Do you think van ambulance's should be outlawed ?

Do you think van ambulances should be outlawed ?

  • Yea}(Yes)

    Votes: 8 13.8%

  • Nay}(No)

    Votes: 50 86.2%
  • Total voters
    58
thegreypilgrim said:
It may not be the prettiest thing, but it's designed correctly.
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Just because it's big doesn't mean it's correct. Sitting secured at bedside in a couple of our medium duty units I'm 5 FREAKIN' FEET from the cardiac monitor. I'd much rather have a smaller box where everything is within arms's reach. Are you familiar with the inside layout of the Boston trucks? If so, can you be secured and still reach everything?

As to rolling the truck, our service has put two Kodiaks on their roof. So driving with some sense will keep the rubber on the road long before type of truck will.
 
I think it is like anything else.

If you buy something cheap you get something cheap.

I have worked in the back of Sprinters and I have never wanted for room. There seems to be plenty when the layout is right.

I like being seatbelted in a forward facing seat at the patients side.

I know that speed rarely if ever makes a difference in pt outcome, but the acceleration and maneuverability seem fine for the rather narrow roads, high traffic winter weather and mountain conditions of Central Europe.

If you are working with fords of stripped down whoever is building sprinters in the US, then you got what you paid for.

I never stand or stradle a patient, in addition to being a deathwish, I am left handed and sitting on the pt right side works out perfect for me.

I also like how the cot sits at almost chest level. It is all around a fine piece of equipment. Especially intubating in the rig.

As for the boxes and medium duties, yea, been there, done that, nothing special. Just something hard to drive in very urban conditions, too much wasted space in the back, and dangerous to work in when you have to leave the seat. (which seems damn near always when the cot is so far.)

If you are doing compressions during transport, fail. Join the 21 century and work your codes on scene.

Outlawed certainly not. If I had my way, Mercedes Sprinter would be the rule, not the exception.
 
We do not have any sprinters here. We had Ford type 2 vans for years. They were OK to work out of. A bit cramped at times. I've gotten several of them stuck in snow over the years. We had a few modular units but now most of our trucks are what we call a "mini mod". Personally I like them as a reasonable compromise on size. They can still get stuck, I know.

Here is a link to our units. Just click on an icon and then click on a door to open it. The interior layout has changed a little since these pictures were taken about 5 years ago.

http://www.emci.ca/community/Pages/ambulance.aspx
 
Started out in ford and gmc boxes, went to Mercedes sprinters some years ago and couldn't be dragged back to the others by a team of Clydesdales. Mercedes also do a very chunky 4x4 sprinter to get to wherever Brown's next scenario is.
 
I've worked in Vans, Sprinters, and Boxes. IMHO, Sprinters are quite possibly the worst idea my old service ever had. The fuel tanks were so small that one IFT trip from an outlying facility was all that could be handled without filling up. I know that the crews at this particular station had to fill there truck up after each call before they could run another. Plus the O2 tanks were much too small. Poor, poor design for Rural medicine.

OTOH, the side of the service that is in a Urban area has no issues with them.

Personally, these and the vans may be ok for IFT's in the city. However, for running 911, especially in a more Rural/Suburban area, a bigger box with capabilities to double load is much better. I say this after having to double load pt's. in both a Van and a Box. As far as the Sprinter...I hate them with a passion. Far too cramped, and being right handed just makes it more difficult.

Thing is, what works for a rural county in Texas may not work for an inner-city in the Northeast, and vise-versa.
 
Lets see I have worked in Chevy's, Fords, and GMC's, configured as Type I, Type II and Type III. No one rig is perfect. I agree with the sentiment you get what you paid for.

For those of you that are Fire based, yeah a Type III works great for carrying all that equipment.

For those that are ALS/IFT in a Urban/Suburban area vans/Type II work great, especially getting into tight spaces. They are great for us out here as we have some tight space due to geography and old builds. Take a look at Kaiser San Francisco's ED lot sometime, gives tight space a new meaning.

What is really boils down to is that management takes input from those in the field prior to purchasing. Also EMS agency need to consider that as well when systems are put out to bid. Santa Clara County has mandated that Rural/Metro purchase GMC Type III GL4500 for the new contract. Oh yeah they required 55 of them.

It comes down to what you need for your system. There is no one size fits all.
 
eynonqrs said:
1) Van vs mod in winter weather. Drove mods in blizzard conditions no roads plowed, no chains, did not get stuck once. Vans stranded all over the place.
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No vehicle is infallible. Look on Youtube if you think Type I, III, or IV (medium duty) ambulances always do just fine in winter.

2) Critical care transports, RN on board, pumps, equipment. No room for anything.
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Type IIs would be cramped, that's true. But CCT is one specific purpose. You're question is should Type IIs be banned, period. For BLS stable-patient IFT transports, for one example, Type IIs are fine.

3) High winds: I've got blown into other lanes on a two lane highway with out turning the wheel.
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If you got blown into another lane without turning your steering wheel, then YOU ARE DOING IT WRONG. If you're getting blown into another lane while holding the wheel straight, then TURN THE WHEEL. It's really not that complicated. There is no demigod of EMS that's going to get angry at you because you had to turn the wheel to go straight. If you get blown into a car in the other lane, what are you going to tell them—"Sorry, but I was holding the wheel straight?"

4) Reaching over a pt if you need supplies when transporting.
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In all the Type II units I've been in, the stretcher is oriented longitudinally on the floor, with cabinets on the left wall. In all the other kinds of ambulances I've ever been in, the stretcher is oriented longitudinally on the floor, with cabinets on the left wall. Oh, there are a few cabinets above the bench and behind the passenger seat, too, but the stuff that gets regularly used is almost all in a cabinet on the left wall. In my experience, in ANY kind of ambulance I've ever been in. So it seems to me that I'd be reaching over the patient in ANY kind of ambulance.

5) Limited space for equipment.
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Isn't this just a repeat of #2? No ambulance has infinite space, therefore every ambulance has limited space. Some have more, some have less. If you work for a service that has so much stuff they need more space than a Type II can offer, then your service should buy bigger ambulances. Seems like a pretty simple solution to me.

I don't see why Type IIs should be banned for everyone just because they're not perfect for all situations.
 
On the contrary I work in a big city and prefer vans. The only other vehicles we have other than sprinters is old Ford F350 with a box on the back. We dont have high winds or cold (snow) in my state and our biggest obstacle in traffic. Im quite happy with the room in them
 
our new box is a 4x4 road rescue though, so hopefully thatll do the trick
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Only if the driver is competent. Most are not.
 
DarkStarr said:
yeah, we are using it in driver training this weekend :crossesfingers:
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I have my doubts about the true benefits of most driver training programs. They are a lot like EMS training: just enough to get you out on the streets where you can be dangerous.
 
Every single ems provider from small to the biggest uses van ambulance and you want to outlaw it because you do not like it? Try driving box ambulance around la compare to van and you will soon realize why van is being used much more. Top heavy van is no problem unless you are having really , really high winds in which case you likely would not be going out as it will be to dangerous.
 
I think it has to do with what you were originally trained in and have spent most of your time working in. If you start out on a box ambulance and "downgrade" then you're going to feel like you're working in a phone booth.
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Nope, I started in a van. I still think they're small. We have some boxes (our 24s and our brand new critical care truck that just has most of us standing there, whining "man couldn't we have just gotten a raise?" Mind you we already do critical care transfers in our regular ALS trucks. grumblegrumblegrumble.)

I mainly don't like the vans because we have started to get newer ones, and I find myself sitting in the back on long transports telling myself "please don't throw up please don't throw up please don't throw up." while listening to the patient going "Ow ow ow ow ow".. Bottom line, those things are SUPER bumpy in the back. You feel every single little bump in the road.

Maybe it was all in my head, but when I was on one of our box trucks the ride seemed so much smoother.
 
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I'll vote yes as soon as you offer a plan for making the extra money to pay for the box styles.
 
spike91 said:
I'll vote yes as soon as you offer a plan for making the extra money to pay for the box styles.
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You don't need to spend a lot on box units. You can do what my first EMS employer did and buy them used. They were very proud of the deal they got on three Type III units for $6,500 total. :rolleyes:
 
They were very proud of the deal they got on three Type III units for $6,500 total.
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Nice.

BTW, you've never seen cost until you try to buy a WWII vintage ambulance.
 
Sasha said:
Nope, I started in a van. I still think they're small. We have some boxes (our 24s and our brand new critical care truck that just has most of us standing there, whining "man couldn't we have just gotten a raise?" Mind you we already do critical care transfers in our regular ALS trucks. grumblegrumblegrumble.)

I mainly don't like the vans because we have started to get newer ones, and I find myself sitting in the back on long transports telling myself "please don't throw up please don't throw up please don't throw up." while listening to the patient going "Ow ow ow ow ow".. Bottom line, those things are SUPER bumpy in the back. You feel every single little bump in the road.

Maybe it was all in my head, but when I was on one of our box trucks the ride seemed so much smoother.
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I love this post! Especially the please don't throw up part.

Do you know how embarrassing it is to try to quietly toss your cookies in the garbage can while the pt keeps asking you if you are ok? :unsure:

We run all Type Is and I love them. Plus, out here with all the wildlife, it is nice to have a bigger rig. And, with nothing but two lane undivided county road and US highway, the bigger my rig is, the better. Most stuff on the road is going to take the worst of it (I hope).
 
There are times I wish we could get Caddy's back! Seriously, most EMS transports do very little in patient care and majority of the time all the patient needs is a comfortable ride!

Okay, from one who has worked in almost every configuration (vans, suburbans even a modified bread truck)... vans have their place. One's that should be banned are those large trucks (i.e. Boston EMS pic). Twice the price as most EMS units, have a higher incidence of poor performance on ice, wind and bad roads and bumpy OMG! I don't care how many "air ride" you have on them! We have several that have to be parked everytime ice appears and you know it's bad when the Paramedics prefer the smaller trucks because of the jarrring and rough rides.

I drove and rode in vans over 10 years... never once had a problem and yes, I live in area of ice storms and a state with one of the highest wind speed average. Room... yes, their limited to a degree, then when you look at the large units many of the cabinets are empty or double stocked. For critical care transports, I would love to have a designated critical care van. Mount IV pumps and vent on board with a large LED screen for the ECG/bio. Take all the "EMS" crap out, the bench seat and redesign it. It would be much smoother, and more economical.


R/r 911
 
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