van ambulances

[C.T.E.M.R.]

I was wondering if anyone who runs in a "vanbulance" has any problems with storage. A private service here only runs them and i got a good look at theirs. Can you carry multiple backboards, stair chair, Other larger equipment with a lack of out side compartments? I'm not sure all of the equipment we carry on our "box" rigs at my DEPT. would fit in a van ambulance. Or are there any problems moving around or problems with Technician space? thanks

 

[EMSLaw]

No, I don't think it's a problem. Around here, most private services, and even ALS in a pinch, have Type II ambulances (vans). They have to carry at least the state minimum in equipment, same as we do in the box, which means two backboards, stair chair, scoop stretcher, reeves, etc.

Things can get a little tight in the back, but they have an airway chair and squad bench the same as a box ambulance. Usually, though, the stretcher is flush against the left (driver's side) wall, instead of being in the middle of the floor, so there is no CPR seat.

They also have advantages. Easier to drive, easier to park, and a lot cheaper.

 

[WolfmanHarris]

Honestly, there's been talk about transitioning back to Sprinters around here and I have my doubts.

We keep adding more equipment to the trucks that require not only storage space, but room to operate, chargers and more importantly often extra crewmembers who need to access both sides of the stretcher.

For example, in the last year my service has not only added CPAP, and the LP15 (not a big change over the 12, but we do now have in car chargers), harnesses for service dogs (to remain compliant with the Ontarians with disabilities act) but is now rolling out the Lucas 2 CPR device. We've also added tracked stair chairs which take up significant space. Once it hits the market we'll be getting the Stryker powerload system, which as per Stryker will not currently fit in Type II trucks.

Further, one of the biggest changes needed in Ambulance safety is leaving behind the squad bench and switching to captain's chairs that allow us to remain belted without the side impact zone being the small of our backs. While this is necessary and desired, we'll also loose the under bench storage.

Certainly there's room for efficiency. We don't need so much guaze and saline in a single truck, but that will only free up so much room.

 

[Lola99]

I work for a private serivce that uses vans. We just got our first mini-mod, but haven't actually put it out yet. We have, I believe, 13 vans now, a wheelchair van, and 1 mini-mod. We also used to have a box, but the owner despises them so he got rid of it. That was before my time with the company. We don't carry multiple backboards, but probably could. As far as too much extra goes, I don't see it happening, and if it does, I don't see it being easy whatsoever. We have Indiana's minimum requirements on our rigs. (Mind you, we're a BLS service doing emergent and (mainly) non-emergent transports. For our purposes, the rigs do what we need them to. If you tried running them ALS though, I would have very serious doubts.

 

[TransportJockey]

My old service in NM used Type IIs and we never had any problems with space unless we happened to pick up an overlarge specialty flight team. And almost all of the trucks we ran were ALS or CCT level.

 

[Flight-LP]

My old service in NM used Type IIs and we never had any problems with space unless we happened to pick up an overlarge specialty flight team. And almost all of the trucks we ran were ALS or CCT level.

Damn man, are you sayin' we be fat?!?!? lol

 

[medicdan]

I, as well, for for a large service that puts BLS providers in vans, ALS in boxes, although I work PB and when our usual truck is in the shop, we end up in a van fairly often.

Vans with BLS loading really do accommodate all the equipment quite well. We keep 2-3 LSBs/Scoops under the bench without trouble (accessible only with the doors open). Stairchair goes on driver's side near the patient's feet.

With an ALS/CCT configuration, our drugs, pedi, vent/cpap, pump, suction and backup jump kit replace the BLS jump kits and AED near the side door shelves. The larger jump kit either lives on the bench (near the main O2) or on the stretcher (with the LP12, which moves to behind the patient's head or side rail during transport).

Generally, all the equipment previously mentioned fits in a BLS truck, it seems, with the exception of the Lucus, which I presume could be placed under the bench seat or behind the airway seat. In fact, a Lucus/AutoPulse/Geezer Squeezer is more important in a van, because of the lack of CPR seat/room for additional personnel just for compressions. A monitor charger/harness does fit on the shelf near the airway seat. I'm not familiar with the Stryker power stretcher, but I do know a powered Ferno fits in a van without difficulty.

Long story short, BLS has no trouble fitting, and ALS can make it work, even CCT is possible.

 

[TransportJockey]

Damn man, are you sayin' we be fat?!?!? lol

I dunno, have you seen some of the Native Air planes... they're large enough to haul several whales

Heh, but no really I had one flight crew that was three members plus an isolet on their special Stryker. Plus another flight team I took had a very large vented patient on multiple drips and the crew was RN/RRT/EMTP so it got pretty crowded in the back

 

[Shishkabob]

Storage was never really a problem on Type IIs. The problem lies with actually working inside one.


Hate it, hate it, hate it, hate it, hate it. Especially if you need access to the patients right side.




Straddling a patient with one leg on the floor and the other in a cabinet to start an IV on the right arm is not something I enjoy doing.

 

[brentoli]

I can honestly say Linuss is the first person I have ever heard thats worked in a van, complain about a van. Most of the people I hear complaining about them, have never worked in one.

 

[WolfmanHarris]

I'm not familiar with the Stryker power stretcher, but I do know a powered Ferno fits in a van without difficulty.
.

The cot isn't the problem. The Power LOAD system will be. Stryker hasn't placed it on their site yet, but we've had the reps at my service and the plan is to purchase the powercots with the power load system as part of our transition to no lift.

Finding info on this system is hard at the moment, but I have found some bits and pieces that state the system will not be able to go on Type II's.

 

[clibb]

My agency is talking about moving to the setup the European ambulances are doing but with the box like how Careflite in Texas has theirs.

 

[medicdan]

My agency is talking about moving to the setup the European ambulances are doing but with the box like how Careflite in Texas has theirs.

Just for the peanut gallery, Careflite showed off their new configuration (with Crestline, I believe) for a CCT-level Sprinter chassis.
Take a look at Kelley Grayson (Ambulance Driver)'s description

http://ambulancedriverfiles.com/2010/10/a-fresh-outlook-on-ambulance-design/

(photos taken from AD's blog)

 

[Flight-LP]

Straddling a patient with one leg on the floor and the other in a cabinet to start an IV on the right arm is not something I enjoy doing.

Could be worse man, you could have to teabag the pt. for the whole transport like we do in some of the smaller rotors. lol

In the AS350 as well as some of the smaller Bell products, you have minimal access to the whole lower body, the left side, and you get up close and personal with them. Hope you had a breath mint and clean underwear!

 

[Flight-LP]

My agency is talking about moving to the setup the European ambulances are doing but with the box like how Careflite in Texas has theirs.

Just for the peanut gallery, Careflite showed off their new configuration (with Crestline, I believe) for a CCT-level Sprinter chassis.
Take a look at Kelley Grayson (Ambulance Driver)'s description

http://ambulancedriverfiles.com/2010/10/a-fresh-outlook-on-ambulance-design/

(photos taken from AD's blog)







]

I like the new Crestline set up. Safety is emphasized, you have adequate room to work, and it appears to be quite aerodynamic and cost effective as well.

 

[usalsfyre]

Could be worse man, you could have to teabag the pt. for the whole transport like we do in some of the smaller rotors. lol

In the AS350 as well as some of the smaller Bell products, you have minimal access to the whole lower body, the left side, and you get up close and personal with them. Hope you had a breath mint and clean underwear!

The AS 350 variants were the only one I've seen in which you REALLY went gonads to face on, all of my flying was in the small Bells, and they're head at least stayed above the waist. :blush:

 

[Chimpie]

holy margin killer batman... changed photo sizes to make them viewer friendly

 

[Flight-LP]

You are correct overall, it really depended on the product. The old Critical Air aircraft had the pts. head against the back wall with the two providers sitting to the right facing each other. When AEL bought us out and started rolling out their L-4 conversions (a.k.a. a pretty paint job with even less lift capabilities) they had the 2 forward facing seats with the oversized drug box being in the aft facing seat. Even with these, depending on the placement of the flat, you may still be up close and personal.

The 407 at least had some room to breathe. I'll still take my A-Star anyday of the week and twice on Sunday as I will never have to worry about power getting out of a scene or having to limit my patient to under 250 lbs. because we were at our max gross weight. Sorry, but Bell 206's have no place in EMS, especially in the south with the humidity and higher DA.

 

[usalsfyre]

You are correct overall, it really depended on the product. The old Critical Air aircraft had the pts. head against the back wall with the two providers sitting to the right facing each other. When AEL bought us out and started rolling out their L-4 conversions (a.k.a. a pretty paint job with even less lift capabilities) they had the 2 forward facing seats with the oversized drug box being in the aft facing seat. Even with these, depending on the placement of the flat, you may still be up close and personal.

The 407 at least had some room to breathe. I'll still take my A-Star anyday of the week and twice on Sunday as I will never have to worry about power getting out of a scene or having to limit my patient to under 250 lbs. because we were at our max gross weight. Sorry, but Bell 206's have no place in EMS, especially in the south with the humidity and higher DA.

Absoloutely agree about the 206 in EMS. My ride was one of the unconverted Crit Air configurations...and it sucked. Hard. The forward facing seats were only marginally better.

I flew a few flights in a 407, and the difference was amazing, even if it was only a few cubic feet. Plus the A/C was nice.

 

[NomadicMedic]

Ahem... back to the subject of Typle IIs...

I work ALS for an agency that uses only Type II rigs and while they are cramped, we manage to make it work. It's tough with two or three people plus a patient.

The bigger concern for me is the fact that we don't secure much of our gear. Our Pelican Box full of drugs, pedi kit, monitor and asorted other flotsam and jetsam that accumulate in the back of the rig will all turn into projectiles that will KILL ME if we ever get in an accident.