One of the most inhospitable and dangerous places to attempt a rescue is from a mountainous terrain.
The elements invariably conspire against you, wind, snow and ice all making even the simplest movements difficult.
The mountain terrain itself is difficult enough, rough, rugged exposures where rocks and boulders can come falling down at any moment.
Therefore stretchers that are deployed to these areas need to be very special.
Helicopters are most often used to airlift casualties from these treacherous places but sometimes the weather even conspires against them and then it's a straight foot slog.
Whether you are using an airlift evacuation or carrying the injured person out by hand there are a number of essential pieces of equipment necessary.
From the very early days of mountain rescue the need for specialist stretchers was recognised and some of the most innovative advances have been made due to the demands of this sort of work.
One of the earliest advances was the use of aluminium frames to provide a stable platform on which to transport patients.
To these basket stretchers there were often skids added to make crossing these inaccessible areas easier.
These basket designs have become the basis for many of the stretchers used in mountain rescue, whether undertaken on foot or with the aid of a helicopter.
The shallow basin design keeps the injured patient securely fixed while being transported and backboards, neck braces and face covers can be added to protect them on their journey.
Wheeled stretchers like the early Ashford litter led to the addition of casters being added to stretchers so that they could roll over the ground better and later motorised versions were also built, although these were quite heavy and slow moving.
Today's mountain rescue teams employ the latest in technologically advanced stretchers that use polyethylene plastic scoops and lightweight stainless steel baskets to get into the most dangerous places and extract fallen climbers or wayward hikers.
These stretchers can also be fitted with anchor points for attaching a sling to be used with a rescue helicopters hoist and a number of designs can be broken apart to make transporting them to the accident site a lot simpler.
The rigours of rescue at altitude has provided emergency services with many improvements that have not only benefited outdoor enthusiasts but all of those who find themselves in difficulty and in need of a stretcher to ensure their safe transport to hospital and medical care.