I cannot overstate the need for reliable apparatus. They need to be operational for the emergency and in service continually with minimal downtime for repairs and routine maintenance.
Organizations must look for vehicles that suit their budget and consider the initial price tag as well as the costs over the life of the apparatus. Initial savings on vehicles that spend too much time in the shop do not serve the public or the firefighters who rely on them. This is just as important for ambulances as it is for engines and ladders.
There are many more functions and moving parts with fire apparatus in addition to vehicle weight and equipment carried. Engines have fire pumps, carry ladders, and have many compartments. Ladders and aerials have elevating platforms, straight sticks or other devices, and additional equipment. Ambulances have no additional mechanical parts, which means fewer issues with breakdowns and maintenance. This should be good for the department, as this is a simpler vehicle requiring less training to use and less routine maintenance.
The main issue of reliability for ambulances is keeping them moving down the road. These vehicles will typically have a lot more road miles than other apparatus, especially if hospital transports are involved. There can be a lot of wear and tear from just driving to emergencies and then on to emergency rooms. The nature of the work produces “hard miles” on the vehicle. To produce a vehicle that will carry the load and maintain reliability throughout its life expectancy, you need sound purchasing practices with appropriate specifications along with a sound preventive maintenance program.
Ambulance specs have different priorities than other emergency apparatus, such as the ride (less like a truck for patient comfort) and restraint systems for fire personnel and patients. While the “Clean Cab Concept” for fire trucks is gaining ground, medical decontamination has been a way of life for ambulances for a long time. As such, the ability to decontaminate must be part of the specifications so it can be done easily, quickly, and effectively. Turnaround time after an incident is important in keeping vehicles in service as much as possible, so anything that can be done to shorten the time while doing the job properly is very important.
Developing a plan for ambulance acquisition must factor in the expected life span of the unit. As mentioned above, there will be a lot of road miles. Newer vehicles are lasting longer, so consider not only actual miles driven but also travel conditions. For example, it would not be unusual for a department to put 25,000 miles on an ambulance in a year; that would be more than 100,000 miles in four years. If the vehicle is not equipped for this usage or maintenance is not done, the vehicle can become unreliable sooner. It may also be possible to boost the specifications to get more life, but there will be a cost you need to factor into the decision making.
Some departments consider an ambulance somewhat disposable—they accept that they will get a few years of service and then trade the vehicle in for a newer model. They budget accordingly and continually evaluate what has worked and what needs improvement. Some choose to go with a less expensive vehicle with fewer options and replace it more frequently. Others have tried to improve on the quality and get a few more years out of the apparatus. Another option is to refurbish—generally reuse the patient compartment and replace the chassis. There is not a “one size fits all” way to look at this, and every department needs to look at its situation and the expectations of the community and membership.
Obviously, ambulances are used for emergency medical services (EMS) work. But departments also need to look at the role the vehicle will play in other types of incidents. Firefighters need equipment if they are expected to respond to and operate at fires and vehicle accidents. For roadway incidents, they need safety items such as traffic cones. Besides all the EMS equipment, you need room for any extra tools you want to carry. There are space considerations and possibly weight issues that can affect the total gross vehicle weight.
Frequently, fire departments view ambulances as easy-to-drive vehicles with no extra components such as pumps or ladders. Since ambulances are smaller than most fire trucks, it is sometimes assumed that anyone who can drive a pickup truck can handle an ambulance. This can lead to inadequate driver training. However, there are challenges related to patient transport and the need for very good driving. You are delivering patients who need good care. Good driving is part of this, and personnel need to consider all their “cargo.” Organizations need to avoid falling into the mindset that anyone can drive an ambulance since it is so much like a passenger vehicle. Do not get complacent just because it is smaller and less complex.
Some might say there are many more fire service professionals interested in fire engines and ladder trucks than ambulances. Ask for volunteers for an apparatus committee to develop specifications for an engine or a ladder, and there are many. This may not be the case if it is “just an ambulance.” However, buying an EMS vehicle is just as important and requires forethought and detailed specifications to guarantee service and reliability.
From miles driven to equipment carried, ambulances offer different challenges than fire apparatus. When considering purchases and maintenance, take a slightly different approach than you would with typical traditional fire apparatus.
RICHARD MARINUCCI is the executive director of the Fire Department Safety Officers Association (FDSOA). He retired as chief of the Farmington Hills (MI) Fire Department in 2008, a position he had held since 1984. He is a Fire Apparatus & Emergency Equipment and Fire Engineering Editorial Advisory Board member, a past president of the International Association of Fire Chiefs (IAFC), and past chairman of the Commission on Chief Fire Officer Designation. In 1999, he served as acting chief operating officer of the U.S. Fire Administration for seven months. He has a master’s degree and three bachelor’s degrees in fire science and administration and has taught extensively.