. In many parts of basic designs. It is, therefore, Nobel Peace Prize. However, Britain, St John Ambulance appropriate to have a quick look at despite all his massive Brigade was the first and only what was in use prior to the contributions to the relief of provider of an ambulance service emergence of mountain rescue as suffering which endure to this day, right up to the middle of the 20th we know it today. on 30 October 1910, Henri Dunant century, when the National Health died alone and in overwhelming Service was founded.4,5,6 Warfare and work poverty. Others before him had tried, with Warfare from the 1850s onwards, some success, to raise medical The Furley stretcher leading to the inevitable human standards on the battlefield. The development and casualties, coupled with a most George Guthrie (1785–1856), deployment of a standard casualty significant increase in work-related surgeon to the Duke of Wellington, stretcher by the St John accidents in the late 1800s and was certainly one of these, but Ambulance Association was early 1900s, fuelled the greatest 1nobelprize.org/nobel_prizes/peace/laureates/1901/dunant-bio.html 2www.ppu.org.uk/learn/texts/doc_geneva_con.html 3www.rhs.ac.uk/bibl/xSearch.asp?database=dcatalo&rf=200703734 STRETCHERS PAGE 1 OF 22 section7 equipment A short history of stretchers initiated and motivated by one the development of stretchers for person whose ongoing participation use in open spaces. In essence, was of paramount importance. this stretcher consisted of two poles, John Furley – later Sir John Furley, four vertical supports to raise the CH, CB (1836–1919)7 – was born in stretcher bed off the ground, a Ashford in Kent. He became canvas bed panel and spreader involved with the Association and bars that could be folded or gave his wholehearted support to removed so the stretcher could be its work, being credited with the ‘compacted’ lengthways to assist design of the Furley stretcher and storage and rapid deployment to of the Ashford Litter, which was a an accident site. basic Furley stretcher provided However, there continued to be with wheels and a canvas cover. difficulty in confined spaces. A Wheel devices for Furley stretchers need for a very narrow stretcher, to came to the fore during the First complement the standard Furley, World War.8 became evident. Specifically this To overcome some of the narrow stretcher, including problems of using a Furley pole attached casualty, had to be small and canvas stretcher vertically, the enough to be hauled up a two foot Lowmoor Jacket, normally used six inch diameter hoist for fire-box as a hauling device underground, ash from the boiler room of a ship. was adapted to fit the Furley The Mansfield stretcher was stretcher. This ‘jacket’ originated already being used on some ships from the small coal mines at of the Royal Navy but there were Above: Example of a horse ambulance Lowmoor, near Bradford.9 occasions when this was carriage, which varied ‘from a light vehicle to The Furley stretcher was now unsuitable. be drawn by two men or by a pony, established as the foundation for costing with India-rubber tyres to wheels £32 10s, The Neil Robertson to a single or pair-horse wagon capable of stretcher accommodating three patients in a By way of an alternative, recumbent position and an attendant inside twenty-four modified Japanese Middle: ’The ‘Ashford’ Litter – a two wheeled hammocks, were ordered by the under carriage fitted with elliptical springs and Navy in 1907. This piece of a Furley stretcher equipment boasted the extremely wordy official title of ‘Hammock for Below: The Furley stretcher, with telescopic Hoisting Wounded Men from handles open and closed,1899 Stokeholds and for Use in Ships Illustrations: First Aid to the Injured whose Ash Hoists are 2ft 6in (St John Ambulance Association) 1904 diameter’! It was from these Japanese origins, combined with experience of the Mansfield stretcher, that the ‘Neil Robertson stretcher’ evolved, to overcome problems specific to confined space rescue. Initial production took place shortly after 1906. How much John Neil The Lowmoor Jacket in action 4http://www.sja.org.uk/sja/about-us/our-history 5http://en.wikipedia.org/wiki/St._John_Ambulance 6BMJ 1994;309:1718–1720 7Obituary BMJ, 4 October 1919 page 453 8Illustrated History – World War 1 Lloyd Clark RMA Sandhurst 9Ambulance Lectures, page 142 Surgeon-Major Evatt MD 10Surgeon Commander J J Keevil DSO RN, page 162 RNMOJ 530 1944 STRETCHERS PAGE 2 OF 22 section7 equipment A short history of stretchers Robertson contributed to the design the new millennium that the Stokes of the stretcher which bears his stretcher entered the British name, is not clear. From some mountain rescue environment. evidence, it would seem he was Accordingly, to maintain a logical the last of a number of contributors, sequence, the description of the which included Captain origins and application of the Fitzherbert, Captain C A W Stokes stretcher is covered Hamilton and Fleet Surgeon I M towards the end of this account. McElwee. The Neil Robertson stretcher, That said, very rapidly, his fitted with a skid means, a footrest adaptation of the original cane and and a device to hold a helmet or canvas device became well other head protection remains to known to mariners as ‘the Neil this day in use underground, Robertson stretcher’. It gave good especially by the various cave service during both the first and rescue teams in England and second World Wars and continues Wales. to be of service. A hundred or so Fleet Surgeon John Neil years on, it is still in production. Robertson, MB CM was born in A parallel development was Beith, Ayrshire on 28 July 1873. He occurring in the US Navy, under qualified in 1895 at the University A combination of the Neil Robertson with a skid the eye of Surgeon General of Glasgow and travelled to India device for use in the British cave rescue Stokes. These simultaneous and America before working environment, circa 1994 developments were to have an briefly in Scotland. His Naval impact upon the scene in Britain service began in 1899 and, at the but it was many years before this start of the First World War, he was occurred. In fact, it was not until serving on HMS Blake. He died of an aortic aneurysm at the tender age of 41, on 22 December 1914 and was buried, with full naval honours, in Ford Park Cemetery (Pennycomequick), Plymouth.11 During this time of rapid development in Britain, other stretchers and associated extras began to emerge but, except for the Furley and the Neil Robertson, none survived the test of time. For example, there was also, for a short time anyway, the Kirker The Kirker Ambulance Sleigh complete with Ambulance Sleigh, in which the dummy casualty – specially adapted for use casualty was carried with head on board ships or for extricating injured persons and knees slightly elevated.12 This from mines was not unlike the much more recent Mariner stretcher.