Ambulance Design Research

[Inquiry1]

Hello,
I am an Industrial Designer, focusing at the moment on conducting a project that innovates the design of an ambulance. I am verse in Industrial Design, as well as specializing in Transportation Design. The project is left broad for now to leave opportunities open. It can include the over all aesthetic appearance of the vehicle, ergonomics of the inside, medical equipment, the transportation function itself, etc. Our first step is to form a solid foundation of opportunities for improvement.. research. If anyone has any input, ideas, complaints, or concerns, please don't hesitate to send a message or post a reply.

Following are some things that will be helpful in particular.


Most important features
Importance/specifications of shape/ size of Ambulance
Is it necessary to have the cabin be detachable from the cab/chassis (from a manufacturing perspective)?
Design changes throughout time
Problems with driving?
Problems with inside?
Ergonomics?
Physical room?
Exterior use?
Time (takes to get to and from injured individual)?
Accidents?
Driver Training
Exterior features of importance (lights, markings, colors, etc.)
Interior features/requirements (seats, stretchers, medical equipment, etc.)

PROCESS
Describe the "norm" so to speak of a process where an ambulance goes out on duty/a call.


AESTHETICS
How an ambulance is seen.
Style aesthetics.. high contrast (so it stands out in emergency situations)
Professional vs. unprofessional look... how it impacts people around the vehicle/situations (traveling to a destination, parked for use, rushing to a hospital, anywhere open to society)

Thank you for your assistance!

 

[8jimi8]

I am probably most interested in greater increase in working space and internal saftey features for.... NOT TO FORGET increased protection from other vehicles crashing into the patient compartment

 

[JJR512]

Importance/specifications of shape/ size of Ambulance

I don't have any complaints about the size range of most American ambulances. Type II units (vans with extended roofs) are a bit cramped but if used for BLS transfer they are fine. I would probably find European ambulances too small, but that's because I'm used to bigger ones.

Is it necessary to have the cabin be detachable from the cab/chassis (from a manufacturing perspective)?

From a manufacturing perspective, yes, because ambulance manufacturer's don't manufacture the chassis. From a maintenance perspective, yes as well, because the patient compartments usually last longer than the chassis do, and having the patient compartment detachable means it can be taken off an old worn-out chassis and put on a brand-new chassis at far less cost than buying a whole brand-new ambulance.

Time (takes to get to and from injured individual)?

I doubt the design of the ambulance itself has very much to do with how long it takes to get there. One can only go so fast, or exceed the speed limit by so much, and I'm not talking about legally, I'm talking about practically.

Exterior features of importance (lights, markings, colors, etc.)

The markings are more up to the individual department or company operating the ambulance.

There should be lights on the edges of all exterior doorways and hatches. This lets oncoming motorists see the open door. The profile of the vehicle should always be outlined in light.

Research has been done into light patterns and what I read indicated that a candle was found to be the most visible type of light when all other lights, including blinkers, flashers, strobes, etc., had a similar or even slightly greater level of total light output. The researchers concluded that this could be translated into a practical form by having a type of light that is essentially the opposite of a strobe. In other words, the light is mostly on, but periodically flashes off. This was found to be the closest thing to the way a candle flickers. (Sorry I don't have a link to this research available immediately, but I'll see if I can find it later.)

 

[Inquiry1]

I am probably most interested in greater increase in working space and internal saftey features for.... NOT TO FORGET increased protection from other vehicles crashing into the patient compartment

I don't have any complaints about the size range of most American ambulances. Type II units (vans with extended roofs) are a bit cramped but if used for BLS transfer they are fine. I would probably find European ambulances too small, but that's because I'm used to bigger ones.

From a manufacturing perspective, yes, because ambulance manufacturer's don't manufacture the chassis. From a maintenance perspective, yes as well, because the patient compartments usually last longer than the chassis do, and having the patient compartment detachable means it can be taken off an old worn-out chassis and put on a brand-new chassis at far less cost than buying a whole brand-new ambulance.


I doubt the design of the ambulance itself has very much to do with how long it takes to get there. One can only go so fast, or exceed the speed limit by so much, and I'm not talking about legally, I'm talking about practically.


The markings are more up to the individual department or company operating the ambulance.

There should be lights on the edges of all exterior doorways and hatches. This lets oncoming motorists see the open door. The profile of the vehicle should always be outlined in light.

Research has been done into light patterns and what I read indicated that a candle was found to be the most visible type of light when all other lights, including blinkers, flashers, strobes, etc., had a similar or even slightly greater level of total light output. The researchers concluded that this could be translated into a practical form by having a type of light that is essentially the opposite of a strobe. In other words, the light is mostly on, but periodically flashes off. This was found to be the closest thing to the way a candle flickers. (Sorry I don't have a link to this research available immediately, but I'll see if I can find it later.)

Thank you both very much for the input. I will make sure these items get onto the list for development.

 

[usafmedic45]

I would probably find European ambulances too small

Have you spent any significant amount of time in them? Most of them are a lot like: http://emtlife.com/showpost.php?p=277463&postcount=2

When it comes to the issue of crash protection, I'm your man. Although my area of expertise is aircraft rather than ground vehicles. However, there is a significant amount of crossover applicability.

 

[usalsfyre]

Have you spent any significant amount of time in them? Most of them are a lot like: http://emtlife.com/showpost.php?p=277463&postcount=2

When it comes to the issue of crash protection, I'm your man. Although my area of expertise is aircraft rather than ground vehicles. However, there is a significant amount of crossover applicability.

Given headstrike envelopes and how providers and equipment are secured, if I'm going to be involved in a non-fatal incident I'd choose the aircraft.

 

[usafmedic45]

Given headstrike envelopes and how providers and equipment are secured, if I'm going to be involved in a non-fatal incident I'd choose the aircraft.

As long as it's not a Cirrus, you're making a fairly reasonable choice.

 

[Inquiry1]

Our focus right now is on ambulances in the United States. However, I think it important to acknowledge other advances and vehicles outside the U.S. as well.

Safety is definitely a big concern. Any specifics any of you can give in relevance to this, or any other categories would be greatly appreciated.

Thank you.

 

[Inquiry1]

More details/opinions please?

 

[Inquiry1]

Interesting points about the lighting and the way a candle flickers!

 

[JJR512]

Have you spent any significant amount of time in them? Most of them are a lot like: http://emtlife.com/showpost.php?p=277463&postcount=2

When it comes to the issue of crash protection, I'm your man. Although my area of expertise is aircraft rather than ground vehicles. However, there is a significant amount of crossover applicability.

I haven't spent any time in them. They look small to me. The ambulance in that picture looks like it has a patient compartment about the same size as a Type II, maybe a bit wider at the top since it's not curving in like the plain van walls do.

 

[Shishkabob]

Fold-out ramps so when a car decides to ram the ambulance, they get flipped up and over the ambulance instead!

 

[Inquiry1]

Fold-out ramps so when a car decides to ram the ambulance, they get flipped up and over the ambulance instead!

Will take that into consideration.



How do you all feel about side loading versus rear loading designs?

 

[Inquiry1]

Fold-out ramps so when a car decides to ram the ambulance, they get flipped up and over the ambulance instead!

Will take that into consideration..



How do you all feel about side loading versus rear loading designs?

 

[dixie_flatline]

Have you spent any significant amount of time in them? Most of them are a lot like: http://emtlife.com/showpost.php?p=277463&postcount=2

When it comes to the issue of crash protection, I'm your man. Although my area of expertise is aircraft rather than ground vehicles. However, there is a significant amount of crossover applicability.

I actually quite like the look of that German ambo's layout, at least at first glance. It looks like the person in the folding airway seat could reach damn near everything without having to get up. It's hard to tell based just off the one picture, but the layout of cabinets is almost always sub-optimal from both a convenience and safety perspective.

No matter how good the crash and crumple features are, providers are supposed to be strapped in at all times. Sadly, the only time this ever seems to be the case is during the most mundane/non-emergency calls, when the provider is mostly just asking questions. During a Priority 1/Code 3 emergency transport, the medic is probably all over the place grabbing tubes, lines, meds, O2..... I don't know if it's actually the case, but one would logically assume that ambulance accidents are more likely during priority responses (despite the lights & sirens), which is when the provider in the back is generally most likely to be unsecured. Designing the layout to make it so everything is focused on the medic's needs is a good first step.

Bigger isn't always better.

Continuing along the "unsecured" route, I am troubled by the amount of large, heavy, unsecured items in the ambulance. Specifically in Howard County, we have our large BLS and ALS bags - which sit wherever there is free space - as well as the LifePaks. Normally, the LifePak is at least secured to the bench with a seat belt, but if it is taken out on scene and in use during a call, many medics fail to re-secure it after the pt is loaded. Also, the only place in our ambos to put the LifePak is on said bench, which means that all of the leads, cuffs, and SP02 wires are snaking across between the bench and cot. I've seen these get pulled out/tripped on many times. Again, the German ambulance appears to excel in this area as it appears the LifePak is secured in its own spot, which also puts it in a position where the leads and other wires are not blocking traffic or likely to get yanked out unintentionally. In the event of an accident, I would really hate to be killed, but it would be even worse if I was belted but went out due to a flying LifePak to the face.

I think a use case needs to be established first. Is this an ambulance that is designed for a single provider in the back, providing all necessary patient care? What happens when you have the luxury of a second person aiding in care? What happens if you need to transport a 2nd patient? Figure out which case is your most likely/important, and design to that, allowing concessions to others when possible. Personally I would probably start out by securing the items mentioned before somehow, then identifying where the primary provider is going to spend most of his time (probably at the patient's side, around the torso). From there I am going to put the most used items as close to him as possible, keeping in mind that if I have a second provider sitting at the head, I want her to be able to reach the necessary items as well without needing 2 sets. Things that require the provider(s) to stand or unstrap themselves should be things that are removed/prepped on scene or before transport - an OB kit, CPAP, splints. If I have to unbuckle, stand up, and shuffle to the rear of the compartment to grab more trauma dressings or another 500/1000mL bag, the layout should probably be re-examined.

Don't forget about trash, especially sharps. There had better be somewhere close at hand to put used sharps that isn't jamming them into the seat cushion. Another lovely tidbit about Howard County - the ALS bags have a little sharps container, but they aren't big enough to hold the Epi's that we carry; if you force an Epi in, the needle will push out the bottom right through the plastic. Not cool. I realize that particular issue can't be fixed in ambulance design, but come on.

Another feature that I like that doesn't seem to be in widespread use (or is it?) is the ability of the provider in the back to communicate with the driver surreptitiously. Yes, you can try to use codes/medical jargon, but especially in cases where you have a relative riding in the seat up front, you might not want to say "Her BP is bottoming out" or anything even remotely unsettling/alarming like that. The control panels in our ambos have buttons for all the lights, heating, etc, but also 3 little switches to notify the driver of patient condition. Of course, we don't actually use them because each one sets off an ear-splitting klaxon that is more distressing than just saying "She's going to die" in front of the pt. But the idea is worth exploring I think.

Aesthetics are irrelevant.

Also, if you can design a chassis and/or suspension that will last longer than 50k or so miles of hard responses MTTR/MTBF, I reckon a lot of folk won't much care how poorly laid-out the interior is.

Lastly, I will leave you with one word. OK, two: concealed kegerator.

 

[Veneficus]

just built something huge, cheap, and easy to be killed in as possible.

It's what US providers seem to want. Why deprive them?

 

[Shishkabob]

To be honest, if involved in an accident, I want to be in the bigger vehicle. If working at a wreck on the side of the road, I want a big vehicle blocking.


Small sprinter ambulances are neither. Med-duty type 1s are.

Our medium duty ambulances at my agency have forward facing seats with harnesses in place of bench seats, and I like it. Best of both worlds.

 

[dixie_flatline]

Our medium duty ambulances at my agency have forward facing seats with harnesses in place of bench seats, and I like it. Best of both worlds.

Pics (of the inside)?

Also - I was wrong. Aesthetics do matter. BLECH!

 

[Shishkabob]

I'll have to snap some next time I'm at work... so it won't be till Saturday.

 

[Veneficus]

To be honest, if involved in an accident, I want to be in the bigger vehicle.

If it doesn't have a roll cage and the box is just sheet metal and plywood it will hardly make a difference.

If you are not sitting and belted into the seat it won't make a difference.

If you are hit with unsecured equipment you might be better off dead.

I have worked accident scenes with dual axel fire apparatus "blocking" and still almost have been hit. by cars simply trying to drive around it, or worse, the cop trying to maintain traffic flow directing traffic around the berm I was standing on.

Safety isn't just in the vehicle design, it is a way of life. One of the easiest ways to get killed on a freeway is to have a bunch of lights on yor blocking vehicle and you are standing in the darkness infront of it. Nobody can see through the lights so they don't notice you until the "thump." But I see providers stand just beyond the lights everyday.

I see ambulances responding lights and sirens to BS weaving in and out of traffic near double the posted limits.

I still hear US providers claim they can't sit and take care of a patient. That is BS too. There is nothing that needs to be done standing in the back of a rig. But providers are hell bent on it.

If your sitting in the cab of a larger vehicle it is better sure. But historically it is the ones in the box that are hurt/killed.