# evacuation litter



## royal (May 6, 2016)

My first question is: what did you like/ not like about the system that you employed?


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## caverdan (Aug 27, 2004)

This is what cavers use in a rescue situation. It's called a SKED. It is compact and can be used for vertical lifting situations too. A lot of falls require you to isolate the back of the patient from mobility so you combine it with an OSS. (Oregon Spine Splint) Over the years a lot of variations and improvements have been made to the original design, but we still have both in our cave rescue stashes around the state. 

https://www.karstsports.com/skedco-...SBSKZqpK3QZDHRNPhW4kw6-wlIbcQdfRoCsB4QAvD_BwE

https://www.karstsports.com/oregon-spine-splint-ii/


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## griz (Sep 19, 2005)

Never really thought about it but for compact solutions oars run through a sewn long loop tunnel, canvas sheet deal.Something to do if you know someone good at sewing.Maybe make some kind of bolt on crossbars to maintain width and more tension on the canvas. Custom but probably pretty comfortable and compact.

Oars, camstraps looped around oars for support, sleeping pad, sleeping bag would be another lightweight option, I guess.


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## [email protected] (Jun 1, 2010)

caverdan said:


> This is what cavers use in a rescue situation. It's called a SKED. It is compact and can be used for vertical lifting situations too. A lot of falls require you to isolate the back of the patient from mobility so you combine it with an OSS. (Oregon Spine Splint) Over the years a lot of variations and improvements have been made to the original design, but we still have both in our cave rescue stashes around the state.
> 
> https://www.karstsports.com/skedco-...SBSKZqpK3QZDHRNPhW4kw6-wlIbcQdfRoCsB4QAvD_BwE
> 
> https://www.karstsports.com/oregon-spine-splint-ii/


I think you answered the question in the thread perfectly. How much training is necessary to become proficient with spine splint. I raft with the same bunch all the time and those might be a perfect group purchase for the major med kit.


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## mania (Oct 21, 2003)

My last two WFR certs they are definitely moving away from hard flat spine boards which can cause problems, and toward the vacuum mat style (google vacuum spine board). You basically take a raft pump and remove the air to create a molded ridged spine immobilization. Most people won't afford to buy or carry one but you could ask for this in your evac request if your patient can't pass a focused spine assessment.


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## shelbdad (Apr 6, 2005)

royal said:


> My first question is: what did you like/ not like about the system that you employed?


Good question. The plywood board that we used was a cover over a drop bag and was not mine. My setup has a tall table in that spot which could be used, but not really a very good option. Stability was an issue, the victim certainly did not feel comfortable that they weren't going to roll off. Carrying the board was less than ideal - no hand holds, we used straps, but locations were awkward and contributed to overall stability issues. Of course you can (and we did) make all this work. A couple of folks have pointed to the Sked stretcher which looks like exactly what I had in mind. Thanks.


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## Will Amette (Jan 28, 2017)

It's been a decade ago, but Malloypc wrote about a rescue he was involved with on the Rogue. The text color didn't show up when I just looked, so you might have to highlight the text to see it.


https://www.mountainbuzz.com/forums/f11/rogue-river-tr-with-rescue-and-evac-32467.html if the hyperlink doesn't work. 



Of note was the utility of the strap holes to help stabilize the patient.


For what it's worth, I've heard from Malloypc about how well the patient ended up recovering beyond all expectation.


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## BenSlaughter (Jun 16, 2017)

Probably 30 years ago, my Uncle was involved in a bad wreck at Crystal on the Colorado. 
Had to be helivacked out.(pre sat-phone, they were able to use signal mirrors to reach planes flying over) 
They used oars with a combination of life jackets, and I believe empty dry bags, to make a litter to get him down to the boats and then some distance down stream to a spot suitable for a helicopter to land.

As mentioned above, I'd thing a canvas sling, with maybe some crossbars between two oars would be a good solution.


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## mania (Oct 21, 2003)

BenSlaughter said:


> They used oars with a combination of life jackets, and I believe empty dry bags, to make a litter to get him down to the boats and then some distance down stream to a spot suitable for a helicopter to land.
> 
> As mentioned above, I'd thing a canvas sling, with maybe some crossbars between two oars would be a good solution.


If your patient has a positive MOI for spine and doesn't pass a focused spine assessment then this kind of MacGyver solution could paralyze them.

If they don't have spinal injury and you just want to get them from A to B this might be alright.

Either way I would highly recommend training so you can make these determinations. A 9 day WFR is typically less than $1,000.


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## Conundrum (Aug 23, 2004)

The thing with all these extra devices that you can carry need to be used correctly or they can cause more damage.

I'm with Mania. Take a WFR or another way to get the training is volunteer at a local ski hill with National Ski Patrol. They'll put through OEC which I feel is a pretty good course. Pretty winter sport centric but skills that translate to being outside.

There's a lot of different ways to handle a lot of different injuries and illnesses. All of which when outdoors is immediate care designed to keep someone alive until they can be transitioned to a higher level of care.

With PLBs with SOS functionality, I think the best training would be to help people know when to push the button.

For evac like in the OPs question, you could look at a Kendrick, SKED, a few different quick litters, etc. Really, the best "equipment" you can buy is the training and then think through injuries at home and have a plan to work with what you have on your raft. Some people buy all the rescue gear and then want to use it even if not appropriate for the injury. Saw way too many people try to traction breaks that shouldn't be as an example.

I'm lucky in that I have a good amount of outdoor rescue and aid training and would be one of the more knowledgeable on a lot of trips. But my boating circle has some flight nurses and medics and ER docs. So with diminished responsibilities, I get to party more.


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## Leonmajor (Sep 25, 2017)

Or instead of spending $1000 on a SKED just cut holes in the drop bag plywood cover like you would see on a actual backboard. Next search the interwebs for spider straps and wham bam for about $40 you have a backboard with real straps that will hold someone in place, plus a drop bag cover and a table. That’s practical and multifunctional! For a added bonus throw in some loops of webbing that can be attached to the backboard and put over the litter carriers shoulder for added comfort. Most importantly use lots of padding on the patient and never strap over the knees. Being on a backboard will always suck but with some practice and thought you can make it tolerable.


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## DoStep (Jun 26, 2012)

Why would anyone buy those items to bring along on a private raft trip? 

Accidents happen whether on Class 2 trips like the San Juan or 3 weeks in GC or a hike in the woods or a hut trip or a bike ride, but not near the frequency that warrants bringing that level of rescue equipment. We can and should leave that to the pros who mobilize while we in the field stabilize our own situation. 

The OP did their job, which was to get their injured cohort back to camp using improvised plans and techniques based on what they had available. There wasn't elaboration of how she got to the ER, but they got her out with what they had. Even if they only got her back to camp and had to await outside help for extraction they still did their job. If the party is in such poor condition they need a SKED and spinal contraption, higher levels of professional medical/rescue care need to be involved than are on the majority of the trips we are talking about. 

In short, no, you do not need to bring litters and spine stabilizers of this level on your private raft trips. Just keep cool heads and use common sense when these rare instances arise.


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## griz (Sep 19, 2005)

awesome post, dostep. Couldn’t agree more. 

Sometimes a little knowledge from a little course and getting a little certificate ,in the right hands, can save a life.

Sometimes a little knowledge from a little course and getting a little certificate ,in the wrong hands, can turn trips or injuries into an absolute shitshow.


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## caverdan (Aug 27, 2004)

[email protected] said:


> How much training is necessary to become proficient with spine splint. I raft with the same bunch all the time and those might be a perfect group purchase for the major med kit.


To answer your question. The spine splint itself isn't that hard to figure out to put on a patient. All the straps and buckles are color coded. They have tried to make it as idiot proof as possible. The trick is how to move the patient and support the correct parts of the neck and head while you are attempting to mate it to the patient. I would not want to be the in charge medical person calling the shots. I would try like hell wait until real help arrived and concentrate on making the person as comfortable as possible if your thinking of installing an OSS. 

In the outside world you have this option. In a cave, by the time a SKED and OSS reaches a patient, you will have a ton of trained rescue and medical personnel around you working in teams, so installing it is kind of a moot point. In NCRC cave rescue classes show you how to do it and pad the person to make them as comfortable as possible in it. Practicing within your group would be the key to success and that what us cavers do. We as a group in our state try and offer intro to cave rescue classes for new cavers, SAR, and fire depts. on a yearly basis, jumping back and forth from the western slope to the front range.

Back to the OP's problem of finding a compact litter for carrying a person, a SKED would have worked perfectly for getting the patient back to the boats. It does require patient packaging training and lot's of padding and such to make the person as comfortable as possible, knowing how to lift, move, and not injure the person more during transport. Things like laying a line of bodies down over rocky rough terrain and passing the SKED over the top of everybody. Putting a harness on the patient if you have to go vertical along the way. So as others have suggested. Training within your group and getting outside rescue classes under your belt before you need to use a SKED or other extraction device is your key to success. Good luck and don't be afraid to ask a caver to join your trip. They come with a unique bag of tricks.


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## ArgoCat (May 14, 2007)

*Rope Litter*

If you have a throw bag and standard camping supplies you have a litter. Practice in your family room using something that approximates a human, or use a human. Be careful not to pull a loop through as this can really mess with you. If you need more rope in a loop, carefully saw it down from the top. Hint, use an unequal loop figure eight at the bottom as the start and then the tail can be tied to the other loop to finish it off. If you need it to be semi-rigid, add anything that is stiff under lots of camp pads but make sure their are no pokies...especially i fyou actually have someone with a spinal injury as this can cause Autonomic dysreflexia. As with anything, test it with an uninjured person for comfort and stability first.

https://www.youtube.com/watch?v=LQApoA9n6PI 

http://https://www.youtube.com/watch?v=f1PYnel1g14


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## villagelightsmith (Feb 17, 2016)

*Evacuation litter, etc.*

It's either going to be a bit of river kit that gets redesigned for use in a rescue situation,
or a piece of rescue equipment that gets redesigned for daily use on the river.
The better the design for daily use, the more likely it will be you'll have it with you.
The better the design for rescue work, the more grateful you'll be if yours is the trip that really needs it. 

It's kinda like a pistol ... most of us will go our whole lives and never need the thing. Those of us who do, will need it very badly, and will have no time to wait. (Cities ... yuck!)
This being considered, each of us tends to go "naked" and hope someone else has one with the skills to use it if it's ever needed.
It's like CPR, etc. I learned it for you. Please; learn it for me too. Thank you!
Somewhere around here I have a heavy canvas evacuation sling ... a 7' long piece of really heavy canvas with strap handles. I know it worked for me.
Strap handles on a Paco Pad maybe?


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## caverdan (Aug 27, 2004)

Two uses for a SKED
A way for three or four people to collect a bunch of firewood and carry it back to camp. 
A way to take the drunk that passed out next to the fire, carry them to their tent and slide them inside for the night. .


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## suburbs (Feb 12, 2015)

SKED's are handy, but I'm never going to carry one on a river trip. And nobody is strapping one to their backpack for day trips/side hikes anyways. 



It's been said many times before, but the best piece of medical equipment you can bring is the right training. Instead of buying a tacticool piece of gear, learn how to use what you have. A couple of oars and some cam straps would make a bomber gurney, especially with a paco pad and maybe a SAM splint if you have C-spine concerns. Much easier than a couple dudes whose only real memories of their 2004 WFR course was the female instructors ass trying to make a gurney out of their throw bag.


Take a course, and refresh your skills every couple of years. A certification card in your wallet is next to useless without the muscle memory that comes from practice.


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## caverdan (Aug 27, 2004)

suburbs said:


> SKED's are handy, but I'm never going to carry one on a river trip. And nobody is strapping one to their backpack for day trips/side hikes anyways.
> 
> 
> 
> ...


 I totally agree. I don't ever see myself dragging a SKED along on a river trip and training is the key to success. 

Playing armchair rescuer, lets look at what is in camp to help haul a person who is hurt, back to camp.

If it was a child or small adult, maybe you could put them in a camp chair and two people carry them back in it. Maybe someone has a cot along, how about strapping oars to it to make a litter? Looking over on the beach you see a ducky and a SUP. How about utilizing one of those as a gurney?


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## ArgoCat (May 14, 2007)

*oar litter*

Yes. You can make a litter out of oars, sticks, etc...and it will work for shorter distances over non-technical terrain. Handholds can be a little dificult though for 6 people, which is realhy what you need to carry a person any sort of distance safely. However, over any sort of technical terrain (side canyon hikes, jumbled boulders, ledges) a trip or stumble can flip your patient right out of the litter and cause futher injury. Whatever you decide to do, test it, make an evac plan including route, have a trail spotter, have a litter lead, and be willing to make adjustments. 

As has been said before, getting professional help coming to you with the appropriate supplies and gear (basket litter/wheel) is paramount. But at times, you need to move your patient to an appropriate evacuation spot or need to start heading towards help if time is of the essence. But yes, in most circumstances, it is better to stay put and wait for the pros rather than attempt a risky carry out with inadequate supplies and resources.


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## shelbdad (Apr 6, 2005)

thanks folks. Great information from a spectrum of folks to whom I'm grateful for sharing their input and knowledge. The information is helpful to me and hopefully to others as well. take care.
Russ


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## jaleel_da_sheik (Jan 22, 2014)

*evac liter & camp table & raft bench*

Check out SDG River Gear's nesting camp tables. They have cutouts strategically placed for using a folded table as a liter board in an emergency situation. Great piece of multi-purpose kit - kitchen camp table, liter board, gear or passenger deck on raft.


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## Taosgsr (Jul 15, 2017)

I have a background in SAR and EMS. There are many tools to use and the SKED is one of them I have employed many times over the years. There is too many variables and there is not “one size fits the bill” for any rescue. I have my long table as a backboard and I carry what is known in the industry as a “mega mover” it’s basically a big sturdy fabric with straps sewn on for carry handles. It packs small is light and can be used as a small kitchen floor if needed. They are inexpensive we discard them with the patient so if one does not get gross on a flight I take it home wash it and keep it as my go to lightweight litter. Throw a couple oars through the loops and you can work even easier. If you have friends in EMS they might be able to get you one for nothing.


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## Michael P (Mar 18, 2009)

I will not get into the first aid aspects, we all know the training we should have or better yet invite some medical professionals on the trip.
The best way to transport a patient that I have used is to take two poles, oars work really well, remove blades, take three to four jackets, zip them up and slide the oars/poles up the sides from the bottom of the first jacket and out the sleeves, repeat covering the sleeves of the first jacket with the body of the second, etc, etc. The jackets surprisingly will not unzip and allow four people to carry the stretcher or two in narrow situations.
Place something under the knees of the patient as this takes a lot of strain off their back. 

In rough terrain you can create space between the jackets to tie the patient onto the stretcher. If you have to transport them by boat, remove the straps. Never have anyone tied into anything on the water. Shouldn't need to be said but I have done stupider things in stressful situations.
Stay Safe


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