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Bigger isn't always better: How ambulances rolled into the modern day

When you spec out your next ambulance, you can include most desirable features of each

Ambulances have changed a lot during my years in EMS. What is curious is how they started out small, then got bigger and bigger and now are getting smaller and more efficient.

In the 1970s, I worked on a Superior Cadillac. It rode like a dream and handled like a sports car. You could hear every diagnostic sound and obtain a perfect EKG at 65 MPH. Most important, patients were very comfortable. But they were really cramped in the back, and we had little room for equipment.

Then along came the modular ambulance. It had a box big enough to stand up in mounted on a truck chassis.

I remember my immense pride when we got our first one. I thought, "Now people will stop calling us 'ambulance drivers' and start calling us 'paramedics.'" It looked like an emergency room on wheels

The only problem with the early modular ambulances is that they were terribly heavy and rode like farm equipment. Orthopedic patients screamed at every bump in the road.

They did offer immense storage space, but the problem with all those compartments was our tendency to fill them up. Then they were at the upper end of their maximum payload and rode even worse.

The rise of the modern ambulance

Then came much lighter-weight aluminum boxes, which ushered in the age of the modern ambulance. Some of the best were brands like Road Rescue Excellance and Braun. EMS agencies now had the ability to customize every feature.

Wheeled Coach is one of the largest ambulances builders in the world. The company has brought many innovative ambulance features to the industry. Some of my favorites include the P.A.F. System, which is a self-contained heating and cooling system that cleans and decontaminates air. It reduces the risk of infection from airborne pathogens.

Another is the SafePASS safety system, with specially designed door handles and an emergency release tab for exit in case of an accident.

Osage Ambulances is a notable smaller builder. It uses construction methods similar to some of the top brands with a high level of personal service. Osage makes a great product backed with a sincere commitment to take care of customers.

The tried and true

Road Rescue has been building ambulances for 30 years now. Some of its better-known features include box pan formed patient and compartment doors and a composite floor system with an expanded foam core for better insulation and less road noise.

Today Road Rescue also offers a computer-driven LCD display providing system diagnostics and the ability to show the backup camera display and GPS.

Excellance has also been around a long time. The company has been building some of the finest ambulances available since 1975. It pioneered unitized, monolithic box construction. That means the entire patient compartment is welded into a single, solid block of aluminum.

Once, years ago, I sideswiped a Suzuki Samurai with one in a parking lot and nearly ripped its front end off. I drove the Excellance ambulance back to base and buffed the scuffmark off the side, leaving no sign that an accident ever happed. These are some really strong boxes.

The slant side

Braun is best known for creating the innovative slant sided box. Large fleets in big cities like Kansas City appreciated the distinctive styling and improved efficiency. Today innovations such as SolidBody Construction and an EZ Glide Door make them some of the best emergency vehicles in the industry.

LifeLine Emergency Vehicles also offers a Slant Side. It's a modern interpretation of a proven design.


Recently we have seen the introduction of Mercedes Sprinter-based ambulances. They are on the small side but are lightweight, nimble and fuel-efficient. They offer advantages in safety if appropriately configured. Anything that improves efficiency and safety while reducing work stress has to be seen as a positive development.

While certainly not ideal for every application, these little vans can be great for getting around in dense and crowded city streets. Three years ago you maybe saw one or two offered at the major shows. This year, most of the major converters offer one.

Miller Coach builds a newly improved version of its Sprinter-based ambulance. It features a more refined and evolved use of interior space.

This ambulance offers the medical provider better patient access for typical EMS care. It reminds me of the same intimate convenience I once enjoyed in a Cadillac ambulance, which is pretty hard to beat in that respect. You sit right next to the patient's arm and can easily take vital signs without removing your seat belt.

Demers Ambulances builds a version called the Mirage EX. Demers' ambulances now feature the Ecosmart ambulance electrical management system. This creates an intelligent and efficient anti-idling engine that can save you $1,500-$2,000 a year in fuel costs.

AEV has the Sprinter 3500 Trauma Hawk. One of the great things about AEV is its emphasis on medics' safety. AEV built the C3 Safety Concept Vehicle and has made a huge investment in building safer ambulances.

These are only a few of the manufacturers that build ambulances. In America, ambulances are custom-built to a department's specification. If you want a safer and more efficient ambulance, all you have to do is ask.

How to shop

The best way to choose the best ambulance for your department is to attend a major EMS Conference like EMS Today or EMS World Expo. There you can evaluate the latest offerings from all the major builders under one roof.

When you spec out your next ambulance, you can include the most desirable features of each. While it may not be possible to get all of them, you should be able to get most of them from your one preferred builder.

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