Ambulances & Vehicle Ops, Operations, Training

A Safer, Smaller Ambulance

Issue 6 and Volume 35.

You, too, can drive the big rigs.

A company that trained long-haul truckers once used that expression as a come-on to attract student drivers. At the time, EMTs in our system responded in Type II (van) ambulances, while paramedics worked in Type IIIs (van cutaways with boxes mounted on them). I had a friend named Miguel Mariscal who, after graduating from P-school, used to encourage his former EMT partners with those words: “You, too, can drive the big rigs.” Funny guy, Miguel.

But bigger is not always better, Life-Saver. I think it’s time we got rid of those “big” rigs. I think they’re a waste of fuel, and they cost a fortune to maintain. They also camouflage directors who don’t put enough ambulances on the road. In the process, they presume that an EMT or paramedic can adequately take care of two patients just as easily as one—even if that means forfeiting their safety restraints and kneeling or standing between two stretchers during transport.

It was worse in the Cadillac days, when we transported two additional patients slung from ceiling hardware, and didn’t have room to care for anybody at all. No matter that it was the standard of care in America; it was indefensible. We risked our backs and our livelihoods, lifting those two extra stretchers into their ceiling supports. Of course, when we transported people that way, many services naturally billed all four patients—even the ones who received no care during transport and had little chance of surviving a collision. (Hey, it was transportation.) Today, the U.S. is the only nation in the world that still routinely presumes ambulances have to be silly-size.

When you’re buying engines or ladder trucks, bigger may be better. But when you’re buying ambulances, it’s goofy. I think we need to get rid of that bench, and build these things so a safely restrained caregiver can actually reach their equipment and their patient from a seat that faces forward.

Wise Emergency Medical Seating, of Piggott, Ark., makes a seat that rotates and slides in four directions. It comes with a low-profile, DOT-approved mount that can be attached to the top of the right rear wheelhouse to make this all possible.

What good is a five-point harness when you’re sitting sideways? I’m betting there aren’t many of us who even bother with those things while trying to render care. In a frontal collision, you’re a goner. Your whole body is strapped in, but your head is free to gyrate like a 12 lb. tetherball.

There’s a better way to build an ambulance, and if you insist on it, somebody will build it. You could call the above example “Type J,” for JEMS—or “Just got tired of waiting.” It hasn’t been built yet, but don’t let anybody tell you it can’t be done. If you keep on waiting, you’ll just keep on waiting. JEMS