# Medium-Duty Ambulances



## TreySpooner65 (Oct 4, 2012)

I'm sure there is a reason, but why do some agencies use medium duty ambulances? 







Here we just use the smaller ambulances, mostly just the van conversions, but some have the box on the back. I believe all of those here are bariatric.


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## Devilz311 (Oct 4, 2012)

Having worked in Type I, II, III, and International chassis rigs, I prefer the F-450 type I rigs.  I really don't see any benefit to the medium duty ambulances at all.


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## Christopher (Oct 4, 2012)

Devilz311 said:


> Having worked in Type I, II, III, and International chassis rigs, I prefer the F-450 type I rigs.  I really don't see any benefit to the medium duty ambulances at all.



I prefer an International by far.


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## rwik123 (Oct 4, 2012)

Some fire departments utilize them to double as heavy rescue trucks. The added space hold all the equipment on one exterior wall.


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## AlphaButch (Oct 4, 2012)

Medium's work well for rescue if you're lugging a rehab trailer or use it for winch mounts. Better ground clearance. Has more room and can handle more weight in the back (if you have to have alot of providers in there). Most services also find that they last longer than lighter duty trucks (I'm not a mechanic so couldn't really tell you why).

They're also prettier


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## medicdan (Oct 4, 2012)

TreySpooner65 said:


> I'm sure there is a reason, but why do some agencies use medium duty ambulances?
> 
> 
> 
> ...



Medium duties are liked and often used by critical care and NICU/PICU services. They like the additional space for providers (in the front and back), more storage room for equipment, floor space for interventions (Ecmo, balloon pumps, etc.) and more comfortable for patients (and parents, etc). 

As others have said, some fire departments like storing and using other equipment off of these rigs.


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## DrParasite (Oct 4, 2012)

In my experience, type II vans are cheaper, which is why you see them in for profit companies.  not only that, but the vans are GREAT for stable IFT calls where you only have or only will have 2 providers in the back.  

As for medium duty trucks, they are expensive, but they last forever.  so if it costs you $100,000 for a type 3, the medium duty will cost you $150,000.  but while the type 3 will need to be replaced after 10 years or 100,000 miles, the medium duty will last 15 years or 150,000 miles (of course I'm making the numbers up, but the ratios are accurate).

Also the medium duty trucks are great for ICU transfers, when you have 2-4 providers in the back treating the patients for extended periods of time.


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## Christopher (Oct 4, 2012)

DrParasite said:


> Also the medium duty trucks are great for ICU transfers, when you have 2-4 providers in the back treating the patients for extended periods of time.



The boxes on most medium duty ambulances have more of a MICU feel than the boxes on our light duty Type III's. Definitely feel like you have room to work.

Plus for some strange reason the International chassis has a better turning radius than the Chevy or Ford chassis Type III's. Not driven a Dodge, so I can't comment on those.


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## NomadicMedic (Oct 4, 2012)

All of the fire departments here run medium duty ambos. Lots of room for me to do ALSsey stuff.


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## DesertMedic66 (Oct 4, 2012)

The medium duty ambulances are pretty much no where to be seen in my area. Private ambulance companies use mostly type 2 with a couple of type 3s. Fire departments use type 3s. The only medium duty one I have seen is our mobile communication center.


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## Tigger (Oct 4, 2012)

No one it seems uses them in Colorado, which is likely attributable to the lack of four wheel drive on most medium duty chassis. Back in Massachusetts though, the well funded fire departments and third service agencies love them. I thought the ride was rather rough though. An international 4400 is a work truck, an ambulance box is barely enough weight for the suspension to work properly and it felt like there was a lot more bouncing and slamming.


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## shfd739 (Oct 4, 2012)

Yeah some use them for the extra room/capacity. Or as a status symbol.

For the NICU/PICU/transport teams that go long distances the ability to have a large module for the comfort makes sense. They also tend to have larger modules which settle the suspension some.

For 911 response they are overkill. Too big. Why do you need that many providers on a 911 call? And rescue tools? Are they supposed to be the medics or rescue?

The economics dont make sense. They cost alot more, get worse fuel economy, have the same lifespan as a lighter duty vehicle and the maintenance/parts cost more.


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## rwik123 (Oct 5, 2012)

Why Boston EMS uses them is beyond me. I wouldn't wanna be driving one of them in the city... And many of them are BLS units.


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## Christopher (Oct 5, 2012)

rwik123 said:


> Why Boston EMS uses them is beyond me. I wouldn't wanna be driving one of them in the city... And many of them are BLS units.



Not sure what Boston's chassis is, but I know our Internationals have a tighter turning radius than our Chevy Type III's.


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## rwik123 (Oct 5, 2012)

BEMS uses the GMC version of the international.


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## Tigger (Oct 5, 2012)

rwik123 said:


> BEMS uses the GMC version of the international.



And some killer looking international terrastars now.


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## Milla3P (Oct 7, 2012)

Maybe they just don't like their knees touching the stretcher? Icky stuff happens on that thing.


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## Medic Tim (Oct 7, 2012)

Milla3P said:


> Maybe they just don't like their knees touching the stretcher? Icky stuff happens on that thing.



BEMS don't have center mount cots. There is a lot of room between the bench and the stretcher.


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## MMiz (Oct 7, 2012)

Medium duty ambulances look impressive and are nearly always purchased with public funds.  

I can think of very few services that actually need them, they embody what's wrong when municipalities are entrusted to spend public funds.  Services with excess funds seem to buy the biggest ambulance money can buy.

With the exception of very few critical care / PICU units, I'm not sure what they accomplish that can't be accomplished with the significantly cheaper Type III rig.


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## medicdan (Oct 7, 2012)

DrParasite said:


> In my experience, type II vans are cheaper, which is why you see them in for profit companies.  not only that, but the vans are GREAT for stable IFT calls where you only have or only will have 2 providers in the back.
> 
> As for medium duty trucks, they are expensive, but they last forever.  so if it costs you $100,000 for a type 3, the medium duty will cost you $150,000.  but while the type 3 will need to be replaced after 10 years or 100,000 miles, the medium duty will last 15 years or 150,000 miles (of course I'm making the numbers up, but the ratios are accurate).
> 
> Also the medium duty trucks are great for ICU transfers, when you have 2-4 providers in the back treating the patients for extended periods of time.


I agree with the longevity, but it turns out to be cheaper overall to just remount the box on a new chasis, rather than starting with a medium duty... that's why it's so common for departments.


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## WestMetroMedic (Oct 7, 2012)

In ten years, i have seen 3 of them in Minnesota.  2 were units traveling to mayo clinic from Iowa and one was an ill conceived flop by one service.  The big trucks don't fit into most ambulance garages and many overhangs (which are kinda of important in the middle of a Minnesota winter).  Actually, pretty much everyone here uses a van chassis with a box and only a couple metro services that use a vanbulance for BLS.


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## abckidsmom (Oct 7, 2012)

MMiz said:


> Medium duty ambulances look impressive and are nearly always purchased with public funds.
> 
> I can think of very few services that actually need them, they embody what's wrong when municipalities are entrusted to spend public funds.  Services with excess funds seem to buy the biggest ambulance money can buy.
> 
> With the exception of very few critical care / PICU units, I'm not sure what they accomplish that can't be accomplished with the significantly cheaper Type III rig.



A.freaking.men.

And speaking of men, I think the medium duty helps firefighters trapped in the EMS role feel more manly.

I preach about this all the time, and nobody ever listens because they are tired of hearing me talk.

One of the biggest problems with municipalities spending the money to buy stuff like this is that they never, ever consult the high-functioning private agencies to see what they're doing.

I've seen a Type III configured so well that it had plenty of room in the backboard compartment for the reeves and stair chair, so that all the compartments on the driver side could be given over to gear and air packs.  Voila, a perfect fire/medic unit.

In our rural area, we rely on the medic crews to fill out the engine crews on the rare occasion there's actually a working fire.  They need to have air packs they brought to the scene, but not at the expense of driving a behemoth.

They are just so stinking manly, though.


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## emt11 (Oct 7, 2012)

I like this one, just saying.


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## Tigger (Oct 7, 2012)

abckidsmom said:


> A.freaking.men.
> 
> And speaking of men, I think the medium duty helps firefighters trapped in the EMS role feel more manly.
> 
> ...



With most manufactures, the difference between the largest box you can get on a Type 1 compared to a Type III is usually around a whopping six inches. Van chassis are so much cheaper, it amazes me how many fire departments around Massachusetts use giant Internationals yet operate on well paved suburban roads. Not to mention that one can still have the biggest box available and 4WD by putting it on an F450 and it will still be far cheaper.


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## usalsfyre (Oct 7, 2012)

My favorites are the guys who claim type IIs are "too small" and then turn around and say they want to be flight medics h34r:

I've yet to find anything they do better than any other truck, and a lot they are far worse at.


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## rescue1 (Oct 7, 2012)

We use medium duties... Big medium duties. I still have yet to hear a convincing reason why. The type IIIs are plenty big enough, unless you're planning on mounting rescue tools on the unit. I'm also convinced the type IIIs have smoother rides.


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## abckidsmom (Oct 7, 2012)

usalsfyre said:


> My favorites are the guys who claim type IIs are "too small" and then turn around and say they want to be flight medics h34r:
> .



Lol.


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## TransportJockey (Oct 7, 2012)

usalsfyre said:


> My favorites are the guys who claim type IIs are "too small" and then turn around and say they want to be flight medics h34r:
> 
> I've yet to find anything they do better than any other truck, and a lot they are far worse at.



This. I love my Type II. In the rural areas I work, box trucks don't fit down a lot of the roads. I've worked in Type I, II, III, and medium duties and I still love vans the most. I can reach everything pretty much while I'm strapped in. We don't work codes en route (I don't transport dead bodies), so a Type II is just fine for my rural 911 work

EDIT: And I've done CCT type calls in a type II, and have had no troubles


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## rwik123 (Oct 7, 2012)

Local critical care team....largest ambulance I've ever seen.


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## emt11 (Oct 7, 2012)

rwik123 said:


> Local critical care team....largest ambulance I've ever seen.



I think you should look at the picture I posted, I'd say their pretty close to being the same size.


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## rwik123 (Oct 7, 2012)

emt11 said:


> I think you should look at the picture I posted, I'd say their pretty close to being the same size.



Definitely close. The one I posted can hold one stretcher from one sidewall to sidewall and another the long way.


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## Danno (Oct 19, 2012)

rwik123 said:


> Local critical care team....largest ambulance I've ever seen.



Wow. I want to see a picture of the inside


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## abckidsmom (Oct 19, 2012)

We're taking the family on a road trip this year.  I want to take that truck, as long as someone else is paying for the gas.  5 kids shoudl have plenty of room to spread out in there, and we may not even need a hotel room if we can install a shower in teh backboard compartment.


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## NomadicMedic (Oct 20, 2012)

Almost every fire department around runs something like this...






Most departments have 2 or three. Can you say "overkill"?


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