Patient Cot, Cot Mount & Patient Restraint

[ Music ]>>In 2010 the federal
government and a team of industry partners began work
on new testing requirements to improve the crash
worthiness of the patient cot, also known as the
litter or gurney. Through the partnership, cot
manufacturers have designed and tested a range of products to meet these new
testing requirements. These new testing requirements
are now published as SAE J3027. This module will
cover cot developments and mounting systems, strength
testing, and patient restraint, in addition to providing
information on manual and powered cot options.>>I think it’s really important
A, to the safety of the patient that the cot be held
to the floor 100%.>>The industry standard
has used an antler and rail-style system
to affix the cot to the ambulance
floor for many years. And that was done because
it’s very easy to use and there’s a lot of
familiarity with that over the last few decades.>>The litter manufacturers have
migrated to a new track method of restraint and
gurney to go with them. [ Music ]>>What makes us
feel good about some of the current cot technology is that there has been
crash testing that we can actually
see the science.>>There’s very specific
testing that’s been done — slow-speed cameras where you
can really see the flex points in the stretchers, how
things stay secure, where things need
to be improved.>>If you look at how
automobiles are tested, there’s a specific
methodology with the dummy and the accelerations.>>The same dummy that’s used for our passenger car
standards today — the same one that’s used by
everyone else in the industry — it’s the same one that we use. It’s a standardized
piece of test equipment.>>So using the test dummy, we
were able to measure HIC values, neck tension loads,
and study the effect of the new crash standard on a
supine patient in an ambulance.>>The conditions
that we wanted to use to evaluate the characterization
of the patient compartment in a crash came from the same
standards that are used today for passenger vehicles. [ Music ]>>The new test standards not
only require a stronger cot, but they also require a
change in those restraints to be able to reduce excursion.>>When you talk about
excursion, we mean the amount — the distance dummy would
move in a crash test or in a real scenario
would be the patient that actually is moving
in the compartment.>>I know when you just
have the three straps, sometimes just the two
straps, and you hard brake, those people are
flying up front.>>To me, one of the more
visible things was the securing of the patient to the cot. And that was so dramatic
to us in such a plain way that we wanted to immediately go with the SAE-approved strapping
mechanisms for the cots. Because that look like things
that we’ve all experienced in decelerations,
that kind of thing in the back of an ambulance.>>The shoulder harness in particular are what keep a
patient in place in an accident. And yes, it does take a
couple of extra seconds to put those restraints on,
but it is a key to making sure that that patient is not
going to move or hurt or harm somebody else in
the back of the ambulance.>>It was kind of well,
people didn’t want to use it because it was different
and it was cumbersome. And people really
didn’t want to do that. Because they thought it would
be harder for patient care. The newer-style shoulder
straps, if you will, you could still very easily
do your patient treatment without removing them.>>Even with the use
of shoulder restraints, we are seeing patient
excursion sometimes up to 30 inches off
the end of the cot.>>Prior to this we used
a restraint system — a shoulder restraint system — that attached at the very
head of the stretcher. That left a very large gap there
that a patient had to travel through before they
met any restraint.>>So there was some changes
from moving the restraints right down by the shoulder
or there were some different configurations.>>And in fact, what we
saw was reduced excursion from 30 inches down
to less than 14.>>And by limiting
that distance, you’re enhancing safety
and really, you know, keeping the patient free
from hitting the caregiver or other things in
the ambulance.>>In the following section
you will see demonstrations of manual and powered cots
and cot mounting systems that have been tested and meet
the requirements of SAE J3027. These demonstrations
are provided to help with the decision-making
process. Certainly others may become
available in the future.>>There are a range of products
out there on the market today. They’re from basic
manual-style systems, you know, that meet the crash standard
through powered systems as well. So there should be a product
that’s available for the needs of your particular service. [ Music ]>>This is the Stat Trac. It’s designed to meet all
the new international safety standards, as well
as the SAE standards that have just been released. So the Stat Trac fits into
that keyhole just like this. So we’ll set it in and then
slide it and lock it into place, and it’s ready to
operate at this point. And if you look at the cot
itself, there’s a configuration on the front of it that gives
you a post that actually comes into the channel and goes
straight into the vehicle. Lock it into place. Because you heard the
snap, it’s locked. And now we’ll bring
up the carriage. Using good ergonomics, we’ll
lift that bottom carriage up, keep the cot level,
and run it straight in. And here’s the back end post,
and that will go straight in, and then we’ll latch into place. And once it’s locked, now we’re
secure into the Stat Trac.>>Our newest solution for
cot fasteners for SAE J3027 — that’s solution is
performance load. What performance load is
going to have is two locations where your cot is going
to lock into the fastener, a rail that runs the length of
it that will prevent drifting from left to right, and
then a release mechanism to remove your cot
when you’re unloading. Your ambulance cot will
change a little bit as well. There’s a pin at the head
end, as well as a latch down here at the foot end. Those are the two locations
where the cot is going to lock into the fastener to meet
that new crash criteria. Let’s see how it works. In order to load my cot,
I walk it up and I’m going to engage my safety bar
with my safety hook much like you’re probably
doing today. I then lift my cot up
in an ergonomic stance, press and hold the minus
button to raise my cot legs, and I can walk this thing in. Notice I don’t have to do
much looking around to guess if this thing’s in
line to lock into place because the system’s
automatically set up to do that.>>This is an example of a center-mounted
power load system. Pull the trolley out. These indicator lights
will be flashing amber to let you know that it’s ready. So you push forward. All you have to do now
to load the patient, press the negative
button, the arms are going to automatically come up. Legs come up. You push forward, and then it
will just guide in on a rail. Then you’re going to notice it’s
going to automatically settle into the floor, and that’s when you know you’re
in transport mode. And that is your dynamically
crash-tested system.>>So the center-mount fastener
for the iNX is designed to fit right into the floor
plates of the Stat Trac. The nice thing about
this is when it’s loaded, it takes everything
away from the operator. So they can actually
operate by themselves. So my partner will
raise the unit up. As you can notice, we’ll
bring it into the vehicle. So the nice thing about this is
when the vehicle’s side to side or forward or backwards,
you get an open space here, an open landing area
for this unit to come down to the floor
of the vehicle. You press the minus button,
pull it back, we catch the hook. There’s the hook. Press the minus button
again, front legs come up. He’s not assuming any
weight at this time. Load it in past the second
hook and pull it back, press the minus button
one more time. This piece is now
holding the unit, as well as the front
safety hook. And we locked it
into the fastener.>>The cot, the fixation, and
the restraints are all part of a system that
is tested together. And if one piece or
part of that is changed, that can have a ripple effect
to the rest of the system. So all things need to be
tested together accordingly to make sure that the
patient stays attached to the ambulance in
the proper method.>>When purchasing a
cot for your service, make sure you refer to the
requirements in SAE J3027. This is the standard that has
been created by the industry to ensure your safety, as
well as your patient’s safety.>>Change is hard. The industry needs to change. We’re all on board here. And we’re going to
go through that. And pretty soon when
we look back, we’re going to be glad we did because it was the
right thing to do. [ Music ]