Vanbulances (Type II) for ALS?

[SunshineCamo]

I'm on a kick right now about learning more about ambulances right now. I've been reading about the various types and I've found a question I can't answer. Is there any articles or information that you guys are aware of recommending against Type II ambulance (Vanbulances/IceCreamtrucks) for ALS vehicles even in an interfacility service? I've found a few articles that say vanbulances shouldn't be used for 911 systems. But many manufactures have things written up that all seem to point towards TypeI/III ambulances being better for ALS, and Type II being mostly for BLS or IFT work. Which I'm sure is because they want people to buy the more expensive type I/III models, but it got me thinking.

So is there any information on this topic? Do you have any experience about having different types of ambulances for ALS and BLS?

 

[TransportJockey]

Most of my career has been spent in type 2 units running rural 911. I honestly prefer them over the big monsters I'm in now.

 

[Angel]

I only think the space is necessary on codes on when there will be people in the back
Otherwise I would much prefer thee type 2s
they're easier to drive (IMO), lower than a box rigs and easy for my short self to reach things

 

[chaz90]

I like being able to sit on either side of a patient in a Type I or III. I'm probably just spoiled from almost always working in monster modules, but type IIs or even mini mods feel a bit cramped to me. Here, we have at least two providers in the back on every ALS call, so a type II would be a bit small.

 

[SunshineCamo]

I guess I should have also pointed out my experience. My IFT has probably 16 ALS units, 12 of which are Vambulances. While they are pretty easy to drive, what with being vans, I hate trying to work in the back. Trying to get several things done at once is almost impossible. However our type III units (which I believe are AEV models) are great IMO. Big enough to work in without being too big like those FD rescues I see. Although it is kinda nice being able to fit an entire football team in the back during a code I guess.

 

[Carlos Danger]

But many manufactures have things written up that all seem to point towards TypeI/III ambulances being better for ALS, and Type II being mostly for BLS or IFT work. Which I'm sure is because they want people to buy the more expensive type I/III models, but it got me thinking

Bingo.

If we can do CCT in a BO-105 or an A-star, 911 can certainly be done in a vanbulance.

 

[MonkeyArrow]

Bingo.

If we can do CCT in a BO-105 or an A-star, 911 can certainly be done in a vanbulance.

True. It can be done. But is it optimal to be done in such a cramped environment or is it better done in something a bit larger? I'll definitely say that I, for one, am a fan of the monster rescue medium-duty ambulances. I don't care about their cost or maintenance or whatever else because it doesn't really affect me. IMO, more space is better than less, can add additional advanced equipment on a whim making it CCT capable if the bus was specced right, and they look cooler too.

 

[Tigger]

I don't have an issue with it. Having access to both sides of the patient is not that big of a deal. I can still start a line on the patient's right arm while seatbelted in our new ambulance with it's fancy swivel chair (pictured). Our five year old massive Type Is don't have right side access either, it's all counter space.

 

[DrParasite]

I hate type 2 ambulances. a contributing factor might be me being 6'3", but I digress...

The City of Trenton, NJ, only uses type 2 ambulances for all 911 calls. on ALS patients, you have one EMT driving, one EMT and one Medic in the back, and the second medic in a chase car. if the patient is really sick, you get one EMT and both medics in the back.

That all being said, if you only work in a two person crew, the type 2 should work for 911 calls. everything is within reach of the single provider in the back. you only have one provider in the back during transport. If you have a code, work them on scene, no need to move them to the truck unless they arrest while transporting. and yes, I have been in that position, and it sucked, but we did what we had to do.

Personally, I like big box ambulances with 911. But everyone's experiences and opinions are different.

 

[Carlos Danger]

True. It can be done. But is it optimal to be done in such a cramped environment or is it better done in something a bit larger? I'll definitely say that I, for one, am a fan of the monster rescue medium-duty ambulances. I don't care about their cost or maintenance or whatever else because it doesn't really affect me. IMO, more space is better than less, can add additional advanced equipment on a whim making it CCT capable if the bus was specced right, and they look cooler too.

Sure, sometimes it's nice to have more room.

 

[MrJones]

I don't have an issue with it. Having access to both sides of the patient is not that big of a deal. I can still start a line on the patient's right arm while seatbelted in our new ambulance with it's fancy swivel chair (pictured). Our five year old massive Type Is don't have right side access either, it's all counter space.

Is it safe to assume that there's no way you can transport 2 supine patients in that rig?

 

[Tigger]

The street side has a bench long enough for a 6' tall patient. It would be difficult to access that patient because of the side mount cot, but we can certainly transport two in it. I would have preferred a counter with seatbelts to secure a board or scoop with, that way we would have another place to mount the monitor, vent, and pump.

 

[cruiseforever]

I don't have an issue with it. Having access to both sides of the patient is not that big of a deal. I can still start a line on the patient's right arm while seatbelted in our new ambulance with it's fancy swivel chair (pictured). Our five year old massive Type Is don't have right side access either, it's all counter space.

We are starting the process of going to this type of seating. Does the staff like it? How it the location? Do they use the seatbelts?

 

[Tigger]

It gets mixed reviews. People are just so used to the bench that it's tough to get people to change. The five point harness is *slightly* more of a pain to don, but that's no excuse.

It is setup to run the very vast majority of calls without having to get up, and for that it works well. The only thing I wish we had done was put the seat on a front-to-back track. You can slide it closer to the cot at up to a 45 degree angle each way but it would be better if it slid back and forth as well.

We are still tweaking the setup a bit. Currently the forward workstation has the tablet and pump mounted there along with the hospital radio and module control panel. Above that are all the O2 delivery devices. Above the seat on the curb side wall are 90% of the medications. The remainder that are too large (premix bag, nitro drip bottle, narcotics safe), are located in the locked drawer above the glove boxes in the foreground. Beneath the monitor mount are IV supplies and above it is the fluid warmer and associated IV things. End tidal cannulas and electrodes are also with the IV stuff since the top and back pockets of the monitor are inaccessible in the mount.

As you can see we have regular sliding doors for the cabinets. I would not do this again as they only open half the space on small cabinets. I'd use plastic rollup doors next time.

 

[DesertMedic66]

I've only been in a type 3 about 5 times and I wasnt a huge fan.

I like and am used to type IIs. It's easier to reach all the equipment. It's also a lot easier to grab on to things if your partner makes a hard stop.

 

[johnrsemt]

You can do anything in whatever ambulance you have. I have worked in Freightliners that were big enough to run semis off the road, and vans, and sprinters, and mini mods, and Military HMMVV ambulances; and golf carts adapted to carry patients, and John Deere Gators. It depends on what is available at the time.

 

[cruiseforever]

I have always liked the Braun slant sides. Some extra room, yet everything is in easy reach.

 

[johnrsemt]

The nice thing about the Sprinters is how tall they are (I am 6'2" and can walk upright in the back) and the doors are just as tall as the back. Bad thing, you work in one for awhile, then go back to a normal truck and hit your head for the first couple trips out the back door.

 

[COmedic17]

In both my previous jobs and current job, trauma twinkies (that's what I call vanbulances) are used as back up squads when a truck is temporarily out of service. I am not a fan of the twinkies. It's not that big of a deal for typical everyday calls, but get a code or a bad trauma and throw a couple firefighters in the back and your going to want the extra room of a typical truck.

 

[drl]

The nice thing about the Sprinters is how tall they are (I am 6'2" and can walk upright in the back) and the doors are just as tall as the back. Bad thing, you work in one for awhile, then go back to a normal truck and hit your head for the first couple trips out the back door.

Yep, I like the Sprinters a bit more than the Ford Type II's mainly because of the extra height in the back. I can sit on the bench with my back against the side wall and not be stooped over like in the Fords.

That, and they ride better than the Fords and aren't completely gutless like the gasoline Triton V8's...