TOTW has a great article responding to a reported breakthrough in ambulance design by our friends on the other side of the pond. Clicky for ready.
As I was reading that article, and the original he linked to I was taken back to my days in Newcastle upon Tyne with (then) UK Paramedic Mark Glencorse. I didn't like the ambulance layout at all, but the full access around the patient and forward facing seat in the back were great. But it works for the patients they treat, which is one of the hallmarks of EMS 2.0. That each community has unique challenges and needs unique solutions. We treat heart attacks the same all over this nation, unless you take into account the training, equipment, vehicles, staffing, location, hospital capabilities, transport times...you get the idea. With this in mind each community will look slightly different, much like they do now, only we hope to strengthen what is working and eliminate what is not.
Finishing TOTW's review of the "advances" the littlest of the HM JRs, Miss Eliza, was playing in the room with the ambulance bin. We call it that because these girls have a lot of ambulance toys. Go figure.
I peeked over my shoulder to see her little ambulance company lined up for her inspection.
Asking why she did that, her reasoning was to make sure everyone knew what to do today. But then I began to look at some of the "non-ambulance" toys that had made the lineup.
Then she blew my mind. Her description of why each vehicle was in the lineup sounded like a research project from my college days.
I give you Miss Eliza's Ambulance Company LLC.
Miss Eliza staffs 8 distinct apparatus in her fleet
1. Emergency Ambulance - "I like the noises" A standard 2 person reclined van ambulance. This rig likely carries most of her clients, is painted in distinctive colors for safety and has an impressive warning lights and sirens package.
2. Heavy Rescue (for tiny things) - "It does lots of sounds. It has Happy on it." Indeed this truck does have the markings "Happy Medic" and a license plate of "Free Ride" (all thanks to the Angry Captain). But with decreasing budgets at the municipal level, Miss Eliza may be unable to call another agency for extrication or rescue. It also allows her to train her people with her own equipment instead of having to rely on other agencies. She's thinking ahead.
3. Light Duty Transport - "The back opens for the bed in the back." This unit is short and narrow, clearly for use at special events. It fits one provider, who can then drive while the patient reclines in the back. A great use for tough to access patients.
4. Advanced Care Clinic - "I like it colorful" She likes the colors on this rig and the irregular shapes, but I like what's inside. Cabinets, sinks, an x-ray machine, hospital type lighting, it really is a clinic on wheels. Even better, the entire side folds down to reveal a treatment area. Park this rig at a special event and all those treatment dollars the hospital is getting are now to Miss Eliza. Added benefit, no need to staff multiple ambulances at the event. Just call one if you need it.
5. Rapid Response Car - "Because the car can go fast." Jimmy Johnson will be surprised to know he's been flexed into active EMS duties, but Miss Eliza sees the benefits of getting ALS eyes on scene first to guide the remainder of the system depending on the patient's presentation. Perhaps there is a better vehicle available, but she opted for #48, so who am I to judge.
6. Ladder Truck - "I like the fire truck and the ladder" I see where she's going on this one, but really, the ladders should be fitted to your heavy rescue squad. I don't think we'll need that 100' stick nearly as much as she thinks.
7. Tactical Response Vehicle - "It does new tricks. Goes fast and has guns." The SWAT has a giant armored vehicle, we need something too. Maybe the Green Hornet car is a little much, but pull up in this baby on the scene of a violent assault and the crowd will not only part, but disperse...and fast. Added bonus? Competing companies won't want to meet you at the intersection trying to grab the same call!
8. Ambulance (Non-Emergency) - "I like that its white." At first I thought she was just looking at the colors of the toys, but then I realized...that's exactly what she's doing. The white rigs are passenger vans for non-emergent patients and clinic appointments. If the little blue van can get me to the airport with 2 hours notice, surely we can apply the same design to scheduled transports to appointments. Put a modified ramp on the back for wheelchairs and I think she'll corner the market.
So there you have it. She didn't design the inside of an ambulance, that will take a complete redesign from the patient out, not the walls in, but she does bring up some interesting concepts in response models that I think should be considered moving forward, especially if municipalities keep cutting back.
As I was reading that article, and the original he linked to I was taken back to my days in Newcastle upon Tyne with (then) UK Paramedic Mark Glencorse. I didn't like the ambulance layout at all, but the full access around the patient and forward facing seat in the back were great. But it works for the patients they treat, which is one of the hallmarks of EMS 2.0. That each community has unique challenges and needs unique solutions. We treat heart attacks the same all over this nation, unless you take into account the training, equipment, vehicles, staffing, location, hospital capabilities, transport times...you get the idea. With this in mind each community will look slightly different, much like they do now, only we hope to strengthen what is working and eliminate what is not.
Finishing TOTW's review of the "advances" the littlest of the HM JRs, Miss Eliza, was playing in the room with the ambulance bin. We call it that because these girls have a lot of ambulance toys. Go figure.
I peeked over my shoulder to see her little ambulance company lined up for her inspection.
Asking why she did that, her reasoning was to make sure everyone knew what to do today. But then I began to look at some of the "non-ambulance" toys that had made the lineup.
Then she blew my mind. Her description of why each vehicle was in the lineup sounded like a research project from my college days.
I give you Miss Eliza's Ambulance Company LLC.
Miss Eliza staffs 8 distinct apparatus in her fleet1. Emergency Ambulance - "I like the noises" A standard 2 person reclined van ambulance. This rig likely carries most of her clients, is painted in distinctive colors for safety and has an impressive warning lights and sirens package.
2. Heavy Rescue (for tiny things) - "It does lots of sounds. It has Happy on it." Indeed this truck does have the markings "Happy Medic" and a license plate of "Free Ride" (all thanks to the Angry Captain). But with decreasing budgets at the municipal level, Miss Eliza may be unable to call another agency for extrication or rescue. It also allows her to train her people with her own equipment instead of having to rely on other agencies. She's thinking ahead.
3. Light Duty Transport - "The back opens for the bed in the back." This unit is short and narrow, clearly for use at special events. It fits one provider, who can then drive while the patient reclines in the back. A great use for tough to access patients.
4. Advanced Care Clinic - "I like it colorful" She likes the colors on this rig and the irregular shapes, but I like what's inside. Cabinets, sinks, an x-ray machine, hospital type lighting, it really is a clinic on wheels. Even better, the entire side folds down to reveal a treatment area. Park this rig at a special event and all those treatment dollars the hospital is getting are now to Miss Eliza. Added benefit, no need to staff multiple ambulances at the event. Just call one if you need it.
5. Rapid Response Car - "Because the car can go fast." Jimmy Johnson will be surprised to know he's been flexed into active EMS duties, but Miss Eliza sees the benefits of getting ALS eyes on scene first to guide the remainder of the system depending on the patient's presentation. Perhaps there is a better vehicle available, but she opted for #48, so who am I to judge.
6. Ladder Truck - "I like the fire truck and the ladder" I see where she's going on this one, but really, the ladders should be fitted to your heavy rescue squad. I don't think we'll need that 100' stick nearly as much as she thinks.
7. Tactical Response Vehicle - "It does new tricks. Goes fast and has guns." The SWAT has a giant armored vehicle, we need something too. Maybe the Green Hornet car is a little much, but pull up in this baby on the scene of a violent assault and the crowd will not only part, but disperse...and fast. Added bonus? Competing companies won't want to meet you at the intersection trying to grab the same call!
8. Ambulance (Non-Emergency) - "I like that its white." At first I thought she was just looking at the colors of the toys, but then I realized...that's exactly what she's doing. The white rigs are passenger vans for non-emergent patients and clinic appointments. If the little blue van can get me to the airport with 2 hours notice, surely we can apply the same design to scheduled transports to appointments. Put a modified ramp on the back for wheelchairs and I think she'll corner the market.
So there you have it. She didn't design the inside of an ambulance, that will take a complete redesign from the patient out, not the walls in, but she does bring up some interesting concepts in response models that I think should be considered moving forward, especially if municipalities keep cutting back.
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