1. #1
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    Default Designing Medical Transportation Vehicles

    Hello,

    I am a designer, currently focusing on a project in Transportation Design involving Emergency/Rescue vehicles. The specific area is in between a Type III Ambulance and a Heavy/Technical Rescue Vehicle (first responder). I am curious as to what input, response, complaints, anything you all may have.

    Some Design Drivers so far
    Response Time/Speed Efficiency
    Safety
    Interior Spacing/Layout
    Ride Quality
    Loading Options (for the stretcher of an Ambulance)
    Communication
    Visibility

    --> A more specific question for you. One issue that has been pin pointed is slow response time for Ambulances'. Research has shown that a lot of the time the first responder on the scene of an emergency is a Technical Rescue Vehicle from the Fire Department. I am trying to figure out if it may be plausible for this Technical Rescue Vehicle to transport the patient to a hospital (providing the vehicle had the right equipment and space -- this is where I come in --) instead of an Ambulance in certain situations since a majority of Fire Fighters are trained as EMTs already.

    I appreciate the responses, any and all input will be helpful.

    Thank you!!

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    Short story - sounds like you want to build... an ambulance.

    In my system, the first responder is usually an engine. I don't know exactly what your mean by "Technical Rescue Vehicles" - sounds to me like Rescue 1, and they don't do shoe runs. Squad 47 and Squad 72 do them, but they're just engines on steroids.

    The reason engines are there first has nothing to do with the speed of the ambulance. Heck, medics are probably the fastest vehicles we have, short of the chiefs' cars. An engine shows up, holds the patient's hand for 5, 10, (the cynic in me says 45) minutes, then releases care to the medic. Bada-bing-bada-boom, they're available. It just sucks that a 5 minute shoe run can generate 30 minutes of paperwork. Medic transports, and is tied up for anywhere from 20 minutes (BEST case) to 90 minutes - usually around 30-45 minutes, assuming they then don't have to go to detectives for a shooting or something. A typical medic unit here does something around 8,000+ runs per year. We just need more of them, not some newfangled concept car.

    You want to figure out a better way than waiting for an ambulance? Make the durned things for 1/5 of what they cost. That way, we can have 5 times as many, and reduce our UHU, or cost/benefit for the medic, or response/transport time, or whatever stat you want to look at...

    MAKE A CHEAPER AMBULANCE.
    Opinions expressed are mine alone, and do not necessarily reflect those of the Philadelphia Fire Department and/or IAFF Local 22.

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    If the Fire department wants to run EMS , then they need to buy & staff more ambulances.
    Responding to a medical emergency with a 70,000 pound ladder truck is a waste of resources, and while they may start care it would make more sense financially to buy and staff the appropriate vehicle. AN AMBULANCE !
    The reason fire trucks get there sooner is there aren't enough ambulances avail.able

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    Various configurations of vehicles of this sort have been tried before. To the best of my knowledge they have one thing in common - nonsuccess. Consider if you will the following: In order to carry more equipment such a vehicle would have to be larger and heavier. Even taking into account the European talent for packing much stuff into small spaces, you're going to wind up with something pretty big and pretty heavy.

    As the vehicle grows in weight and dimensions, its manuverability and ride quality suffer.

    But there's something else even more important. As you go to use your vehicle's many capabilities, you are removing the equipment needed to perform the various tasks. So before you can transport the victim(s), you have to take up and stow whatever you took off. That can be quite time consuming.

    Sometimes the tasks that were being performed aren't yet completed, so while you may be ready to transport, the vehicle may still be needed at the scene. What about staffing? If you are running a typical ambulance crew of two or three, what are you going to commit to - patient care or rescue? If you need to do things simultaneously, you need additional personnel. If you need additional personnel, you need someplace for them to ride. That, in turn, translates into more space/bigger vehicle.

    If you can design around those and many other criteria, go for it! For the time being, I will remain skeptical.

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    Inquiry -

    I'm not sure where you got the information that technical rescue vehicles are often the first thing to arrive at a patient's side. In FD lingo, technical rescue vehicles are generally few and far between in each department, and a lot of times, they don't even go on EMS calls. It's much more common that an engine company responds to EMS calls.

    Two trains of thought:

    Technical Rescue Vehicles with transport capability - Because there are generally dar fewer technical rescue vehicles in a fire department, we'd want to leave them in service for those specialized calls on which they'd be needed. Adding a patient transport capability to these vehicles would be counterproductive to the most of the department's missions. I'm a very open-minded apparatus committee member, but I doubt that I could ever be convinced that a transport-capable TRT would be a good idea.

    Engine company with transport capability - this isn't a new idea, a handful of departments across the US have experimented with this for 20+ years. The only one that I know if that's still using a transport-engine is Sycamore Twp, OH. It shares many of the same downfalls of the TRT-transport idea: 3+ members and and a specialized piece of the equipment are being removed from service for more time than necessary in order to do the same thing that a 2-person ambulance at 1/3 to 1/4 of the cost could do.

    If you want feedback on ambulance design itself, I'll be happy to give you some input on that as well, but I don't believe that combining fire apparatus with ambulances is the right direction to go.
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    As a person with long legs, one gripe I have about anything on a van-type chassis (E-Series Fords...) NOT ENOUGH LEG ROOM.

    I wish ambulance builders would add a few inches onto the back of the cabs, and move the driver and passenger seat back those few inches. Would make life a lot more tolerable for us tall guys.
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    Quote Originally Posted by Inquiry1 View Post
    --> A more specific question for you. One issue that has been pin pointed is slow response time for Ambulances'. Research has shown that a lot of the time the first responder on the scene of an emergency is a Technical Rescue Vehicle from the Fire Department. I am trying to figure out if it may be plausible for this Technical Rescue Vehicle to transport the patient to a hospital (providing the vehicle had the right equipment and space -- this is where I come in --) instead of an Ambulance in certain situations since a majority of Fire Fighters are trained as EMTs already.

    I appreciate the responses, any and all input will be helpful.

    Thank you!!
    For clarification, our Technical Rescue Vehicles are rarely used for EMS calls. If they are, they are for extrication and such. As well, are usually the last on scene.

    I honestly don't see a need for such a vehicle (at least not here). When an ambulance is needed, with manpower support from an engine, the ambulance is always there first. I don't see where you get the idea (research), that ambulances are not on scene faster than another piece of equipment.

    If I was you, I'd reread "BoxAlarm187s'" and "chiefengineer11s'" posts. Both are spot on.

    If you're interested in making a better Med Unit/Ambulance, I've got a ton of suggestions.

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    Quote Originally Posted by FIREMECH1 View Post
    For clarification, our Technical Rescue Vehicles are rarely used for EMS calls. If they are, they are for extrication and such. As well, are usually the last on scene.

    I honestly don't see a need for such a vehicle (at least not here). When an ambulance is needed, with manpower support from an engine, the ambulance is always there first. I don't see where you get the idea (research), that ambulances are not on scene faster than another piece of equipment.

    If I was you, I'd reread "BoxAlarm187s'" and "chiefengineer11s'" posts. Both are spot on.

    If you're interested in making a better Med Unit/Ambulance, I've got a ton of suggestions.

    FM1
    Thank you. I am definitely most interested in your advice on making a better Med Unit/Ambulance! I have attempted to send you a private message but am not sure if I have enough posts. You can e-mail me at Bdzind@gmail.com

    Quote Originally Posted by BoxAlarm187 View Post
    Inquiry -

    I'm not sure where you got the information that technical rescue vehicles are often the first thing to arrive at a patient's side. In FD lingo, technical rescue vehicles are generally few and far between in each department, and a lot of times, they don't even go on EMS calls. It's much more common that an engine company responds to EMS calls.

    Two trains of thought:

    Technical Rescue Vehicles with transport capability - Because there are generally dar fewer technical rescue vehicles in a fire department, we'd want to leave them in service for those specialized calls on which they'd be needed. Adding a patient transport capability to these vehicles would be counterproductive to the most of the department's missions. I'm a very open-minded apparatus committee member, but I doubt that I could ever be convinced that a transport-capable TRT would be a good idea.

    Engine company with transport capability - this isn't a new idea, a handful of departments across the US have experimented with this for 20+ years. The only one that I know if that's still using a transport-engine is Sycamore Twp, OH. It shares many of the same downfalls of the TRT-transport idea: 3+ members and and a specialized piece of the equipment are being removed from service for more time than necessary in order to do the same thing that a 2-person ambulance at 1/3 to 1/4 of the cost could do.

    If you want feedback on ambulance design itself, I'll be happy to give you some input on that as well, but I don't believe that combining fire apparatus with ambulances is the right direction to go.
    Thank you. I am definitely most interested in your feedback on ambulance design! I have attempted to send you a private message but am not sure if it went through because I may not have enough posts. You can e-mail me at Bdzind@gmail.com

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    As mentioned, this has been tried before. E-One built a pumper/ambulance on a Hush chassis. I know Rosenbauer (General Division) had a unit designed (on paper anyway) that looked pretty sharp. It was a pumper with 500 gallons of water (if memory serves) 1250 pump, hosebed, etc.

    I understand why some folks try to put more stuff on fewer vehicles, but honestly, a jack of all trades, master of none becomes just that....a master of none. Why waste the money on a machine that can't perform either function very well.....

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    Quote Originally Posted by FWDbuff View Post
    As a person with long legs, one gripe I have about anything on a van-type chassis (E-Series Fords...) NOT ENOUGH LEG ROOM.

    I wish ambulance builders would add a few inches onto the back of the cabs, and move the driver and passenger seat back those few inches. Would make life a lot more tolerable for us tall guys.
    Amen, Brother!

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    I have to echo what a few others have said very well. For us EMS runs are the norm, with the typical first due ambulance out of the house way more than any fire apparatus. On the opposite end, the technical rescue stuff is used far less than anything else, is far less available area wide, and far more critical when needed. Thus tying up said capability on the most common calls that require the equipment the least would be the last thing that we'd do.

    For us, the ambulances are the transporting units and only need to carry a bare minimum of "fire" stuff, such as turnout gear, SCBA and proper hand tools so the crew may dismount and be ready to work at a fire call. Our transport unit issues tend to be poor build quality and the lack of a better small chassis that's reasonably priced. The equipment changes enough that keeping these things beyond our 8 year plan seems shortsighted, so making the standard package better or cheaper without being shoddy would seem to make the most sense for our FD/EMS system.

    Part of the issue you're tackling seems to address a system model where the FD does not provide EMS or at least does not transport. As Mpita notes an ambulance in every house would seem to address best the response time issue and put the best personnel for the job at the scene. Very often one ambulance per house wouldn't cover a given area I suppose. We're routinely running two out of one station to cover simultaneous calls in a small community.

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    Quote Originally Posted by rmcatee1 View Post
    As mentioned, this has been tried before. E-One built a pumper/ambulance on a Hush chassis. I know Rosenbauer (General Division) had a unit designed (on paper anyway) that looked pretty sharp. It was a pumper with 500 gallons of water (if memory serves) 1250 pump, hosebed, etc.

    I understand why some folks try to put more stuff on fewer vehicles, but honestly, a jack of all trades, master of none becomes just that....a master of none. Why waste the money on a machine that can't perform either function very well.....
    Do you have any more information on the specific vehicle or concept attempted? A picture maybe?

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    Quote Originally Posted by Inquiry1 View Post
    Do you have any more information on the specific vehicle or concept attempted? A picture maybe?
    In Larry Shapiro's book Pumpers: Workhorse Fire Engines, on Page 106, he describes the 1994 E-One Hush EMS series that had a 3 door cab with patient treatment and transport area. When I sold E-Ones back then, I had the chance to see one. They were unique to say the least.

    As far as the General Division unit, I had the drawing at one time. I haven't sold Rosenbauer prducts in nearly 5 years, so where the drawing is now, I have no clue. But I recall it was based on a Spartan chassis, with side panel pump, hydraulic ladder rack and rear entry door for patient treatment/transport. Essentially, it looked like a ambulance box with a side panel pump house mounted between the box and custom chassis.

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    Quote Originally Posted by rmcatee1 View Post
    In Larry Shapiro's book Pumpers: Workhorse Fire Engines, on Page 106, he describes the 1994 E-One Hush EMS series that had a 3 door cab with patient treatment and transport area.
    The Widewater VFD's Potomac Hills station in Stafford County, VA took delivery of one. After some amount of back-and-forth with the Virginia Office of EMS, they couldn't get an EMS transport license for it, so the stretcher and cabinetry was removed and a bench seat was installed. It looked just like a standard pumper from the outside, aside from "ambulance" in reverse lettering on the front.

    I recall it was based on a Spartan chassis, with side panel pump, hydraulic ladder rack and rear entry door for patient treatment/transport. Essentially, it looked like a ambulance box with a side panel pump house mounted between the box and custom chassis.
    I've also misplaced my literature on this....there has to be a cached picture of it on the internet somewhere....
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    On page 45 of the Kent Parrish book called Emergency One Fire Apparatus, 1974 - 2007, there is a photo of Sandy Fire, Utah's 1993 Engine 33. Its a pumper transport unit as well. The Hush offered the most vehicle but the overall length was horrible.

    The General Division unit was the most compact, but again, I don't think it did either job (fire or EMS) very well.

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    Crimson also built this rig for the Salisbury, NC department. Does not look like a good environment to be working on a patient, it doesn't look like one could be belted in while transporting.

    Lot's more pictures (click on the doors)-- http://www.ci.salisbury.nc.us/fire/K...Rescue%201.htm
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    Quote Originally Posted by rmcatee1 View Post
    On page 45 of the Kent Parrish book called Emergency One Fire Apparatus, 1974 - 2007, there is a photo of Sandy Fire, Utah's 1993 Engine 33. Its a pumper transport unit as well. The Hush offered the most vehicle but the overall length was horrible.

    The General Division unit was the most compact, but again, I don't think it did either job (fire or EMS) very well.

    You all have mentioned that the concept of combining the vehicles (in a sense) has been attempted before (like the examples given)... but also add that it has never been a success. It didn't do either job well. Could you all elaborate? What exactly was it that did not work, and if I was to create another concept, what would be most important to include and problem solve for??
    Last edited by Inquiry1; 05-15-2011 at 07:14 PM.

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    There are several reasons not to do it. First, its not a good piece of fire apparatus or a good ambulance. Second, if the apparatus is committed to an EMS call, its of no use for a fire and vice versa. Third, the size of a combination unit makes it really hard to get in to some places.

    Of course, the E-One Trident concept that Miami-Dade used was probably better, but then I thought it looked funny seeing a pumper laying into an ambulance.

    I just don't see the concept taking off, regardless if its the pumper or TRT vehicle or anything else. Just my .02 worth, and we know that doesn't mean anything.

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    Quote Originally Posted by rmcatee1 View Post
    There are several reasons not to do it. First, its not a good piece of fire apparatus or a good ambulance. Second, if the apparatus is committed to an EMS call, its of no use for a fire and vice versa. Third, the size of a combination unit makes it really hard to get in to some places.

    Of course, the E-One Trident concept that Miami-Dade used was probably better, but then I thought it looked funny seeing a pumper laying into an ambulance.

    I just don't see the concept taking off, regardless if its the pumper or TRT vehicle or anything else. Just my .02 worth, and we know that doesn't mean anything.

    Could there be a vehicle that would be beneficial to the Fire Department that would be designed in a smaller size that could act as a first responder and certain other functions necessary in rescue situations? -- A merger of the two roles in a way --

    (These questions/comments are most definitely open to anyone -- feel free to e-mail or PM me as well.. the assistance is greatly appreciated --)
    Last edited by Inquiry1; 05-15-2011 at 07:50 PM.

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    You might check out this article I found in Fire Chief:

    http://firechief.com/mag/firefighting_right_tool_right/

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    Quote Originally Posted by rmcatee1 View Post
    You might check out this article I found in Fire Chief:

    http://firechief.com/mag/firefighting_right_tool_right/

    Interesting. It seems as though a smaller combination vehicle would be more plausible and useful with both interactions within a fire station and maneuverability and response time

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    Quote Originally Posted by FWDbuff View Post
    As a person with long legs, one gripe I have about anything on a van-type chassis (E-Series Fords...) NOT ENOUGH LEG ROOM.

    I wish ambulance builders would add a few inches onto the back of the cabs, and move the driver and passenger seat back those few inches. Would make life a lot more tolerable for us tall guys.
    This is why I like Type 1 ambulances.... so nice to drive. Also, can we be realistic... who is climbing from front to back and back to front?
    Last edited by ChiefKN; 05-15-2011 at 09:37 PM.
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    Quote Originally Posted by Inquiry1 View Post
    Could there be a vehicle that would be beneficial to the Fire Department that would be designed in a smaller size that could act as a first responder and certain other functions necessary in rescue situations? -- A merger of the two roles in a way --

    (These questions/comments are most definitely open to anyone -- feel free to e-mail or PM me as well.. the assistance is greatly appreciated --)
    Hell, I've seen cop cars with a set of extrication tools in the trunk.

    Anything is possible. However, at some point you need the manpower anyway, so why not have more then 1 apparatus respond and not put all your eggs in one basket?
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

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    Quote Originally Posted by skipatrol8 View Post
    Crimson also built this rig for the Salisbury, NC department. Does not look like a good environment to be working on a patient, it doesn't look like one could be belted in while transporting.

    Lot's more pictures (click on the doors)-- http://www.ci.salisbury.nc.us/fire/K...Rescue%201.htm
    The chief showed me this truck the last time I passed through Salisbury. He stressed one point - that setup is for one purpose only - to take care of one of their members should it become necessary. They do not do transports or EMS for the public, the county's EMS can and does handle all of that.

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