Hartwell Medical Creates The Next Generation CombiCarrier II™

 If, in fact, our first and foremost goal as caregivers is to not cause further harm or discomfort to our patients, then we must look closely at how we move and manipulate patients suspected of having neck, back, pelvis, hip or spine injuries.  We all learned from our basic anatomy class that the human spine is not a straight pole, but a very well engineered curving structure designed to protect the spinal column that runs through it and at the same time support many structures in our torso, as well as our head.  For most adults our head is equivalent to a 10-12 lb. bowling ball which sits atop the spinal column where relatively small vertebrae support the skull with the help of many muscles and tendons.  This allows for great flexibility and movement of our head, but also represents the area of the spine that is the least protected by other body structures. The vertebrae grow in size as you move down the spinal column which directly reflects the amount of torso weight being supported at the different levels of the spine.  This grand design means your lumbar vertebrae are noticeably larger than your cervical vertebrae. No matter what their size is, all vertebrae can be injured.  Larger skeletal bones, like those in your pelvis, can also fracture and when they do you want to minimize movement of these damaged structures.

When moving a patient suspected of having a neck, spine or pelvic area injury, our goal is to maintain the position of the patient’s spine with a minimal amount of movement.  Based on research which was conducted at the University of Pittsburgh three years ago (1), the act of “scooping” a patient will result in less movement of the patient versus logrolling a patient.  Even with proper training and 4 to 5 caregivers, the simple act of rotating a patient 90 degrees from a supine position is difficult to accomplish with no movement of the patient’s spine.  Thirty years ago, a scoop type stretcher (also known as a split litter) was used frequently and was a standard piece of equipment of many ambulances throughout the world.  In Europe the standard of practice was to scoop a patient onto a vacuum mattress.  This practice is still common practice in many parts of Europe for it simply minimizes the amount of movement of the patient during the transfer procedure and then supports the patient’s spine with a conforming device which adapts to each individual patient.  Based on the current literature this could be considered the best practice with the tools that are available to us today.

Adjustable length split litters that were constructed primarily of aluminum began falling out of favor because they would sag when fully extended, were harder to clean if fluids got trapped inside the aluminum panels, became difficult to connect and extend after some wear and tear and were hot in the summer months and cold in the winter time.  Still, these types of “scoop” stretchers were good devices for moving patients if used properly, well maintained and kept in good repair.    You took your scoop stretcher with you when you left the hospital. Some attempts were made at making split litters from extruded aluminum parts, but they were considerably heavier and bulkier and did not gain much acceptance in the field. Years ago it was common in some areas to take patients into the Emergency Department on a scoop stretcher and the hospital staff would maintain support and stabilization of the patient while you removed your scoop stretcher from the patient.  You left the hospital with your equipment in hand.

The original CombiCarrier® was created to offer the benefits of a scoop-type stretcher and improve on the shortcomings of the aluminum devices in the marketplace.  There are number of features that make the CombiCarrier a unique two in one device.  Each half of the CombiCarrier is identical and has a single leading edge forming a continuous support structure for the patient.  This design feature provides improved support and eliminates the aluminum panel corners of earlier designs so potential pinch points are minimized.  By incorporating a continuous support surface, the device be used as a backboard on one call and then a scoop stretcher on a later call.  The CombiCarrier is rotationally molded cross-linked polyethylene which eliminates drive screws and roll pins, plus it provides a seamless exterior for easy cleaning and disinfection.  Most backboards are made from standard high density polyethylene.  Cross-linked material was selected for the CombiCarrier because it is stronger, less prone to cracking and has better UV and chemical resistant properties.  The concave patient surface provides a higher sense of security for the patient and reduces the lateral movement of the patient when they are placed on the device.  The end areas are slightly raised to provide better neutral alignment for the patient.  Some padding under the occiput will most likely still be needed for many adult patients.

During the development process, customer input was essential to our R&D efforts.  A common complaint we heard was about the latches.  Our solution was to relocate the latch point to an off-center location where it is easily accessible and does not catch the patient’s hair.  The latch mechanism is simple and sturdy with no maintenance required.  It is beefed up so that it performs smoothly even under load.  No more struggling with the latches when you are trying to get the device under a patient on a bed.  We were the first in the industry to place the stiffeners outside of the handhold areas providing a better hip and pelvic x-ray for the orthopedic surgeons.  And even better, because the CombiCarrier separates in half with minimal movement, the device can be easily removed from the patient at the hospital if detailed x-rays or other diagnostic tests are required and then reapplied to the patient if necessary.  

The CombiCarrier is an intuitive device so training is minimal.  Application procedures are similar to other split litter devices.  We find that the best method for applying the device in the field is to connect the foot-end of the device first and then the head end with the caregivers providing support of the patient’s torso and head during the application process.  There is still no substitute for having multiple sets of well-trained eyes and hands on your patient.

The next generation CombiCarrierII™ improves on an already great product.  All the proven features like the heavy-duty latch, seamless construction and the pinch-free single leading edge are retained.  The new design incorporates a carbon fiber composite stiffener to improve strength and reduce weight.  The profile is thinner so the CombiCarrierII will fit in almost every conceivable backboard compartment and the handgrip is smaller in diameter to be more ergonomically friendly for caregivers around the globe.  The speed-clip strap pins are now molded in and the head area is slightly larger to accommodate the new CombiCarrierII head immobilizer.  The original CombiCarrier was teal color and the new CombiCarrier II is lime green for a higher level of visibility.  We don’t have J.D. Power awards in our industry, but ask around and you will find that the CombiCarrier has a proven record of durability and reliability.  Our company motto is “Creating Quality Products for Life” and the CombiCarrierII is a great example of that commitment to meeting the needs of the people in the field.

So, what’s next?  If you truly want to minimize patient movement, provide the best possible support of the patient’s spine and do this in a comfortable manner, consider using a CombiCarrierII in conjunction with a vacuum mattress.

Every CombiCarrier includes patient restraint straps and is covered by a five-year warranty.  The CombiCarrier and CombiCarrierII are available through authorized Hartwell Medical dealers throughout the world.