Main and scoop stretchers in an ambulance

What is the difference between main stretchers and scoop stretchers

The main stretcher is the primary patient transport platform. The patient remains on it from the moment of placement until handover at the hospital, with full immobilization, position adjustment, and the possibility of performing resuscitation without transferring them to another surface. Scoop stretchers serve a different role: they are a separate tool for safely transferring the patient from the scene of the incident to the main stretcher or a spine board, without the need to lift them entirely.

In a typical ambulance setup, both elements are present simultaneously, each at a different stage of working with the patient, and one does not replace the other. The difference stems directly from the design: main stretchers have a full lying surface, a complete set of securing straps, and a wheeled base compatible with a transporter, whereas scoop stretchers divide longitudinally into two blades that can be pulled apart and slid under the patient from both sides without rolling them onto their side. Hence the name scoop stretchers — the equipment literally scoops the patient up instead of carrying them.

What standards regulate stretchers in an ambulance — EN 1789 and EN 1865

EN 1789 and EN 1865 regulate two different levels of the same system. Confusing them is one of the most common mistakes in materials about ambulance equipment, also among suppliers. EN 1789 specifies the requirements for the medical vehicle as a whole: the construction of the patient compartment, ventilation, lighting, and mountings permanently built into the bodywork. EN 1865 applies to the patient handling equipment itself, regardless of the vehicle in which it is installed.

The EN 1865 standard is divided into several parts, each corresponding to a different element of the system:

Part of standard	Scope
EN 1865-1	General stretcher systems and patient handling equipment — basic requirements
EN 1865-2	Power assisted stretcher systems (electric, hydraulic or pneumatic) intended to reduce the physical effort of staff
EN 1865-3	Heavy duty stretcher systems for bariatric patients
EN 1865-4	Foldable patient transfer chairs
EN 1865-5	Stretcher supports mounted in the ambulance as a carrier for main stretchers

The EN 1789 certificate of conformity for the vehicle itself does not replace the EN 1865 certificate for the stretcher and transporter. Both documents are required independently of each other, apply to different elements of the system, and usually appear as separate items in tender documentation — not as a single joint attestation. The certificate must be issued by an independent notified body (EN 1865 standard, official text available through CEN).

It is worth clarifying one more thing, as an imprecise reference circulates on the web: the bases and mountings of stretchers in the floor of an ambulance are not subject to the DIN 75078 standard. It regulates restraint systems for wheelchairs in vehicles for the transport of persons with reduced mobility — a completely different type of transport. The applicable standard for mounting main stretchers is EN 1865-5 in conjunction with the EN 1789 requirements for the vehicle itself. If a reference to DIN 75078 instead of EN 1865-5 appears in a supplier’s offer for a stretcher mounting, it is a worrying signal: the documentation may have been prepared superficially or copied from materials about a completely different segment of special vehicles.

Construction and functions of main stretchers — manual, electric, straps, CPR function

Main stretchers are divided into two categories based on the method of height adjustment: manual and electric, covered by EN 1865-2. In manual stretchers, the height change is performed manually by the paramedic using a hydraulic or spring mechanism. In electric stretchers, raising and lowering are done by an actuator controlled by a button.

This difference has a direct impact on the crew’s workflow. With manual stretchers, lifting a patient to the level of the transporter is usually a task for two people simultaneously. With electric stretchers, one person can operate the adjustment, while the other attends to the patient at that time. In teams working in shifts, with a large number of daily interventions, this difference is noticeable on a weekly scale, not just during a single call (although with sporadic calls, the difference can be almost unnoticeable — hence manual stretchers still make sense in a less heavily utilized fleet).

A separate category consists of heavy-duty stretchers, covered by EN 1865-3. Standard main stretchers have a load limit, which is no longer sufficient for patients with a higher body mass. In such cases, a bariatric version is needed, featuring a different frame design and a different track width of the transporter. Overlooking this distinction at the purchasing stage is a mistake that usually only comes to light during the first call to a patient exceeding the standard limit — and by then, it is too late to exchange anything.

The standard equipment of main stretchers includes:

• A complete set of transverse and diagonal straps — a single central strap is not enough; the set must secure the patient from multiple points simultaneously.
• CPR function — a hard board or stiffened segment of the bed, enabling effective cardiac massage without transferring the patient to another surface.
• Adjustment of the anti-shock position and Fowler’s position — changing the alignment without removing the patient from the stretcher.
• Retractable handles for carrying outside the vehicle, where the transporter cannot access.

What are scoop stretchers used for and when to use them?

Scoop stretchers prove their worth primarily where a conventional patient transfer would carry the risk of additional injury or pain:

• when a spinal fracture or injury is suspected,
• in elderly patients with limited mobility,
• in tight spaces where it is impossible to maneuver the main stretcher freely.

The design of two extendable blades allows the equipment to be placed under the patient from both sides simultaneously, without rolling them onto their side. This is crucial when the condition of the spine is uncertain, where any additional movement of the body increases the risk.

A typical sequence of use in emergency conditions:

1. Paramedics unfold the scoop stretcher to a length adjusted to the patient.
2. They disconnect the blades on both sides.
3. They slide them under the patient from both sides simultaneously, without rolling.
4. They reconnect the blades and fasten the locks securing against accidental unfastening.
5. Only after securing with straps do they transfer the patient to the main stretcher or an orthopedic board.

The structure is radiolucent to a diagnostic degree, so the patient can remain on the scoop stretcher during initial imaging diagnostics without additional transferring.

This solution has one practical limitation: it does not replace full immobilization on an orthopedic board in the event of a severe spinal injury, but merely reduces the number of direct patient transfers. The scoop stretchers available in the KG Special Performance offer function within standard equipment alongside main stretchers, not instead of them — treating them as a cheaper substitute for a full set is a configuration mistake that is worth sorting out before ordering, not after.

Mounting and main stretcher transporter — compatibility with the build

The main stretcher set alone does not operate independently in an ambulance. It requires a transporter, i.e., a wheeled base, and a system for mounting it to the floor of the patient compartment, covered by the EN 1865-5 standard. The transporter is responsible for safely moving the stretcher between the scene of the incident and the interior of the vehicle, and the mounting secures the entire set against displacement during the ride, including in the event of sudden braking or a vehicle rollover.

When selecting a set, four compatibility elements are important, which are easy to overlook when looking solely at the stretcher itself:

Element	Why it matters
Locking mechanism	Must perfectly fit the transporter model, not just the main stretcher brand — a mismatch is one of the most common causes of complaints when purchasing elements separately.
Gravity lock	Additional protection in case of vehicle rollover, independent of the main snap lock.
Ramp angle adjustment	Smooth positioning of the transporter plane relative to the floor, important with different approach angles.
Resistance to corrosion and disinfection	The transporter operates in constant contact with bodily fluids and disinfectants throughout its entire service life.

The certificate of conformity of the entire set — the stretcher, transporter, and mounting combined — with the EN 1789 and EN 1865 standards should apply to the assembled system, not to individual components separately, and must be issued by an independent notified body. Buying main stretchers and a transporter from different suppliers without a joint set attestation is a risk that in practice is only revealed upon taking delivery of the vehicle — sometimes literally on the day you have to head out to the first patient.

How to choose a stretcher configuration for the ambulance type and operator profile

The selection of a configuration starts with the ambulance type and the profile of calls, not just the stretcher brand itself. A Type A ambulance, designed mainly for the transport of non-life-threatening patients, less frequently requires electric stretchers. A Type C ambulance, fully equipped for intensive care, utilizes them much more often — they allow for quicker reactions with patients in critical condition and reduce the physical strain on a three-person crew working in continuous mode.

When making a decision, it is worth examining three factors simultaneously, and not just the purchase budget:

• Operator profile — number of daily calls, average shift length, typical body mass of transported patients. An operator with a large number of interventions and an aging fleet of manual stretchers usually feels the benefit of transitioning to an electric version faster than would result from the mere calculation of purchase costs.
• Cost of strain injuries — less physical strain on the crew translates into fewer such injuries in the long run, and this is a cost that rarely appears in the initial purchase budget, although it realistically burdens the schedule and staff turnover.
• Consistency with the rest of the fleet — so that replacing one element in the future does not require rebuilding the mount. A transporter purchased separately for a new main stretcher should have the same track width and loading height as the rest of the fleet; otherwise, handing over a patient between vehicles from different years becomes slower than it should be.

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