Introduction: The transfer of patients from the site of an incident to healthcare facilities constitutes a critical component within the continuum of emergency medical services and rescue operations. Historically, the earliest transport apparatuses comprised primarily wooden boards or rudimentary metal carriers, offering only limited short‑range mobility. With the progressive expansion of rescue operations and the increasing complexity of operational environments—such as roadways, mountainous terrains, and confined urban settings—the demand for lighter, ergonomically optimized devices tailored to harsh environmental conditions has become evident.
Background:
Over the past decades, fabric stretchers have emerged as a viable alternative to rigid or metallic designs and have been extensively adopted by advanced emergency service systems [1]. Their defining attributes—including collapsibility, low weight, maneuverability within constrained spaces (e.g., elevators, narrow alleyways), and ease of storage—have been key factors driving their widespread utilization.
Case of Iran – Localization Approach:
In alignment with national objectives to localize medical devices and reduce reliance on imports, Behina Company has developed a domestically produced fabric stretcher. This product offers notable economic advantages over imported equivalents and demonstrates strong competitiveness through its adaptation to domestic operational conditions and the specific requirements of national rescue organizations.
Methods: Product Overview:
The Behina fabric stretcher, developed by the Iranian company Behina, is a domestically designed rescue and evacuation device aimed at meeting the operational requirements of pre‑hospital emergency medical services.
Technical Specifications:
Dimensions: 200 × 100 cm — suitable for the body size of most adult patients.
Load Capacity: 120 kg — compliant with clinical standards for adult patient transport.
Weight: Less than 1.5 kg — classified among ultra‑light stretchers.
Foldability: Can be folded and stored in a compact rescue bag, enabling rapid deployment in field emergencies.
Service Life: Up to 5 years when maintained under standard storage conditions.
Material and Construction: Made of tear‑ and tensile‑resistant fabric, reinforced with industrial stitching and heavy‑duty straps to enhance patient safety [6].
Advantages
Qualitative and comparative assessment reveals the following notable strengths:
Lightweight and compact — facilitating transportation in field operations and demanding environmental conditions.
Cost‑effectiveness — lower production cost compared to imported equivalents, enabling wider access for emergency organizations.
Localized design — fully aligned with pre‑hospital emergency requirements and operational needs in Iran.
Adequate load capacity — accommodating a broad range of adult patients without compromising safety.
Washability and easy maintenance — supporting hygiene standards and extending the product’s life cycle.
Limitations
Despite its advantages, the product presents certain limitations that must be considered in future iterations:
Restricted spinal immobilization — in cases requiring complete immobilization of the spine, the stretcher alone is insufficient and must be combined with a backboard or alternative immobilization device [5].
Discussion
Comparative evaluation with existing scientific and commercial stretcher models indicates that the Behina fabric stretcher meets a significant portion of the operational requirements of first responders:
Weight and Volume: Among the lightest stretchers currently available in the Iranian market.
Load Capacity: Meets the international standard (minimum 120 kg) [7].
Design: Industrial stitching offers greater safety compared to simple conventional designs.
Economic Feasibility: Lower price compared to foreign alternatives, with enhanced accessibility for domestic organizations.
Nevertheless, literature indicates that advanced technical fabrics such as spacer fabrics could further minimize the risk of pressure ulcers and skin injuries, thereby adding value in future product generations. Furthermore, developing hybrid variants such as the Emergency Carpet or Vacuum Mattress, alongside the standard model, could significantly broaden the product’s application range [5, 7].
Results: Functional Role and Design Considerations of Modern Fabric Stretchers
Preventive Function in Patient Handling
A stretcher is not merely a device for patient transport; rather, it plays a preventive role in avoiding secondary injuries. In situations such as spinal fractures or severe limb trauma, even minimal unintended movement can lead to irreversible neurological or spinal cord damage. Therefore, stretcher design must adhere to biomechanical principles and ensure safe patient transfer.
In a clinical study, Liu et al. (2012) evaluated an innovative stretcher known as the Emergency Carpet. Findings from 20 patients indicated that this device could transfer patients without aggravating neurological symptoms, while also enabling medical imaging procedures without the need for further repositioning. These results highlight the critical importance of precise design and multifunctional capabilities in stretcher systems for preventing clinical complications [2].
2.2 – Skin Pressure and Pressure Ulcers
One recognized challenge in traditional fabric stretchers is the creation of localized pressure points on the body, which increases the risk of pressure ulcers. Webb et al. demonstrated that fabric texture directly influences skin pressure. In their study, three‑dimensional spacer fabrics with elastic properties significantly reduced localized pressures and helped prevent soft tissue damage. Conversely, non‑elastic materials such as simple polyvinyl chloride (PVC) generated higher levels of pressure and increased the likelihood of skin injury and pressure necrosis.
Consequently, material selection and the engineering of fabric layers must ensure even force distribution and effective skin protection for the patient.
2.3 – Limitations of Basic Models
Research evidence indicates that fabric stretchers lacking stabilizing supports do not provide adequate patient stability [1]. This deficiency is particularly critical in patients with limb fractures or cervical injuries, where uncontrolled movement may exacerbate the clinical situation. Therefore, modern design standards recommend the integration of high‑strength industrial stitching to ensure complete stability and safety during patient transport.
2.4 – Key Features of Modern Design
Professional rescue guidelines emphasize several essential characteristics for modern stretcher design [3]:
Ultra‑light weight (preferably under 2 kg) to maximize portability and mobility.
Foldability and compact packing, enabling use in confined environments and storage in small carrying bags.
High load capacity (minimum 120 kg) to accommodate diverse clinical contexts.
Moisture resistance and washability to maintain hygiene and prolong service life.
These design attributes not only align with clinical requirements but also enhance operational efficiency and improve the field experience for rescue personnel in critical environment
Conclusion: The Behina fabric stretcher represents a successful example of medical equipment localization in Iran. By combining lightweight construction, standard dimensions, high load capacity, and affordability, it has proven to be a reliable operational choice for emergency response teams. Research findings indicate that the use of durable fabrics and ergonomic design can significantly enhance patient safety and comfort during transport.
While primarily intended for short‑term patient transfers in emergency scenarios, this product can play a critical role in the pre‑hospital care chain when used in combination with other stabilization devices. As such, the Behina fabric stretcher exemplifies the success of domestic medical equipment development and, with further design enhancements and the adoption of novel technologies, holds the potential to evolve into advanced generations and even penetrate export markets.
Ultimately, this study demonstrates that the integration of technical innovation, ergonomic design, and economic localization can provide an effective model for developing lightweight and portable medical devices in other healthcare and rescue domains.
Keywords: Ergonomics; Medical Equipment; Stretcher; Patient Transfer; Pre‑Hospital Care; Emergency Medical Ser