Accidents rarely happen in convenient locations. Those that occur close to a road allow for easy transportation of patients to an ambulance and onwards to hospital, but those that occur in less hospitable terrain require the use of specialised evacuation equipment to transport patients rapidly to help and safety.
The choice of evacuation equipment for remote locations is primarily one of portability, with two main options being basket stretchers, also known as stokes basket or litter, or the Reeves or SKED stretchers.
Basket stretchers are a litter which the patient is strapped to, usually with a back board and cervical collar to fully immobilise them. The litter has raised sides and often includes a head and torso cover. After the casualty is secured in the litter it can be wheeled, carried by hand, mounted on an ATV, towed behind skis or snowmobile, lifted on ropes or hoisted by helicopter. Modern basket stretchers are designed to be disassembled for transport in backpacks, and are widely used by search and rescue teams. They are often referred to a stokes baskets, after one of the earliest examples of this style of stretcher invented by Admiral Charles F Stokes in 1905.
Reeves or SKED stretchers are flexible stretchers, designed to be lightweight and easily portable. These are the stretchers favoured by the military and other ventures where confined spaces are an issue, as the stretcher packs into a small backpack and can easily pass through narrow doorways, manhole covers and other obstacles to reach the casualty. SKED stretchers are designed to be hoisted horizontally by helicopter or vertically through cave systems and confined industrial spaces. Although described as flexible stretchers, once the casualty is secured the stretcher becomes rigid and allows immobilisation of the casualty during rescue. SKED stretchers are favoured by the military, but rarely found in search and rescue teams unless they operate in areas with cave systems or other confined hazards, with the basket stretchers being favoured for search and rescue.
Other stretchers do exist, but they are not optimised for use as evacuation equipment in remote locations. A basic stretcher consisting of canvas or tarpaulin between two poles can be used in an emergency and is commonly found in first response to natural disasters, but it is impossible to immobilise the casualty with this kind of stretcher making it a choice of last resort. Wheeled stretchers, or gurneys, are in common use in urban environments, allowing for much easier and smoother transport of casualties over even ground. Scoop stretchers are used for lifting patients, with the stretcher splitting into two halves which are then eased under the patient and rejoined. All of these stretchers are not portable enough for evacuation equipment in remote locations, and in the case of gurneys badly optimised for moving the casualty to a safe location in the absence of level ground. The basic stretcher carries a high risk of further injury to the casualty as no immobilisation is possible, and should only be used to move the casualty out of an immediate high risk situation.