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A stretcher, gurney, litter, or pram is an apparatus used for moving patients who require medical care. A basic type (cot or litter) must be carried by two or more people. A wheeled stretcher (known as a gurney, trolley, bed or cart) is often equipped with variable height frames, wheels, tracks, or skids. Stretchers are primarily used in acute out-of-hospital care situations by emergency medical services (EMS), military, and search and rescue personnel. In medical forensics the right arm of a corpse is left hanging off the stretcher to let paramedics know it is not a wounded patient. They are also used to hold prisoners during lethal injections in the United States.