Improvised carries: moving an injured person without a stretcher

The default in most casualty situations is to stabilise, insulate, call for help and wait. Professional rescue teams have equipment, training and numbers that a small group does not, and moving an injured person is difficult, slow and risky.

But there are situations where waiting is worse: ongoing hazard, no communication, a casualty deteriorating from cold, or a location that rescue simply cannot reach in useful time. If you are going to move someone, do it deliberately.

Decide first

Ask three questions honestly.

Is staying more dangerous than moving? Rockfall, rising water, avalanche exposure, incoming weather, or hypothermia developing faster than help will arrive.

Can we actually do it? A carry over rough ground is exhausting. Two people carrying an adult manage a surprisingly short distance before they are spent, and an exhausted rescue party is a second problem.

Will moving them cause harm? Suspected spinal injury, unstable pelvis or femur fracture, or serious head injury all argue strongly against moving unless the alternative is worse.

Before you lift anything

Splint what is broken. A fractured limb that flops during a carry causes further damage and severe pain, and pain causes shock. Improvise with sleeping mats, trekking poles, rolled clothing and plenty of tape.

Insulate them. They will be lying still, they will be cold, and cold worsens everything. Layers under and over.

Explain what you are about to do. A casualty who knows the plan is calmer and can help.

The carries, from simplest

Assisted walk. One or two people supporting under the arms. For anyone who can bear weight, this is by far the best option — fast, low-effort, and it keeps the casualty engaged. Do not underestimate how much distance this covers compared with any carry.

Two-person seat. Two rescuers link arms to form a seat, casualty sits and puts arms around their shoulders. Good for short distances on reasonable ground. Tiring quickly, and no good on steep or narrow terrain.

Rope seat or split-coil carry. A rope arranged into two large loops, worn like a rucksack by the carrier, with the casualty's legs through the loops. Distributes weight far better than a fireman's carry and is a genuine technique worth learning. Pad the shoulders.

Rucksack carry. A large pack with the bottom seams cut, or with the contents removed, used to make leg loops. Improvised and effective.

Fireman's carry. Casualty over one shoulder. Very fast to set up and appropriate for a short move out of immediate danger. Unpleasant for the casualty, bad for anyone with chest or abdominal injuries, and it exhausts the carrier quickly.

Improvised stretchers

For anyone who cannot sit up, or where a spinal injury is suspected and you have no choice, you need a rigid or semi-rigid stretcher and a lot of people.

Options: two trekking poles or straight branches threaded through the sleeves of two zipped jackets, worn inside out, with the poles through the arms. A rope stretcher woven between two poles. A tarp or tent flysheet with the casualty rolled in it and multiple handholds gripped along the edges.

None of these are comfortable and all of them require substantially more people than seems reasonable — six is a realistic minimum for any distance over broken ground, and rotating carriers frequently.

Padding is not optional. A person on a rigid improvised stretcher for an hour will develop pressure problems and be in considerable pain.

Moving over ground

Slow and deliberate. Announce every step change, every obstacle. Keep the casualty head-uphill on descents where possible, and level where you can.

Rotate carriers before people are exhausted, not after — the fall happens when someone's arms give out unexpectedly.

Talk to the casualty continuously. Their condition can change and they will tell you if you are listening. Check they are still warm, still conscious, still breathing comfortably.

Spinal injury

If there is any real suspicion — significant fall, head injury, neck or back pain, numbness or tingling, or a mechanism that suggests it — the strong default is do not move them. Stabilise the head in the position found, insulate heavily, and wait for a team with proper equipment.

If you absolutely must move them because of immediate danger, keep the head, neck and torso aligned as one unit, with one person dedicated solely to controlling the head, and move the minimum distance to safety.

The realistic conclusion

Improvised carries are hard, slow, and physically brutal. A short distance in a car park is nothing like the same distance on a boulder field.

Which is why the honest advice is usually: get the message out, shelter and insulate in place, and only move if you have genuinely concluded that staying is more dangerous. And why a satellite messenger, a group shelter and a spare insulating layer are worth more in your pack than any amount of carrying technique.