The advent of hybrid-style engine/ambulances or transport-capable apparatuses took the fire vehicle world by storm a few years ago, garnering a lot of positive and negative attention. Supporters of the concept of a hybrid engine/ambulance appreciated how the vehicle could perform two very important roles within the fire service: suppression and EMS transport. Despite this versatility, orders were low. Critics of the design argued that, while these vehicles could theoretically perform both roles, they aren’t capable of performing each role at a level comparable to dedicated single-role vehicles. As a fire apparatus, engine/ambulances devote a significant amount of space to the patient compartment, decreasing available storage for water, hoseline and other tools.
As an EMS transport unit, a hybrid engine/ambulance is more expensive to operate and maintain than a traditional ambulance, can be difficult to load and unload a patient on a stretcher, might not fit in all emergency department bays and is slower and less maneuverable than a typical ambulance. These shortcomings in both areas meant that adoption of engine/ambulances has been low, and many departments with these units have still seen the need for both single-role engines and ambulances. In other words, these haven’t proven to be true one-unit-for-two-jobs vehicles or the future vehicle of choice for dual-role fire/EMS departments.
However, I think there might be a different way to approach the idea of combination vehicles that might produce a new type of truck that can uniquely meet the needs of many departments nationwide. The fundamental philosophy behind the criticized engine/ambulance was to start with a traditional fire engine and add patient transport capabilities. Unfortunately, the result was a vehicle that was regarded by many to be subpar at both. However, to create a vehicle that could do both effectively, why not start with a traditional ambulance and add small-scale, basic firefighting capabilities to it?
The resulting vehicle, as I envision it, would likely be a cross between mini-pumper — a light rescue with suppression capabilities built on a heavy-duty pickup chassis — and a Type 1 ambulance on a similar chassis. It’s worth noting that a vehicle like this will never replace a full-size apparatus, but it will allow departments to provide quick-attack and transport in one easy-to-manage vehicle. Many suburban fire/EMS departments provide ambulance transport to citizens, in addition to EMS first-response, traditional fire suppression and rescue services. These departments might receive several thousand calls per year, and up to 90% of them might be entirely medical calls.