Ambulances & Vehicle Ops, Cardiac & Resuscitation, Operations

New Ambulance Back from the Factory

Issue 1 and Volume 36.

Remember those drawings of a “smaller, safer ambulance” I wrote about in my June column? Well, I wasn’t just doodling around. My chief, Carl Craigle, put my agency’s money on the line, and had one of our existing units modified accordingly. That was a big risk for a little outfit like us, so we crossed our fingers and held our breath until it came back from the factory.

Now it’s back, Life-Saver, and it’s be-YOOTiful. Not only that, but our crews seem to like working in it.

Our answer to the Ford problem has been to hang onto our 7.3-liter diesel chassis until we get a clearer picture of what will emerge from this recession. We don’t put a lot of miles on our ambulances—20,000 a year would be high for us. This one’s gone 170,000, but it’s been very well maintained. It also has a sturdy box (a LifeLine from Sumner, Iowa), which seems worth the investment ($85,000). And most of all, it’s been treated with respect by a bunch of crews you’d really love to steal from us. (Nuh-uh.)

We asked the factory to chop the front end off of our bench seat and replace it with a rotating captain’s chair from Emergency Vehicle Seating that could face forward. The seat is mounted on top of the right rear wheelhouse, which they reinforced with extra steel. We asked for a little, wedge-shaped, vertical cabinet in front of the wheelhouse, with a cutout in its bottom for added toe space. They installed a second set of environmental controls above the cabinet and hard-mounted the Lifepak on top of it. (It’s all easy to reach.)

The seat moves fore and aft on its own mount, in any direction. We tried to get a seat that would also move sideways, but apparently there’s no such thing. (Guess our original seat manufacturer was just kidding when they told us otherwise.)

Paramedics stay alive by obeying one basic rule: Never do anything you know is stupid. So if you put them on a bench seat and expect them to take care of sick people, don’t expect them to wear seatbelts. They know strapping themselves in sideways is stupid, and they simply don’t do it. Give them a practical alternative, namely move their most frequently needed equipment and controls in front of a safe, comfortable, forward-facing seat, where they can reach what they need, and maybe they’ll face forward.

Make sure the safety harness has inertia retractors, so they can move around, and maybe they’ll buckle up. Teach them how to do proper death notifications, and maybe they’ll stop doing CPR on dead people in moving ambulances. What about the bench seat?

The bench seat didn’t come from ambulance crews in the first place; did you know that? Our past leaders may have fudged a little on the true costs of running an ambulance service after they added that bench, which they thought might accommodate a second stretcher patient. They were sure a good EMT could take care of two patients as easily as one.

Silly them. American EMS has a bad history of expecting crews to compensate for unwarranted presumptions, inadequate equipment and unrealistic budgets. We really should stop doing that.

We tried a few other things, too, as part of the cost of this experiment. Electronic door locks with switches in both doorways, and a third one added to the new, third console. A highly reflective, lime-green beltline on three sides. Reflective striping that outlines the profile of the vehicle. A Whelen Howler siren. A no-foolin’ air horn that says “outta the way, if you please.”

This isn’t a showpiece; it’s a line ambulance, and it’s in use today. If crews continue to like it, we plan to extend its design to the rest of our fleet—both new and existing.

When it comes to ambulances, big isn’t necessarily good. I think we’re all destined for smaller, more sensible vehicles, and I think the rationale behind this design may answer crews’ concerns about working in them. EMTs are human, and they require physical space to work—on one sick person at a time.

You know, kind of like they do in the rest of the world. JEMS

This article originally appeared in January 2011 JEMS as “Back from the Factory: Ambulance Makes its Debut.”