Safer - More Functional Ambulance Design

[crotchitymedic1986]

CB, i agree, but ask yourself this, how is that monitor and O2 secured. Do you have a portable bottle velcroed to the end of your stretcher ? Is the monitor in a mounting bracket, if so is the bracket secured to the truck using 4 wood screws that are bout one inch long ? Do you have spare O2 bottles inside your truck, maybe in those little silver cups, screwed to the floor by one screw, and then has one screw tightened down against the bottle to hold it in place. None of that works in a 40mph crash.

[zippyRN]

This looks to be a much more stable, secure system. Unfortunately I don't think it's available in North America. We seem to be behind in most other ways so why not this one too :roll: .

usual factors

local legislation may make it hard to get novel systems approved

the inbuilt resistance there appears to be on the left pond to changing working practices, and becasue USAn manual handling legislation has nothing to say on ambulance trolleys ....

cost is an issue as the system runs to something like 9000 gbp for cot and mount (pennies compared to the kind of settlements people get i nthe Uk for manual handling related injuries ) but becasue EN1789 compliance is often specified in contracts iot's a price that has to be paid.

[BushyFromOz]

had a reply but will take photos tomorrow at work, pics better than a thousand words apparently

[CBEMT]

CB, i agree, but ask yourself this, how is that monitor and O2 secured. Do you have a portable bottle velcroed to the end of your stretcher ?

Yup, and another in the bag which goes back into the secured cabinet, and another under the bench seat in a velcro bracket.

Is the monitor in a mounting bracket, if so is the bracket secured to the truck using 4 wood screws that are bout one inch long ?

I wasn't there to see it installed, but we have a bracket yes. On the truck that doesn't have a bracket, I use a seatbelt.

I would dispute that the bracket is going to fly out in a crash just because, unless the impact were on the corresponding point on the outside where the bracket is. In other words, if the surface the bracket is mounted to is not directly damaged, I can't see how the bracket is going to fail.

Do you have spare O2 bottles inside your truck, maybe in those little silver cups, screwed to the floor by one screw, and then has one screw tightened down against the bottle to hold it in place. None of that works in a 40mph crash.

See above for O2.

[Richard B the EMT]

The FDNY EMS ambulances have a built in cabinet with sleeves for 3 D cylinders, covered by a hinged, securable lid, alongside the "captain's chair". The tanks are in the sleeves in an upright position, without regulators attached. There are also 2 Ds, each in it's own carry bag, with some supplies (masks, canulas and connecting tubing, and in my ambulance, an adult Bag-valve-Mask), held in an equipment cabinet that is accessible from either outside the vehicle via a hinged door, or inside from a roll up door.

[Dale]

many of the suggestions mentioned here are already being installed in ambulances- at least in the USA. The problem is the cost- many purchasers of ambulances are traditionalists and are not openingly acceptable to adding high-back seats, extra padding, safety nets, etc. that will all inprove occupant safety and versatility. Many of these "suggestions" are not new- we have been providing some of them for over two decades to clients wanting upgraded safety. However, so many purchases of ambulances are done on the basis of "cheapest" which means you will only get what you are willng to pay for.

With about 15 manufacturers to choose from, there are varying ranges of quality and safety among those builders. Some attract clients wanting the "best" while others seem to cater to production-line "commodity-type" products that are cheap to build and sell, thus catering to clients wanting those.

I have stated many times that if I could get a wheelbarrow certified with warning lights and a mattress, someone would want to buy it because it was "cheap."

[spenac]

many of the suggestions mentioned here are already being installed in ambulances- at least in the USA. The problem is the cost- many purchasers of ambulances are traditionalists and are not openingly acceptable to adding high-back seats, extra padding, safety nets, etc. that will all inprove occupant safety and versatility. Many of these "suggestions" are not new- we have been providing some of them for over two decades to clients wanting upgraded safety. However, so many purchases of ambulances are done on the basis of "cheapest" which means you will only get what you are willng to pay for.

With about 15 manufacturers to choose from, there are varying ranges of quality and safety among those builders. Some attract clients wanting the "best" while others seem to cater to production-line "commodity-type" products that are cheap to build and sell, thus catering to clients wanting those.

I have stated many times that if I could get a wheelbarrow certified with warning lights and a mattress, someone would want to buy it because it was "cheap."

But why do none of them do the one thing that would help every provider last longer and have the back door lifts?

[FireMedic65]

That is a great looking ambulance. No secret passage to the cab though?

I would love to be part of the design of a new ambulance, I am sure a few of us could put together something really nice. Most ambulances now, almost force you to reach over the patient to grab something, or move around the box to do things. Not very safe for you at all, nor for the patient if the driver has to suddenly stop, or worse!

[Dale]

The lif that is incorporated as part of the rear doors is something done in Great Britain. My understanding is that is it a mandated feature for ambulances (maybe by their union?) When a device such as that is incorporated into a vehicle design as "standard" equipment, the overall developments costs can be absorbed by a large quantity of vehicles. This is especially true when someone like an ambulance service trust in Great Britain orders a large quantity of vehicles. They only have a few manufacturers over there and most tend to only last a few years until they are liquidated or sold to another firm. Very unstable marketplace where the government orders large quantities of vehicles and vendors really try to claw for those "deals." Most end up being unprofitable.

Cot lifts are available in the US and I see a good many installed, especially on critical care units and bariatric transport units. I only know of one firm in CA that provides these to most of the ambulance industry. The "run of the mill" street ambulance normally doesn't have one due to extra cost, weight, service issues, etc. Additional weight is a significant issue on many ambulance chassis- they become overloaded quite easily. Many are opting for an electric cot that seems to have more practical value to many EMS systems.

[zippyRN]

The lif that is incorporated as part of the rear doors is something done in Great Britain. My understanding is that is it a mandated feature for ambulances (maybe by their union?)

the unions have comparitvely little to do with it , Statute Law which requires manual handling operations to be assesed and minimise d whenver reasonably practicable effectively manadated lifts or ramps on Ambulances in the Uk .

When a device such as that is incorporated into a vehicle design as "standard" equipment, the overall developments costs can be absorbed by a large quantity of vehicles. This is especially true when someone like an ambulance service trust in Great Britain orders a large quantity of vehicles.

Orders especially with PASA recommendedand approved vehicles and the size of the regional services can run into hundreds of vehicles

They only have a few manufacturers over there and most tend to only last a few years until they are liquidated or sold to another firm. Very unstable marketplace where the government orders large quantities of vehicles and vendors really try to claw for those "deals." Most end up being unprofitable.

not sure where you got that impression from , the market in the Uk has been relatively stable for quite a while ... the relatively few makers is down to the fact that orders are so large which means that breaking into the market propelry needs a lot of investment

Cot lifts are available in the US and I see a good many installed, especially on critical care units and bariatric transport units. I only know of one firm in CA that provides these to most of the ambulance industry. The "run of the mill" street ambulance normally doesn't have one due to extra cost, weight, service issues, etc. Additional weight is a significant issue on many ambulance chassis- they become overloaded quite easily. Many are opting for an electric cot that seems to have more practical value to many EMS systems.

then there is obviously a problem with either the payload of the vehicles compared to their kerbweight or people are attempting to use too small a vehicle to achieve the result they needed ( as the UK saw with coachbuilt bodies on the renault chassis)