Changing look in ambulances
Volume 24, No. 2
The news is good and bad from the apparatus scene and apparently the changes that must come about will lead to a new 'look' for some of the rigs on the street. The bad news, at least according to the rumor mill and probably the result of our lagging economy, is that Ford Motor Company will discontinue production of the Turbo Diesel Type II vehicle. For Type II fleets, this can be a real problem for vehicle replacement as there really are few solid workhorses out there that can cut the rigor and grind that is demanded of these vehicles. Yes, there are bigger apparatus, but we have to be realistic about the initial capitol equipment costs, replacement costs and maintenance, and the operational issues that come up with using simply 'bigger rigs.'
There apparently is a 'new' apparatus out there. Now this rig has been on the scene for a short while but to be honest, I'm surprised there has not been more promulgated about it. It does have a bit of a European look that we may not be accustomed to, but that may be because it has deep European roots. Made by Daimler Chrysler Benz (Yes, it's a Mercedes!) this is the Type II Sprinter (See fig. 1)! It has been around for years mostly used as a delivery vehicle but now an improved design is making this very suitable for use as an ambulance across the board. A lot of thought has been put into this vehicle, and there are many ergonomic features that have also been built into this rig.? Here in the States it is being made and marketed by Dodge, so it will not have the Mercedes Star on the front, but it will have all the same engineering that made Germans famous. It is also going to come standard with a 3.0L Mercedes, V-6 Turbo DIESEL for fuel economy and the power. And talk about fuel economy, this production model boasts of a 30 percent improvement over other base chassis models. The price of fuel has gone down from the highs of last summer but that is not likely to hold for an extended period of time and, long term, the increase in savings anywhere when planning fleet operations should always be considered.
Now fuel savings are not the only matter on the table when planning an ambulance fleet, new, replacement or otherwise. Rigor is probably one of the biggest issues that will ever be in question. When asking, "Can this vehicle withstand the pounding we are going to give it?" This was the reason why many larger operations went with bigger true apparatus as opposed to the "box and chassis" (planning for 20 years of service on the "box" and mileage wear and tear on the chassis, replacing as needed) as many of the Type II set-ups were not that cost effective in the long run. Now did going to larger true apparatus, with the substantial higher up front capitol costs, save money? Well, that is really a matter for the bean counters spreading their cost analysis over many years, but in the long run. It is doubtfully going to be more than "six of this" and a "half dozen of that," especially when looking at almost a two for one, "box and chassis" versus true apparatus.
This new Sprinter configuration is odd look-ing for sure, if for nothing else, it is? TALL! The specs boast 71 inches of head-room for the pat-ient compart-ment, which and that is very good news for "height-challenged" provid-ers. Standard Type IIs (and Type IIIs) were made and configured to be wider vehicles (obviously with the exception of the van conversions) in order to handle the ambulance box on the back with the configuration for cabinets and equipment storage. The Sprinter conversion does not add real width, so the patient compartment appears very narrow. (See fig. 2) While this may seem as a downside to this rig, the clear thought that has gone into some of the cabinetry, storage and equipment placing in this vehicle may completely overcome some of the appearance of shortfalls. It truly has an ergonomic plan. One of my colleagues has even stated that he really prefers the 'smaller' patient compartments because it places everything at arms reach. When you are working alone in the back, that can be a real plus to running laps around the back of some of these behemoths that are out there just to set up an IV or hook a patient to the monitor. That just becomes more food for thought when planning the next purchase. After 35 years in business, manufacturers are starting to dedicate storage for stair chairs, spare oxygen and defibrillators. The design also includes some of the current 'bells and whistles' such as the Vehicle Data Recorder outlined in NFPA 1901-2009, laptop workstations and storage, and plenty of outlets for plug-ins to use the auxiliary equipment. The back step is also high enough to add a hydraulic or pneumatic lift if desired. Now the specs I proofed had all kinds of extras including camera mounts both for rear compartment viewing and side, rear and blind-spot warnings. It also came with low-amp draw LED lighting, which really is a plus as we have all had issues with power when trying to run all of those 'bells and whistles.'
Is losing the Ford Turbo Diesel really a devastating blow? Of course not. There are many sound vehicles out there, some being built from the ground up by very good companies, but this is a substantial impact on 'good power trains.' An un-named consultant to a county in Northern California seems to think that the industry may be leaning heavily toward this vehicle (and this county may invest substantially in this product in the near future) for its practicality, ergonomic layout and overall design. I can't name the county or the consultant because my source cannot get solid confirmation but the reliability of the information is pretty firm or I would not even mention it.?
Yes, this is still 'box and chassis', but with a solid Mercedes diesel power train, on a chassis that may have the ideal 'lift on-lift off' replacement possibilities, it may be just what was needed. Still, it is kind of funny looking and I always expect to hear that European "high-low" siren when I see one.?
I'm sure that will change when someone sticks a real "Howler" on it!
William R. Kerney, MA, EMTP-A, is a professor of emergency medicine at the College of Southern Nevada. E-mail your comments to firstname.lastname@example.org.