1. Introduction to Ambulances and Emergency Medical Services
Ford Transit Ambulance; Ambulances, as an established provider in the emergency medical services (EMS) system, must be able to expediently reach persons in need and provide medical attention during transport. To this end, the modern ambulance must be designed to serve several goals: an extension of the medical care provided in an emergency, a safe mode of transport developed with the benefit of modern engineering, and the ability for the ambulance vehicle to serve other supporting roles in the larger healthcare system. However, the primary functions of an ambulance remain providing transportation for patients in need of medical attention, and as such, the quick reaction time and ability to equip the ambulance vehicle with special equipment cannot be foregone. Despite the consensus that accessibility, response time, and hospital-centered emergency care are advantageous for patients in medical emergencies, little has been published regarding the design or organizational strategies for the personnel, vehicles, and equipment of the professional mobile medical service – the ambulance.
A simultaneous concern is that the benefits of the advanced medical care currently administered by ambulance personnel become marginalized if the ‘right care’ provided by the EMS is not accompanied by the ‘right time’ – since time is often the greatest factor in mortality outcomes. Legislation requires hospitals to provide emergency medical treatment to anyone requesting it, regardless of their ability to pay for the services. Part of the legislation requires that EMS be staffed and ready for dispatch at all times, including a critical component of EMS services: the ambulance, which must be present for ready patient transport. It is therefore a priority to increase the potential of ambulance vehicles, as agencies and urgent care providers often wish to provide the best service possible. Such an analysis can also be undertaken to ensure that ambulance design continues to meet the capabilities of the ambulance crew. Thus, a wide-reaching and thoroughly documented analysis of the necessary content in emergency ambulances has been provided in order to fill that gap in the literature. The design and engineering of ambulances may now be improved by understanding the evolution of ambulance design and considering the multiple ways in which the roles we expect ambulances to play in the future will change. These aspects are discussed at length in this paper.
2. History of Ambulance Design Ford Transit Ambulance
The Ford Transit Ambulance, as we know it today, exists to transport injured or sick people from wherever they become injured or sick to a hospital. But it wasn’t always like that. The modern ambulance has been shaped by history, by technological advances, and by a gradual change in our attitudes toward medical care, safety, and emergency response. Ambulances predate cars by 100 years, when it was made quite obvious that sick, injured, and dying people needed a better way to get to the hospital than being unceremoniously dumped on the side of the street. But ambulances haven’t always been advanced life-support systems with lights, sirens, and reflective tape. Indeed, the first “ambulances” were little more than carts thrown together in times of crisis to get as many injured people as possible to the “hospital” as quickly as possible.
Once motorized vehicles were commercialized in the late 1800s, the concept of “ambulance” quickly began to shift. With faster and more reliable cars, ambulance horses became more and more scarce. There were three primary types of ambulances used during this time: the traditional second-hand coaches, wagons, and hacks, and the Type-2 and Type-3. By the time of the Spanish flu pandemic in 1918, motorized and horse-drawn vehicles were having to bend to a whole new set of rules for transporting the sick and dying. On Halloween of 1918, the Ford Model T marks the first Type-1 Ford-based ambulance, and we’ve been building them ever since. Early on, there were no standards, and every ambulance was built to order. Over the years, these standards have evolved from guidelines based on luxury, convenience, and practicality to modern kitted-out ambulances built to treat patients and hold the maximum number of people. Ford established a partnership with some of the nation’s top ambulance builders in 1965, selling them an appropriate chassis to be prime-moved to or ridden in hospitals called a “box”.
3. Ford Transit Ambulance: A Brief Overview
The Ford Transit is one of the most versatile vehicles on the market and is used in numerous fields, including as an ambulance. The van has numerous configurations that can be adapted to fit specific applications. In the ambulance industry, it is a mid-size vehicle with dimensions of about 11-12.5 feet overall height, 6-7 feet overall width, and a weight of 6,800-8,400 pounds, with a gross vehicle weight rating ranging from 9,900 to 10,400 pounds. Ambulances are also referred to by many other terms, including emergency transport vehicle, emergency medical service vehicles in the U.S., and increasingly called patient transport vehicles in some markets. This van has efficient space, comfort, and power while having less length than larger medium-duty ambulances and a lower height than the Mercedes-Benz Sprinter due to an emergency blue-light bar.
The Ford Transit is a well-proven design, with more than 10 million vehicles sold since it was first introduced in Germany in 1953. In the United States, Ford began offering the Transit in 1961 as the Ford Econoline, replacing the two-seat station wagon that was based on the Ford F-series, which had been turned into a van. These vans were available with multiple lengths and heights as Station Bus. A revamped version of the Transit, called the T-series, was offered in the United States as the Ford T-series in 1948-1949. Over the years of production, the Transit has expanded in size, complexity, and capabilities, but it has retained a reputation for reliability. In 2021, Ford delivered 490,189 Transits in the U.S., which marks the van’s first year in which half a million units were built. In 2022, sales of the Transit once again broke car history records with more than 540,000 units sold in the U.S. The majority of which are cargo and passenger vans; however, almost 48,000 are Transit cutaways. On the ambulance side for 2020, Ford Transit Mid Rooftops make up 23% of class 3 chassis in ambulance service.
4. The Role of Ford Transit in Emergency Medical Services Ford Transit Ambulance
The Ford Transit has ascended to conference-room table standing and is now recognized as an essential and growing part of the global ambulance market. It has been used by ambulance conversion companies and organizations worldwide due to its rigid construction and status as a full-size, unibody vehicle. It has an open floor plan which can fit several different module designs, including a crew van. It has factory-installed wide-mass suspension and oversized tires to minimize rear-end sag and improve ride quality, allowing for a smoother glide through the ups and downs of anyone’s town. The van comes standard with a keyless emergency egress system. This lets the driver and/or passenger push a button to unlock the ambulance doors to escape without looking for the key. The Transit serves a variety of auxiliary and combo roles.
A 148″ Ford Transit was placed at the stand and completed a Type III conversion, rebranding the vehicle in some regions and in other regions. It has been utilized with the ambulance conversion since 2024, with successful deployment in both rural and urban areas. Three shifts of personnel provide continuous coverage for meandering moose and auto accidents. The off-road performance is an excellent fit for the hilly terrain. Market performance keeps Ford relevant in the competitive van marketplace. The Ford Transit is larger than domestic imported vans but not as lengthy. EMS services in Maine and other rural regions of the U.S. have embraced the “Flex” interior and the benefits of a tight conversion. Ford emphasizes ergonomic design because ambulance assistants operate in confined spaces for long periods. In addition to the advantages of a lowered level of care, the specialists found this design to be of significant value.
5. Key Features and Innovations of Ford Transit Ambulances
These vehicles offer higher technological advances, more efficient and ergonomic features, as well as the highest design applied to improve the safety and health of patients and health professionals. The interior space is larger and, therefore, wider and has more usable equipment. Moreover, it has a better storage capacity in the same volume of vehicle compared to others, since the layout has been studied based on almost 10 years of studies.
The ambulance is much more than a van adapted to transport patients. It is an integrated management unit where coordination between hospitals and health centers, the value chain of public health transport, and the central unit for sanitary emergencies is made. Data, external traffic, environmental events, and signals controlled by agents in traffic, as well as intelligent road signs collected by cars with the same radio frequency, are all part of the management system. The management is computerized using the most advanced telemetry systems. Inside, the eradication of noise and ergonomics contribute to enhanced security for the occupants.
It is not only a matter of making it beautiful and adapted to space needs or environmental care, and providing physical access for disabled people and young individuals, but it is also about convincing the health authority that those who must establish a permanent contract for a longer duration in those ambulances, interacting with patients, should prioritize safety, not only for the medical staff during the introduction. Security includes airbags in ambulances, electronic cells, and mobile telephony designed not to distract from the emergency point when assistance is needed. This is the foundation for developing technology in sanitary care and safety assistance. You would be surprised at how your customers welcome these new safety and comfort items.
6. Safety and Regulatory Standards for Ford Transit Ambulance
In each phase of the design process, priority is given to the safety of the patients who are going to be transported and the emergency medical service (EMS) providers who are caring for them. Ambulances today are equipped with several features to help protect against trolley loads becoming projectiles, to help secure patients against sudden vehicle movement, and against the vast majority of driving-related trauma. Design and equipment are now guided by local, state, national, and even international regulations. In the U.S., national standards drive vehicle dimensions and minimum equipment needs, and the vehicles themselves must comply with crash, safety, and emissions regulations in which they operate.
Every effort is made, following the design phase, to ensure that the vehicle and its equipment are tested and operated to regulatory specifications. Operating in nations around the world, manufacturers are familiar with the complex engineering and design required to ensure compliance and to facilitate certification, sale, and operation. Ambulance standards and testing specify many features, some of which are critical to the design of the vehicle. Some EMS vehicles feature trauma-based technology which is consistent with their crash test and safety rating of a vehicle itself. Non-compliant vehicles are not only illegal in operation but the manufacturers or operators may also be held liable should mishaps occur in which compliance may have lessened injury. Ambulance service providers also continually train their drivers and EMS providers through courses offered by both the agencies themselves and outside companies.
7. Ergonomics and Human Factors in Ford Transit Ambulance Design
The ergonomics, or human factors, of ambulances and the Ford Transit configuration in particular can be broken down primarily into two major aspects: how the equipment is laid out and what can be reached and accessed, as well as how well the patient can be accessed within the vehicle. The necessity of both of these items is a result of the physical layout limitations of working in a van-style vehicle. Ergonomics is a particularly important aspect of ambulance design. Additionally, several studies have shown that the majority of injuries sustained in Emergency Medical Services are not a result of lifting or extrication, as is commonly believed, but as a result of being moved around in high-stress environments. It is well understood from the physical sciences that physical injury can manifest as an exacerbating cycle where pain causes compensatory muscle use, which results in more pain, and so on, quickly causing fatigue. Therefore, user interfaces and overall design that promote physical strain in a vehicle where medical providers spend significant amounts of time indeed have an effect on the overall clinician’s performance and behavior, and may indeed negatively affect patients.
In a user-centered design, such as patient and paramedic-centered design of an ambulance, several aspects need to be considered. From the patient’s side, these include access (how high the vehicle sits versus how tall they are for patient self-loading), comfort while on the stretcher (including the ability and ease of communicating with the paramedic in the back), and, of course, the design from the point of view of staff providing care to these patients. To this end, while many researchers have called for more evidence-based practices and designs within the ambulance environment, there is little evidence to guide guidance. This study aims to fill this gap within the transit-style ambulance by investigating the performance of medical personnel providing patient care in such vehicles, in contrast to those working in traditional module-style vehicles. Ultimately, in the development of the next generation of ambulances, it has been recommended that more detailed research should be conducted to obtain quantitative data concerning the physical performance of workers and the ergonomic proportion of their jobs.
8. Comparative Analysis: Ford Transit Ambulance vs. Other Ambulance Models
When compared to every other ambulance model in the market, Ford Transits have always proven to be the most versatile, thus easiest to upfit and the most cost-effective to maintain. Users across America have lauded the Ford Transit for its ride, maneuverability, mileage to the gallon, bending radius, and the ability to get in and out of tight spaces. It is available in a standard and high roof, its width simply unmatched when it comes to head-to-head interior space.
The styling of the Ford Transit, new to the ambulatory economy, has mostly been well accepted by emergency medical technicians where such styles are in use. Use of the Ford Transit, despite customization for general patient transport, requires only a B class driver’s license, a real advantage where staffing is tight. In fact, the Transit’s ambulance design may be one of the most innovative designs available on the market today. Like all other van-type ambulances, it does have its limitations. An undercover observer survey suggested that the emergency workers driving the ambulances were not nearly as satisfied with van-type work trucks as they seemed to be with their larger truck-type counterparts. The latter vehicles generally have more room behind and in front of the chassis cab for patient care ergonomics.
9. Case Studies: Successful Implementations of Ford Transit Ambulance
I. Case Studies
1. Multi-region: North Carolina, Wisconsin, Texas, New York City Ambulance Provider: Currently running between 200 and 300 Type II Ford Transits
As EMS providers explore Type II ambulances and the Ford Transit as a potential option, many questions come up. Is the passenger Ford Transit performing well as an ambulance outside of the urban environment? Yes. Are crews satisfied with their choice? Yes. So, we asked some of these North Carolinians, Wisconsinites, Texans, and New Yorkers to give us additional feedback and possibly shed some light on what makes the Ford Transit perform satisfactorily. Here are their stories:
2. Great River Regional Medical Center Region: 10 counties spread over 2,000 square miles Population: Approximately 62,500 Call Volume: 2022 calls in 2015 (0.64 calls per resident), 3,200 calls in 2020 Owned or Lease: Lease for 270 months
Ford Transit Layout:
• Interior features lowered painted aluminum floor and Havis floor track system to accommodate stair chair and cot securement system with no drilling. • Antilock braking system and independent rear suspension for a smooth ride. • 10-inch body length extension designed and installed by modifier. • Ceiling-mounted heating and AC ducts with additional medicine cabinet in driver’s compartment to accommodate EpiPens, glucometer, ABHR, and other medical supplies and personal protective equipment. • Custom graphics to promote flu shots, gardener’s safety, bike helmet use, and seat belt safety for children under 8 and car seat laws.
10. Future Trends and Technologies in Ford Transit Ambulance Design
This project has set out to understand the present landscape of rich variation against which Ford Transits that serve as ambulances have emerged, thrive, and also evolve. Some elements of this complex system have been unlocked; key trends described are county system directors and communication centers whose business challenges are timing—intervening before a small acutely ill population of very young and very old patients reaches the most critical, most centralized, and most expensive hub for highly specialized treatment in spite of turnaround delays. Against this need, telemedicine at hospitals is beginning to extend into mobile ambulances, networking with system planners. Research trends point to a desire for bigger, more robust data sets, faster diagnosis, and above all, response integration, harmonization, and data transmission on moving vehicles.
Several technologies are emerging that are likely to change the way we perceive ambulances and design potential spaces for their operation. These include such ideas as the rise of robotic surgery, the integration of telemedicine technologies, the use of autonomous vehicles, research into the use of electric engines, growth of diagnostic telehealth, and finally, systems integration that leverages telehealth data in concert with electronic medical records and bed turn predictions for improved response timing on the system level. As any one of these technologies seems poised to revolutionize the prehospital care environment in multiple ways, it seems plausible that a vision including all such trends is only a slight extrapolation of the possible future of ambulance manufacture. Combined with this may be a trend toward sustainable design as part of rethinking product packaging in new contexts, and mass casualty preparedness and the potential role of triage in determining if a traditional multi-patient carrier is the best, most efficient, or most ethical use of product for both manufacturer and consumer systems. Of especial intrigue in these latter contexts might be the role of scenario generators; as of this writing, simulators are used within hospital systems to train teams. A mass casualty scenario generator for paramedicine might be of interest to a trainee planning customer.
11. Conclusion and Implications for the Industry Ford Transit Ambulance
Conclusion
The Ford Transit ambulance has been a true game changer for the EMS industry. In a little over a decade, Ford Transits have gone from a quirky European van unsuitable for the American market to completely dominating the ambulance market. It has reshaped the industry by bringing ambulances off of larger Type II platforms onto smaller ones. This has driven innovation and brought our work environments more in line with the ergonomics of modern medicine. Unfortunately, the increased use of the vehicles has not been accompanied by a decrease in injuries and illnesses. It is important to continue this path of innovation as we redesign and evolve the role of ambulances and the environments they are used in. The ambulance market and modern medicine continue to evolve, and if we are to design forward-thinking ambulances, we need to adapt our ambulance specifications in concert with the specialized requirements of the local EMS providers.
This paper has delved into the history of the piece of equipment with which the vast majority of us started our profession and the new technology behind it. By using the Ford Transit van, we were able to provide ambulances better equipped and with the most up-to-date features in the ambulance industry. What we did learn also has implications for the industry. While we didn’t gather comparative data, it is an interesting side note that we have only one reported line of duty injury in the crew compartment of Type III built via the van conversion after two years of service. The highly curved ergonomic seating, as well as equipment placement, suggest an advanced structural design that will prevent our crews from becoming a human projectile. The increased width and headroom are key features for placing an ambulance designed to house a lift. The overall ergonomic configurations suggested in the initial designs offer an exciting insight into the next generation of ambulances. The van-to-ambulance conversion process is interesting for investigation and certainly an area for improvement and development in future research and standard updates. To continue the evolution of the ambulance, one must examine the rise of ergonomics in the EMS industry to assist in the design and placement of equipment for the next generation of vehicles. Further, one might wish to examine the design and symmetry of the vehicle in additional patient studies to examine the influence of each on patient compartment comfort. Finally, while consideration of the practitioner’s environment was paramount, there is a lack of research on crew member or EMT trauma resulting from collisions while in the ambulance as well as in and around ambulances at accidents and disasters. It is our position that this cannot be completely abrogated by design, but EMT feedback and comments will continue to be important in vehicle and vehicle design specifics, and our vehicles have attempted to address the issue over basic vehicle design.
