We cannot say with any certainly when the first stretcher was used, but its history cannot be separated from the history of rescue.

The earliest documented testimony of something resembling the concept of medical assistance goes back to the time of the Crusades, in the 11th century, when the Order of St. John in Jerusalem learnt the rudiments of first aid from the greatest Arab and Greek experts and gave rise to the first organisation dedicated to the care of soldiers injured in battle. These Hospital Knights took the wounded to tents pitched on the battle field to take care of them. Soldiers were paid to help carry the wounded, presumably over their shoulders.

In 1792 Baron Dominique Larrey, surgeon-in-chief in the French Grande Armée, set up the first official army medical corps, initiating a systematic organisation of medical treatment whereby the wounded were transported on stretchers and with hand-drawn carts from the battlefield to hospital.

It was in 1859 that Henry Dunant, Swiss humanist and philanthropist, arrived in Solferino and organised the local population into helping soldiers injured in the battle of the same name, providing assistance with the acquisition of the materials needed to build improvised structures in which the wounded could be treated. Four years later, in 1863, the Red Cross was born, to help ill and wounded soldiers.

Then followed the institution of St. John Ambulance, founded on the same principles as the Order of Hospital Knights, to apply and teach the practice of first aid.

Generally speaking the stretcher, as can be seen in many images dating back to the late 19^th and early 20th centuries and the two World Wars on show in exhibitions and museums worldwide, coincides with the idea of the ambulance: required to transport the ill and injured quickly and safely. Carried by hand by two stretcher-bearers, then, with the help of two large wheels, and later a protective canopy, it can be pushed by just one person. But this is already the forerunner of the modern emergency vehicle, including the horse-drawn version, which is just like a carriage.

The basic aim of the stretcher is still the same today: to reduce to a minimum further damage to the patient during the journey to the place of treatment.

Today’s stretchers have wheels which make transportation increasingly easier and safer, also because, especially in recent years, many functional extras have been added with dramatic improvements.

Modern versions are a kind of reduced-size bed on a height-adjustable metal frame, with wheels. They usually fold up and have straps and belts to ensure the patient doesn’t fall off, but also to ensure that any injuries are not made worse by a bumpy ride.

There are several different types of medical stretcher, designed to be loaded into ambulances, divided into two main groups: self-loading and normal. The self-loading stretcher has retractable legs and swivel wheels and is used for loading the patient into the vehicle. This operation requires only one person, while the semiautomatic stretcher requires two. Then there is the scoop stretcher, usually made of metal, often combined with a dedicated head immobiliser designed for moving seriously injured patients from the ground onto a spinal board or onto a vacuum mattress.

Other versions include the rescue stretcher, like the basket used by fire fighters, and vertical stretchers for removing people from mines and caves. There are stretchers for all types of extreme conditions; for instance, on snow and ice, or any time a normal stretcher cannot be used.

The stretcher family, intended as systems for transporting patients who are unable to walk on their own, also includes evacuation chairs, which have become extremely widespread over the last decade as a result of the events of 9/11, i.e. folding wheelchairs, ready for use and ideal for carrying downstairs in the event of fire, for which only one rescue worker is needed. Another type of special stretcher is the split stretcher, which can be split into two parts so that the frame or wheel support can be removed, for use in cramped conditions.

The range also extends to other types of stretchers for sea rescue and high-altitude rescue, designed for extreme cases which require very specific aids.

It is not only the engineering applied to stretchers or the choice of increasingly adaptable and technological materials that change its functions and features. The modern stretcher is characterised by its being an integral part of the ambulance, to the extent that it is designed to work in synergy with it. Rescue workers carry out all types of treatment including anti-shock procedures and cardio-pulmonary resuscitation on the stretcher; it is a very real aid that needs to be designed to incorporate very high levels of efficiency.