Emergency Vehicle Operation, EMS System Design, and Prehospital Communications

Questions And Answers

1 What types of vehicles are used by emergency medical services (EMS) systems?

There are multiple types of vehicles employed in emergency services response, with the most common being an ambulance. Other vehicle types like helicopters, airplanes, four-wheel all-terrain vehicles, snowmobiles, and boats or nontransport vehicles like bicycles and fire engines may also be utilized. Vehicle choice is dependent on multiple factors including, but not exclusive of, the geography of the area, the type of event, available staffing, and budget.

2 Why do different services have different sized ambulances?

As a general rule, there are three different types of ambulance designs for ground transport. Type 1 is built on a truck chassis and has separate cab and patient compartments. This allows for refurbishing of the patient compartment on a new cab rather than replacement of the entire ambulance. They tend to be heavier and less fuel efficient but last longer. Type 2 ambulances are built on a van chassis and tend to be smaller than type 1 ambulances. They are more fuel-efficient and can more easily navigate smaller areas but have a shorter lifespan than type 1. Type 3 ambulances are also built on a van chassis but have a separate cab and patient compartment.

3 Why do some ambulances use lights and sirens during vehicle operations and some do not?

The use of lights and sirens after initial dispatch and during patient transport depends on the medical guidelines and standard operating procedures of each company, department, or municipality. Studies have shown that the use of lights and sirens saves approximately 3 minutes; however, it is associated with a higher number of fatal ambulance accidents. Given the minimal time savings, lack of clinical benefit, risk of fatal accidents, and liability, more systems are moving toward significantly decreasing the use of lights and sirens during response and transport.

4 What are the different types of EMS systems worldwide?

There are two predominant EMS “models” used around the world: the Anglo-American system and the Franco-German system. The paradigm in the Anglo-American model is to bring the patient to the physician. Thus, the system is designed with prehospital providers who are dispatched, provide specific treatments according to their protocols, and then transport the patient to the hospital. The paradigm in the Franco-German model is to bring the physician to the patient. This system provides for a much more robust prehospital physician presence in addition to the other prehospital care providers. It also allows more on-scene care and in certain instances can treat and release patients more easily due to the prehospital physician presence.

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