Abstract: A removable litter chair insert adapted to be used with a standard ambulance cot and effectively enables emergency personnel to remove patients from narrow or confined spaces such as when transporting patients from a second floor to a ground floor especially when it is necessary to negotiate steps and landings in the steps, narrow doorways, hallways and the like. The device includes a framework with a canvas type liner connected to the framework and a removable pad or mattress secured to the liner with the insert being capable of orientation in a straight line condition for use as a regular stretcher and convertable to a chair configuration to facilitate extrication of emergency patients from confined areas by ambulance personnel.