How to Secure an Injured Person Onto a Litter

When professional medical care is far away, you may have to evacuate an injured person by litter. Here is the first step: securing the person onto the litter.

Instructions

Difficulty: Easy

Things You’ll Need:

• "Stakes And String, Or Long Rope"
• Padding
• Blankets
• Warm clothing

1. Move the injured person onto the litter, either by carrying or by logrolling, depending on conditions (see "How to Move a Person With a Spinal Injury During First Aid" and "How to Logroll an Injured Person During First Aid").
2. Make sure the injured person is horizontally centered on the litter, and that no part of his or her body is off the litter at the top or bottom.
3. Keep one rescuer at the head at all times, with one hand on each side of the head, holding the neck immobile with gentle but firm pressure.
4. Make and apply a device to assist in immobilization of the head and neck: either a cervical collar or a stuff sack neck splint (see "How to Make a Cervical Collar During First Aid" and "How to Make a Stuff Sack Neck Splint for First Aid").
5. Gather at least four lengths of rope, each of which should be at least 6 feet long.
6. Tie the injured person in, stringing the rope through the holes down each side of the litter. Work from bottom to top, tying the legs down first, then the pelvis, then the chest, and finally the head (via the forehead).
7. "Avoid the void": Place padding (such as articles of clothing) into any spaces between the rope or the litter and the injured person. This not only aids in immobilization, but also increases the comfort of the injured person.
8. Place padding under the buttocks and the heels, taking care not to move the spine.
9. Cover the injured person with enough clothing that he or she is comfortably warm.
10. Proceed with evacuation (see "How to Carry an Injured Person on a Litter During First Aid").

Tips & Warnings

• Use relatively thin rope, preferably 6mm or less, since it's easier to work with than thick rope.
• If you don't have enough rope, tie bandannas together. If you still don't have enough material, use clothing.
• When tying the injured person in, use knots that are easy to adjust, as he or she may shift during evacuation.
• Contact your local chapter of the American Red Cross for information on first aid classes near you.
• Contact the Wilderness Medicine Institute or the National Outdoor Leadership School for information on wilderness medicine courses and books.
• Consider this type of evacuation only as a last resort, unless sufficiently trained rescuers are with you.
• Take time to plan your evacuation carefully before embarking: Consider the route, the weather, and how much daylight is left, and make sure you have maps accessible.
• The litter you use must be extremely firm and not subject to bending.
• Even after the neck splint is in place, keep one rescuer at the head to make sure the head and neck remain immobile.
• Be sure you know some basic knots before attempting this, since it will make the task much less difficult.
• When padding the voids, don't miss the space under the knees and in the small of the back.
• Leave relatively easy access to any injuries that require monitoring during the evacuation.
• Though you want the injured person to be strapped in as tightly as possible, avoid cutting off circulation.
• Check circulation, sensation and motion in the extremities, especially fingers and toes. If the injured person has decreased circulation or has difficulty feeling or moving the extremities, you may need to readjust the ropes and/or padding to allow for more circulation.
• This information is not intended as a substitute for professional medical advice or treatment.