Impressions of the Ferno iN/X

I’m sure that the interested audience for the new Ferno iN/X “power stretcher” was smaller at FDIC 2014 than it would have been if it were released in time for the EMS Today conference earlier this year. But maybe that was a good thing for me because, even though the booth was still crowded, I got to spend some “quality time” with this stretcher and thought it would be worth posting my impressions here. There were several things I wanted to confirm for myself after watching the announcement videos, but what ended up surprising me most were several other innovative features I didn’t even expect to see.


My first concern was all about weight. I was curious about how much this unit weighed and more importantly how much would I have to hold when it is loaded with a patient. But now to be honest, I still have no idea what the unit weight is since I never had to actually “lift” anything – the unit really did at all the work. Even loaded with a Ferno sales rep as a simulated patient, I never had to hold any of the weight with my back or legs. The front and/or rear wheels operate either together or independently using a simple set of only two buttons (“+” or “-”) and the application of a little pressure. When the weight is basically even, the stretcher raises or lowers horizontally. When loading it on to a simulated ambulance floor, the stretcher can be raised above the floor level (to a preset height) moved into the rig and lowered until the wheels of the head end touch the ambulance floor removing just enough pressure to cause the forward axle to automatically lift during the lowering process. A red laser on the stretcher shows a line on the rig’s floor to let you know when it is far enough forward for the total weight to be distributed between three sets of wheels already inside. The design of the X-shaped frame allows the stretcher to be pushed forward past the mid-line balance point where the weight is held on the floor and my effort is to simply “balance”, not “hold” the load while the axle at the foot-end is raised.  At this point, the stretcher is rolled completely inside without that extra “bump” I experience with the current stretchers used at my service. A middle set of wheels have an added feature that allow them to pivot in order to more easily align the stretcher if it is not inserted correctly and eliminates any further jostling of the patient. The locking receiver is unique to Ferno, but backward compatible to accept stretchers of another make or model. What is different about the Ferno receiver is that it charges the stretcher battery whenever it is locked in place during transport.

illustration courtesy of Ferno EMS

illustration courtesy of Ferno EMS

But rolling a stretcher around a showroom floor is different than the obstacles I normally face navigating a yard or home. This was simulated at FDIC with various barriers. To navigate them, the medic at either end where the axle needs to raised, will simply “pull up” on his end while the “-” button is held in order for the sensor to intelligently lift the end with less pressure until the button is released. The sensing mechanism allows for unique changes in height to be navigated even with just these two simple buttons. I also appreciate that the handles on the foot end can extend to allow my hands to operate directly at my sides for good posture and body mechanics.

There is an LCD display that gives operational cues and battery status along with a few extra buttons. These buttons turn on lights beneath the stretcher to illuminate dark hallways or turn on lights along the side rails for extra lighting. At the scene of a night-time traffic accident, the side rails can also alternate red and white flashing lights for extra visibility to motorists and improve my own safety.

Some specific “feedback” I had prepared was a complaint about the lack of “side rails” like I am accustomed to using, but heard that options are currently in development. In the meantime, I began to understand that instead of ‘flip up side rails’, the Ferno design uses ‘fold down arm rests’ that also lock in outward angling positions to accommodate (and help secure) bariatric patients. Further, the straps are not just the traditional cross waist, cross legs and cross chest, but a full 5 point style harness to no only keep the patient centered but also secure when laying flat if the ambulance should have a sudden stop (such as an accident.) While it is clearly equipped for safety, there was no compromise in functionality since the shoulder straps attached low enough in the front to avoid being in the way if CPR was required.


Finally, if all that was not enough to impress me, I saw how to quickly attach an optional monitor shelf between the foot rails to keep the monitor secure, visible, and conveniently ‘attached’ to the patient during transport. The same attachment design on the rails for this feature is also used for attaching optional IV poles or even the future “side rails” (if I decide that I still need them.) Of course there were other small details as well that showed that the designers were either practicing medics themselves or that they at least listened closely to the feedback of field providers who use stretchers like these in the field daily. I was thoroughly impressed and not only hope to get the chance to use one for real soon, I am now even more dissatisfied with what I currently use since I have come home from the show.


  • BH says:

    Further, the straps are not just the traditional cross waist, cross legs and cross chest, but a full 5 point style harness to no only keep the patient centered but also secure when laying flat if the ambulance should have a sudden stop (such as an accident.)

    Since those are required by federal law, and no stretcher can be sold without them, it disturbs me a little that you see these as a new development. A federal lawsuit from the early 90’s settled this issue after a patient death.

    As for the stretcher itself, it sees excessively complicated, heavier than the Styker power stretcher….. And it’s still a Ferno.

    • daleloberger says:

      Sorry to disappoint you “BH”, I guess our stretchers must be older than the 90’s then as we do not have straps that go over the shoulders on our “yellow colored” models.

      As for weight and complexity, I went directly from the Ferno booth to Stryker and tried their power stretcher for the first time as well. I hadn’t planned to do a direct comparison, but since you mentioned it, the Stryker was noticeably heavier (since I had to actually hold it up while the wheels retracted) and when moving it forward it still had the same “bump” we have on our models that gives the patient a little jolt. If you want me to go on, the rechargeable batteries seem like a pain and an extra device to keep plugged in.

      Honestly, all I have ever used in my career (even in training) has been Stryker, so I felt I was predisposed to favor what I knew. Still, I believe Ferno won me over fair and square. Give one a try yourself and compare it open and honest just like I did.

  • John Staymose says:

    Dale–You might want to revisit your Stryker experience because with their system you don’t have to hold any weight. Ever.

    I have some questions for Ferno about their battery and more importantly crash rating and manual overrides. The overrides seem too complicated and not likely to last in our world.

  • Phil Jordon says:

    John Staymose- You’re only half correct on the weight issue. If you are lucky enough to work for an agency that has the Stryker lift system as well as the power cot, you do indeed enjoy having to do very little lifting. However, there are instances when your conclusion is erroneous. The major instance is when the agency has power cots, but no lift systems. The lift systems are extremely expensive, tens of thousands of US dollars per truck. I’m fortunate to have worked both with and without the lift system. I have developed a deep appreciation for having them. However, not all agencies can afford them. At my current agency, this is the case. As much as our director would like to have them, we can’t afford them right now. While I seriously miss this tool, we get the job done (safely) without them. Don’t get me wrong, Stryker’s power cot is a huge improvement over many of the old designs. It just isn’t the be all, end all of the stretcher world. As for the Ferno new kid, I have yet to get to play with one, so I have nothing to say on which is better.

  • WES says:

    Anybody know the price of the new ferno system?

  • Thomas Roberts says:

    We’ve done some pretty substantial research on offerings from both Stryker and Ferno. What we’ve found is information that is both in line and conflicting with some of the prior comments on this page.

    The Stryker power cot is a heavier device in comparison to their old manual cots, however you can’t compare the Stryker power-pro to the Ferno in/X. Ferno’s in/X is around $35,000 where a power cot is about $15k from Stryker.

    If you really want to make a decision you need to compare the Stryker Power-PRO and Power-LOAD to the Ferno iN/X. With Ferno you’ll also need a Stat Trac to be crash compliant so there system total is around $40k as well.

    What we’ve found is that the Stryker system is much simpler, faster, and safer in terms of loading, unloading, raising, and lowering of the patient.

    Hope this helps.


  • Klark Kamp says:

    You must compare apples to apples in this situation.

    Stryker’s powered system runs about $40k and Ferno’s iN/X with a fastener also runs about $40k.

    Both systems remove the lifting, but the Stryker power cot is more than 50lbs lighter. Stryker’s battery also inductively charges when it’s locked in where Ferno’s battery touches a part on the fastener for charging (high possibility hazards make that fail)

    Also, Power-LOAD eliminates cot drift from side to side during loading…think about all the torquing of the lower back we do to get cots loaded. Ferno’s heavy cot will still run side to side depending on geographic landscape. Stryker’s will not.

    Ferno’s manual backups are a joke and if their battery dies (which batteries always do) the process to remove and replace it is erroneous. And oh by the way, Ferno doesn’t give you a backup battery. Stryker does.

    Ferno is well….Ferno. They took their foot off the gas a long time ago and Stryker remains the best in the business.

    • Mkuhns says:

      Having used the Stryker power (and manual) cots for many years, I was very excited when my organization decided to purchase the ferno inx. I had the opportunity to play around with one with the help of a ferno rep prior to getting them in the field and was quite impressed and became something of a spokesperson for the cot. Fast forward about 6 months of regular daily use. My enthusiasm has definitely waned! The no lift into the back of the truck is everything that they promised. Unfortunately, that’s about the only thing that has lived up to promise.

      The weight of the cot, coupled with the narrow tires make it hard to maneuver on most any surface other than a flat, hard, smooth one. The mattress rests high on top of the frame and it flat and narrow. Initially that seemed to look like an advantage, however, I have had numerous patient complaints of the sensation of falling, even when properly secured with all straps (including over the shoulder ). Most patients weighing 170# or more are too wide for the mattress and since there is essentially no side support, they do tend to shift and slide. (The arm rest system is a total fail in almost every way, and usually cannot be used when transporting an “American average” sized patient. When extended out to allow for the extra width, the cot will not fit through most standard doorways.

      A couple of final issues have to do with the “stair climbing ” ability and charging system. First the stair climb. I will say that after much practice, trial and error, I was able to get it to climb 3 steps of equal size and proper depth. However, no matter how I tried, when the steps were too shallow or of different heights, I couldn’t get the internal system to allow me to raise and lower the legs when I needed to and I was still doing a good deal of lifting, only now much more weight. Even in the best conditions, it is still too time consuming. Much easier to use a stair chair and leave the cot in the truck until the patient is brought out. Finally is the charging / mounting system. Our company purchased new “horns” and side locking mechanism from ferno to be used with the in truck charger. Unfortunately, the cot doesn’t lock tight enough to maintain contact with the charger (an issue ferno was fully aware of ) and so the cot battery would rarely charge. We ended up having to purchase additional batteries and plug in chargers to keep on the trucks until one of more creative types developed a metal shim that seems to be working for now. When the service tech from ferno was shown the problem, they advised that they were aware, but had no plans to fix the issue because they were eventually going to a center rail mounting system and eliminating the side lock and horn system. He was planning on using the shim idea at other agencies though. Also, with this mounting system, the under carriage gets hung up and it takes a good yank and an uncomfortable banging the patient around when you have to pull them out. It seems to happen mostly when there’s weight on the cot which is why, I suppose, I never noticed it during the demos.

      Unfortunately, ferno has a lot of re-engineering to do. I think instead of reinventing the wheel they could take advantage of the design ideas that made the Stryker cots good and add it to the good things with this one and then they’ll have a great cot! Unfortunately for me, my company has already dropped the $100K+, so it’ll be quite some time before I see another new cot on any of our trucks! One final comment, ferno’s own pedimate pediatric transport system isn’t compatible with these cots. I have a strong suspicion that the ACR child restraint system that just came out recently won’t work either due to the placement of the slots in the mattress frame in relation to the main frame. Ferno’s straps don’t attach by looping through the way that we’re all used to, it’s a locking pin system now.

      My advice is if you haven’t purchased yet, it may be prudent to wait for a better version. Unless all you do is interfacility, relatively short transports, then it will do you just fine!

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