A Stokes basket is a rigid, body-length rescue stretcher shaped like a shallow tub, designed to fully enclose and immobilize a patient during transport over rough terrain, vertical lifts, or water rescues. It functions as both a stretcher and a splint in one piece of equipment, which is what makes it distinct from a standard flat stretcher. You’ll see Stokes baskets used by fire departments, search and rescue teams, military units, and helicopter crews worldwide.
How the Stokes Basket Was Invented
The device is named after Rear Admiral Charles Francis Stokes, a U.S. Navy physician who grew frustrated with the crude stretchers and transport devices available in the late 19th and early 20th centuries. Stokes observed that existing “ambulance cots” required too much direct handling of a patient’s injured limbs, causing unnecessary pain and further injury during transport. His solution was a wire basket that cradled the entire body, immobilizing injured parts while giving the patient what he described as “comfort and a sense of security.”
The U.S. Navy considers the Stokes stretcher one of the oldest medical devices in continuous military use. Its basic concept has barely changed in over a century: a rigid shell that protects the patient from all sides while allowing rescuers to carry, hoist, or lower them through difficult environments.
Design and Materials
The two main types of Stokes baskets used today are the traditional steel-framed wire basket and a newer polyethylene (hard plastic) basket built around a metal frame. Each has trade-offs depending on the rescue environment.
Steel wire baskets are the classic design. They’re extremely durable, hold up well in harsh conditions, and allow water to drain through the mesh, which matters during flood or maritime rescues. The downside is weight. A steel Stokes basket can be cumbersome for long-distance carries over rough ground.
Polyethylene baskets are lighter and have a smooth interior that reduces snagging on clothing or medical equipment. The solid plastic shell also offers more protection from wind and cold during helicopter hoists. These are increasingly common in fire service and civilian search and rescue operations.
Both types are roughly 7 to 8 feet long and about 2 feet wide, with raised sides that rise several inches above the patient. Some models are one-piece rigid units, while others split into two halves for easier storage and transport to remote locations. The split-frame versions lock together with pins or latches before use.
How Patients Are Secured Inside
A Stokes basket on its own is just a shell. The internal strapping system is what keeps the patient safe, especially during vertical or angled movement. Most setups use a series of webbing straps that cross over the patient’s body from head to toe, secured with buckles along the basket’s rail. The goal is full-body immobilization: even if the basket is tilted or flipped, the patient stays locked in place.
One widely used configuration runs two long lengths of tubular webbing in a cross pattern over the patient, with one end fixed at the foot of the basket and the other threading through rings and ladder-lock buckles at the head. Different-colored straps help rescuers quickly identify which strap goes where under pressure. The strapping systems are also compatible with backboards, so a patient can be secured to a rigid spine board first and then placed into the basket for an additional layer of immobilization.
Buckle quality matters more than you might expect. All-plastic buckles can crack in cold weather or if stepped on. Many rescue teams prefer buckles with metal internal components and plastic outer shells, which handle roughly 500 pounds of force but still have limitations in extreme cold. Losing a small pass-through clip from a buckle can render it useless, so experienced teams inspect their strapping systems regularly.
Where Stokes Baskets Are Used
The Stokes basket’s versatility is its defining feature. It shows up in nearly every type of technical rescue.
- Mountain and wilderness rescue: Teams carry or drag the basket across uneven ground, through narrow trails, and over obstacles. The rigid frame protects the patient from rocks and debris during the move.
- Vertical rescue: In cliff rescues, confined space operations, or high-angle building evacuations, the basket is attached to a rope system and raised or lowered with the patient inside. A four-point hoisting bridle connects to the basket’s rails and distributes the load evenly.
- Helicopter hoisting: The basket can be clipped to a helicopter’s hoist cable and lifted directly from the ground or water into the aircraft. Its rigid shape keeps the patient stable during the swing and spin that naturally occur in midair.
- Water rescue: Flotation collars can be attached around the outside of the basket, allowing it to float while rescuers maneuver the patient through floodwater or open sea. The wire mesh design lets water drain out rather than pooling inside.
- Industrial and confined space rescue: The narrow profile fits through manholes, mine shafts, and tight corridors where a standard stretcher wouldn’t work.
What Makes It Different From a Regular Stretcher
A flat stretcher works well on level ground with easy ambulance access. It falls apart as a solution the moment terrain gets steep, the patient needs to go vertical, or the rescue involves water. The Stokes basket solves all three problems. Its rigid walls prevent the patient from sliding or rolling out. Its shape distributes the patient’s weight evenly across multiple carry points. And its rail system provides attachment points for ropes, hoisting hardware, and flotation devices.
The trade-off is bulk. A Stokes basket takes up significant space in a vehicle or on a rescuer’s back, and it requires more setup time than simply unfolding a flat stretcher. That’s why split-frame models exist, and why many teams cache baskets at locations where they’re most likely to be needed rather than carrying them on every call.
Key Accessories
A bare Stokes basket handles many situations, but specialized accessories extend its capabilities. Flotation collars strap around the basket’s exterior and keep it buoyant during water operations. Hoisting bridles, typically four-point systems made of rated webbing or cable, connect the basket to crane or helicopter hoist hooks. Litter wheels can be attached underneath for long-distance ground transport, turning the basket into a wheeled gurney over flat or gently sloping terrain. Some teams also add windscreens or thermal covers for helicopter operations in cold weather, since a patient suspended beneath a rotor wash loses body heat rapidly.
Patient padding is another common addition. The metal or plastic shell of the basket isn’t comfortable on its own, and for patients with spinal injuries or fractures, foam pads or vacuum mattresses placed inside the basket provide cushioning and additional immobilization before the strapping system goes on.