Ambulances & Vehicle Ops

Colorado Medics Design a Safer Ambulance

Issue 10 and Volume 39.

Platte Valley Ambulance Service (PVAS) is a 42-year-old, three-crew, hospital-based, nonprofit 9-1-1 EMS provider in Brighton, Colo., about 20 miles north of Denver. You may have read JEMS articles in the past illustrating PVAS’ efforts to redesign its existing ambulances so attendants can function while fully restrained in forward-facing seats.1,2

The organization’s third redesign attempt involved a new LifeLine (Sumner, Iowa) Paraliner box with a 72-inch ceiling height, mounted on a Dodge 4500 diesel truck chassis. It’s laid out with a streetside bench, a rear-facing airway station at the head end, and an attendant’s seat behind the curb-side wheelhouse.

PVAS’ previous designs involved Type III LifeLine Fords in which the factory replaced the head end of the existing bench with a forward-facing seat mounted on the curbside wheelhouse. The seat could be folded flat to accommodate a second stretcher patient on the bench. In each of those units, a vertical cabinet behind the curbside door was intended to house essential equipment an attendant could access during transport, but in both cases, the seat was located too far forward.

PVAS’ service area necessitates some 40-minute multiple-patient emergency transports. They need ambulances that can accommodate those transports, yet they’re currently designed for the single-patient calls they handle 90% of the time.

In December 2012, chief paramedic Carl Craigle asked a team of medics to develop a design that met their needs—it just makes sense that if you want a safer ambulance, you make sure it’s designed by somebody who’s going to work in the thing.

Its features are shown in these photos.

1. Dick T. Time’s up: Call for a safer ambulance. JEMS. 2010;35(6):32.
2. Dick T. Back from the factory: Modified ambulance makes its debut. JEMS. 2011;36(1):20.

Curbside view of PVAS’ redesigned ambulance. Safety features include a yellow 3M reflective beltline, white reflective profile striping, skirt lighting to illuminate the ground around the ambulance at night, ED strip lighting on the interior of all outboard compartments, an added streetside window and 3M Perf Tape covering the exterior windows to enable one-way vision from the inside of the compartment looking outward. The Dodge truck is quiet and has a lot of power and plenty of torque, but the suspension system is generally harsh, even with air in the rear.

This specially designed rear streetside outboard compartment allows inside-outside access to standard carry-in gear. The stair chair is mounted in a bin on the inside surface of the door.

The interior includes a 73″ streetside bench, a center-mounted cot, a movable rotating attendant’s seat and upholstered padding around all work stations. The primary attendant has reachable access to oxygen, suction and a full electronic console, a sharps container, the monitor and latched drawers containing essential supplies during transport.

An attendant at the head end can access oxygen, suction, the console, the narcs, a sharps container, cot-mounted portable O2, the restraints, and a tilt-out trash bin. The ambulance is equipped with a self-lifting cot and a hydroelectric loading system. A radio headset is located near the attendant seat for easier radio transmission and monitoring. Redundant interior electrical switches lock all doors simultaneously in both consoles (for crew scene safety) and at the right rear door jamb (to lock the vehicle when it’s unattended and after an offload at the hospital).

The primary attendant’s feet rest on top of the curbside wheelhouse. To allow for more legroom and additional forward travel for the seat in the next version, the crews would decrease the size of the curbside attendant console by eliminating the non-essential extra drawer (A) and moving the trash bin (B) to an area behind the seat instead, without changing the dimensions of the drawers.

Acknowledgment: I’d like to thank Troy Allen (Rocky Mountain Emergency Vehicles); Carl Craigle, NREMT-P; Keenan Early, NREMT-P; Rick Floss, NREMT-B; Scott Gordon, NREMT-P; Brian Gourdin, NREMT-B; Roger Saxton, NREMT-P; and Mark Smith, NREMT-P, all of whom provided essential input for the design of this ambulance. I’d also like to thank the Durango (Colo.) Fire Protection District and Clear Creek EMS (Idaho Springs, Colo.) for the ideas they shared and the ones we snitched from them when they weren’t looking.