Ambulance

Most ambulances use a design based on vans or pickup trucks, though others take the form of motorcycles, buses, hearses, aircraft and boats.

During the American Civil War vehicles for conveying the wounded off the field of battle were called ambulance wagons.

Maintained roads are necessary for road-going ambulances to arrive on scene and then transport the patient to a hospital, though in rugged areas four-wheel drive or all-terrain vehicles can be used.

The first is frequently the manufacture of light or medium truck chassis-cabs or full-size vans (or in some places, cars) such as Mercedes-Benz, Nissan, Toyota, or Ford.

This is done by one of two methods – either coachbuilding, where the modifications are started from scratch and built on to the vehicle, or using a modular system, where a pre-built 'box' is put on to the empty chassis of the ambulance, and then finished off.

[35][36] The type of engine may be determined by the manufacturer: in the past two decades, Ford[37][38][39] would only sell vehicles for ambulance conversion if they are diesel-powered.

[40] In the United Kingdom, the National Health Service has set a target for all ambulances to be fully electric as part of the Net Zero campaign by 2045.

Type I is based on a heavy truck chassis-cab with a custom rear compartment that is often referred to as a "box" or "module", primarily used for Advanced Life Support (ALS) or Mobile Intensive Care Unit (MICU), as well as rescue work.

Type II is based on a commercial heavy-duty van with few modifications except for a raised roof and a secondary air conditioning unit for the rear of the vehicle, primarily used for Basic Life Support (BLS) and transfer of patients, though they are occasionally also used for ALS and rescue.

Type IV is for ad hoc patient transfer using smaller utility vehicles selected for maneuverability in special environments such as dense crowds at events; these are uncommon and are not subject to federal regulations in the United States.

[44][45][46] The move towards standardisation is now reaching countries without a history of prescriptive codes, such as India, which approved its first national standard for ambulance construction in 2013.

[47] Ambulances, like other emergency vehicles, are required[citation needed] to operate in most weather conditions, including those during which civilian drivers often elect to stay off the road.

Research has shown that ambulances are more likely to be involved in motor vehicle collisions resulting in injury or death than either fire trucks or police cars.

[48] When compared to civilian vehicles of similar size, one study found that on a per-accident basis, ambulance collisions tend to involve more people, and result in more injuries.

This could include: In parts of the world that lack a high level of infrastructure, ambulances are designed to meet local conditions, being built using intermediate technology.

Patients in significant danger to life and limb (as determined by triage) require urgent treatment by advanced medical personnel,[60] and because of this need, emergency ambulances are often fitted with passive and active visual and/or audible warnings to alert road users.

Popular patterns include 'checker board' (alternate coloured squares, sometimes called 'Battenburg', named after a type of cake), chevrons (arrowheads – often pointed towards the front of the vehicle if on the side, or pointing vertically upwards on the rear) or stripes along the side (these were the first type of retro-reflective device introduced, as the original reflective material, invented by 3M, only came in tape form).

In addition to retro-reflective markings, some services now have the vehicles painted in a bright (sometimes fluorescent) yellow or orange for maximum visual impact, though classic white or red are also common.

[citation needed] Another passive marking form is the word ambulance (or local language variant) spelled out in reverse on the front of the vehicle.

[citation needed] Additional white lights may be placed strategically around the vehicle to illuminate the area around it when it is dark, almost always at the rear for loading and unloading stretchers and often at the sides as well.

In areas very far North or South where there are times of year with long periods of darkness, additional driving lights at the front are often fitted as well to increase visibility for the driver.

A certain balance must be made when deciding on the number and location of lights: too few and the ambulance may not be noticed easily, too many and it becomes a massive distraction for other road users more than it is already, increasing the risk of local accidents.

[72] The speakers for modern sirens can be integral to the lightbar, or they may be hidden in or flush to the grill to reduce noise inside the ambulance that may interfere with patient care and radio communications.

[74] In the United States, the cost of an ambulance ride may be paid for from several sources, and this will depend on the local situation type of service being provided, by whom, and to whom.

Civilian based designs may be painted in appropriate colors, depending on the operational requirements (i.e. camouflage for field use, white for United Nations peacekeeping, etc.).

[citation needed] Military helicopters have also served both as ad hoc and purpose-built air ambulances since they are extremely useful for MEDEVAC.

[91] In terms of equipment, military ambulances are barebones, often being nothing more than a box on wheels with racks to place manual stretchers, though for the operational conditions and level of care involved this is usually sufficient.

The Israeli Defense Forces modified a number of its Merkava main battle tanks with ambulance features in order to allow rescue operations to take place under heavy fire in urban warfare.

[97][98][99] Some navies operate ocean-going hospital ships to lend medical assistance in high casualty situations such as wars or natural disasters.

[105] Others are refurbished and resold,[106] or may just have their emergency equipment removed to be sold to private businesses or individuals, who then can use them as small recreational vehicles.