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{{Use dmy dates|date=July 2020}}
[[File:Armstrong Ambulance P17.jpg|thumb|A [[Ford E-Series]] ambulance with its [[Emergency vehicle lighting|emergency lights]] on in [[Boston]]]]
[[File:NHS_ambulance_rushing_London_SW10.jpg|thumb|An NHS ambulance in south-west London
An '''ambulance''' is a [[Medical device|medically
Ambulances are generally considered [[emergency vehicle]]s authorized to be [[Emergency vehicle equipment|equipped]] with [[emergency vehicle lighting|emergency lights]] and [[Siren (alarm)|sirens]]. Generally, vehicles count as an ambulance if they can transport patients. However, it varies by jurisdiction as to whether a [[Patient transport|non-emergency patient transport]] vehicle (also called an [[#Ambulette|ambulette]]) is counted as an ambulance. These vehicles are not usually (although there are exceptions) equipped with life-support equipment, and are usually crewed by staff with fewer qualifications than the crew of emergency ambulances. Conversely, EMS agencies may also have [[nontransporting EMS vehicle]]s that cannot transport patients.<ref name="essexcar">{{cite web|url=http://www.carpages.co.uk/honda/honda_essex_ambulance_chooses_honda_power_24_07_04.asp|title=Essex Ambulance Response Cars|publisher=Car Pages|date=24 July 2004|access-date=27 June 2007}}</ref>
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Ambulances can be based on many types of vehicle although emergency and [[disaster]] conditions may lead to other vehicles serving as makeshift ambulances:
* '''Van''' or '''[[pickup truck]]''' – A typical general-purpose ambulance is based on either the chassis of a van ("vanbulance") or a light-duty truck. This chassis is then modified to the designs and specifications of the purchaser. Vans may either retain their original body and be upfitted inside, or may be based on a chassis without the original body with a modular box body fitted instead. Those based on pickup trucks almost always have modular bodies. Those vehicles intended for especially [[Intensive care medicine|intensive care]] or require a large amount of equipment to be carried may be based on medium-duty trucks.
* '''Car''' – Used either as a [[fly-car]] for rapid response<ref name=essexcar/> or to transport patients who can sit, these are standard car models adapted to the requirements of the service using them. Some cars are capable of taking a [[stretcher]] with a recumbent patient, but this often requires the removal of the front passenger seat, or the use of a particularly long car. This was often the case with early ambulances, which were converted (or even serving) [[hearse]]s, as these were some of the few vehicles able to accept a human body in a [[supine position]]. Some operators use modular-body transport ambulances based on the chassis of a [[minivan]] or [[station wagon]].
* '''Motorcycle and motor scooter''' – In urban areas, these may be used for rapid response in an emergency<ref>{{cite web|url=http://www.southcentralambulance.nhs.uk/dynamicpage.php?pagerec=60 |title=South Central Ambulance Service NHS Trust – About Us |access-date=18 October 2009 |publisher=South Central Ambulance Service NHS Trust |url-status=dead |archive-url=https://web.archive.org/web/20090303174744/http://www.southcentralambulance.nhs.uk/dynamicpage.php?pagerec=60 |archive-date=3 March 2009}}</ref> as they can travel through heavy traffic much faster than a car or van. [[Trailer (vehicle)|Trailer]]s or [[sidecar]]s can make these patient transporting units.<ref name=motor1>{{cite web|url=http://www.tnn.co.uk/WorldwideNews/plonearticle.2006-07-04.2967165399 |title=News Reference to Motorcycle Trailer Ambulance |access-date=2 June 2007 |publisher=TNN |url-status=dead |archive-url=https://web.archive.org/web/20070927160815/http://www.tnn.co.uk/WorldwideNews/plonearticle.2006-07-04.2967165399 |archive-date=27 September 2007}}</ref><ref name=motor2>{{cite web|url=http://www.ittransport.co.uk/documents/Bicycleambulance.pdf|title=Motorcycle Trailer-Ambulance Brochure|publisher=IT Transport LTD|access-date=2 June 2007|archive-url=https://web.archive.org/web/20070614021104/http://www.ittransport.co.uk/documents/Bicycleambulance.pdf|archive-date=14 June 2007|url-status=dead}}</ref>
* '''Bicycle''' – Used for response, but usually in pedestrian-only areas where large vehicles find access difficult.<ref>{{cite web|url=http://www.londonambulance.nhs.uk/news/news_releases_and_statements/two-wheeled_medics_cover_more.aspx |title=Two-wheeled medics cover more ground in the capital |access-date=18 October 2009 |url-status=dead |archive-url=https://web.archive.org/web/20110427033036/http://www.londonambulance.nhs.uk/news/news_releases_and_statements/two-wheeled_medics_cover_more.aspx |archive-date=27 April 2011}}</ref><ref>{{cite web|url=http://www.londonambulance.nhs.uk/news/news_releases_and_statements/square_mile_cycle-paramedics_b.aspx |title=Square-Mile cycle paramedics become the new City-Slickers |access-date=18 October 2009 |url-status=dead |archive-url=https://web.archive.org/web/20110427033022/http://www.londonambulance.nhs.uk/news/news_releases_and_statements/square_mile_cycle-paramedics_b.aspx |archive-date=27 April 2011}}</ref> Like the motorcycle ambulance, a bicycle may be connected to a trailer for patient transport, most often in the developing world.<ref>{{cite web|url=http://www.designfordevelopment.org/activities/bike_ambulance.html|title=Bike Ambulance Project|publisher=Design for Development|date=20 July 2005|access-date=14 July 2007|archive-url=https://web.archive.org/web/20070928191033/http://www.designfordevelopment.org/activities/bike_ambulance.html|archive-date=28 September 2007|url-status=dead}}</ref>
* '''[[All-terrain vehicle]]''' – Used for response off-road,<ref>{{cite web|url=http://www.quadtech.co.uk/index.php?section_id=100|title=Information on Quadtech EMS quad|access-date=2 June 2007|publisher=Quadtech}}</ref> especially at events or in remote areas. ATVs can be modified to carry a stretcher, and are used for tasks such as [[mountain rescue]] in inaccessible areas.
* '''[[Golf cart]]''' or '''[[Neighborhood Electric Vehicle]]''' – Used for rapid response at events<ref>{{cite web|url=http://www.diversifiedgolfcars.com/standardambulance.htm|title=EMS golf cart brochure|access-date=2 June 2007|publisher=Diversified Golf Cars |archive-url = https://web.archive.org/web/20070405122944/http://www.diversifiedgolfcars.com/standardambulance.htm |archive-date = 5 April 2007}}</ref> or on campuses. These function similarly to ATVs, with less rough terrain capability
* '''Bus''' – In some cases, buses can be used
▲* '''[[Golf cart]]''' or '''[[Neighborhood Electric Vehicle]]''' – Used for rapid response at events<ref>{{cite web|url=http://www.diversifiedgolfcars.com/standardambulance.htm|title=EMS golf cart brochure|access-date=2 June 2007|publisher=Diversified Golf Cars |archive-url = https://web.archive.org/web/20070405122944/http://www.diversifiedgolfcars.com/standardambulance.htm |archive-date = 5 April 2007}}</ref> or on campuses. These function similarly to ATVs, with less rough terrain capability, but with less noise.
▲* '''Bus''' – In some cases, buses can be used for multiple casualty transport, either for the purposes of taking patients on journeys,<ref name="jumbulance" /> in the context of [[Disaster response|major incidents]], or to deal with specific problems such as drunken patients in town centers.<ref>{{cite web |date=18 December 2008 |title=Ambulance crews prepare for party night pressure |url=http://www.londonambulance.nhs.uk/news/news_releases_and_statements/ambulance_crews_prepare_for_p.aspx |url-status=dead |archive-url=https://web.archive.org/web/20160303202825/http://www.londonambulance.nhs.uk/news/news_releases_and_statements/ambulance_crews_prepare_for_p.aspx |archive-date=3 March 2016 |publisher=London Ambulance Service}}</ref><ref>{{cite news |date=17 December 2007 |title=Aboard the 'Booze Bus' |url=http://news.bbc.co.uk/1/hi/magazine/7147646.stm |access-date=1 January 2010 |work=BBC News}}</ref> [[Ambulance bus]]es are discussed at greater length in [[Ambulance bus|their own article]].
* '''[[Helicopter]]''' – Usually used for emergency care, either in places inaccessible by road, or in areas where speed is of the essence, as they are able to travel significantly faster than a road ambulance.<ref>{{cite web|url=http://www.highways.gov.uk/business/15658.aspx |title=Highways Agency – Air Ambulance |access-date=18 October 2009 |url-status=dead |archive-url=https://web.archive.org/web/20090603213633/http://www.highways.gov.uk/business/15658.aspx |archive-date=3 June 2009}}</ref> Helicopter and fixed-wing ambulances are discussed in greater detail at [[air ambulance]].
* '''[[Fixed-wing aircraft]]''' – These can be used for either acute emergency care in remote areas (such as in Australia, with the '[[Royal Flying Doctor Service of Australia|Flying Doctors]]'<ref name=Flying>{{cite web|url=http://www.flyingdoctor.net/|title=Royal Flying Doctor Service of Australia|access-date=2 June 2007|publisher=Royal Flying Doctor Service of Australia|archive-url=https://web.archive.org/web/20070612073357/http://www.flyingdoctor.net/|archive-date=12 June 2007|url-status=dead}}</ref>), for patient transport over long distances (e.g. a re-patriation following an illness or injury in a foreign country<ref>{{cite web|url=http://www.heathrowairambulance.com/repatriation.html|title=Heathrow Air Ambulance Service|access-date=2 June 2007|publisher=Heathrow air ambulance|archive-url=https://web.archive.org/web/20070617031304/http://heathrowairambulance.com/repatriation.html|archive-date=17 June 2007|url-status=dead}}</ref>), or transportation between distant hospitals. Helicopter and fixed-wing ambulances are discussed in greater detail at [[air ambulance]].
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* '''Train''' – In remote or hard-to-reach areas that are accessed primarily by [[railway]] connections, [[train]]s may be used to provide medical care as a mobile treatment facility or transport patients to better care in more accessible areas. These are generally called [[hospital train]]s.
* '''Trailer''' – In some instances, a [[Trailer (vehicle)|trailer]], which can be towed behind a self-propelled vehicle, can be used as an ambulance. This permits flexibility in areas with minimal access to vehicles, such as on small islands.<ref>{{cite web |title=General Information – Medical Services |url=http://www.sark.info/index.cfm?fuseaction=gov.content&cmid=552 |url-status=dead |archive-url=https://web.archive.org/web/20120217064132/http://www.sark.info/index.cfm?fuseaction=gov.content&cmid=552 |archive-date=17 February 2012 |publisher=Isle of Sark Government}}</ref>
* '''Horse and cart''' –
* '''[[Fire engine]]''' – Fire services (especially in North America) often train firefighters to respond to medical emergencies and most apparatuses carry at least basic medical supplies. By design, most apparatuses cannot transport patients unless they can sit in the cab. However, some fire trucks may be designed to have a large ambulance compartment behind the front of the cab, where the driver and officer's seats are located.
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File:Eyr Ytterholmen.jpg|A [[water ambulance]] operated by the [[Norwegian Society for Sea Rescue]]
File:Surgeon Nikolay Pirogov 9.jpg|The "Surgeon [[Nikolay Pirogov]]" [[hospital train]] operated by [[Russian Railways]]
</gallery>
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==Costs==
[[File:American Medical Response AMR Ford Transit Ambulance (52794460376).jpg|thumb|A [[Ford Transit]] ambulance operated by [[American Medical Response]], a privately
[[File:Wellington Free Ambulance 430.jpg|thumb|A [[Mercedes-Benz Sprinter]] ambulance operated by [[Wellington Free Ambulance]], a charity-funded service in [[Wellington]], New Zealand]]
In the United States, the cost of an ambulance ride may be paid for from several sources, and this will depend on the local situation type of service being provided, by whom, and to whom.
* '''Government-funded service''' – The full or the majority of the cost of transport by ambulance is borne by the local, regional, or national government (through their normal taxation).<ref>{{cite web|url=http://www.health.gov.on.ca/english/public/pub/ohip/amb.html|title=OHIP:Ambulance Services Billing|publisher=Ontario Ministry of Health and Long-Term Care|access-date=19 November 2009}}</ref>
* '''Privately
* '''Charity-funded service''' – Transport by ambulance may be provided free of charge to patients by a charity, although donations may be sought for services received.<ref>{{cite web|url=http://www.yorkshireairambulance.org.uk/|title=Yorkshire Air Ambulance Charity|access-date=19 November 2009| archive-url= https://web.archive.org/web/20091125202654/http://www.yorkshireairambulance.org.uk/| archive-date= 25 November 2009 | url-status= live}}</ref>
* '''Hospital-funded service''' – Hospitals may provide the ambulance transport free of charge, on the condition that patients use the hospital's services (which they may have to pay for).<ref>{{cite web|url=https://vic.pvhs.org/portal/page?_pageid=333,429645&_dad=portal&_schema=PORTAL&pagid=108|title=Ambulance Services|access-date=19 November 2009|url-status=dead|archive-url=https://web.archive.org/web/20071025072438/https://vic.pvhs.org/portal/page?_pageid=333%2C429645&_dad=portal&_schema=PORTAL&pagid=108|archive-date=25 October 2007}}</ref>
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[[File:World War I ambulance Pittsburgh 20th Century Club.png|thumb|left|1917 Red Cross ambulance]]
Military ambulances have historically included vehicles based on civilian designs and at times also included armored, but unarmed, vehicle ambulances based upon [[armoured personnel carrier]]s (APCs). In the [[World War II|Second World War]] vehicles such as the Hanomag [[Sd.Kfz. 251|Sd Kfz 251]] half-track were pressed into service as ad hoc ambulances{{citation needed|date=April 2021}}, and in more recent times purpose-built AFVs such as the U.S. [[M1133
Since [[laws of war]] demand ambulances be marked with one of the [[Emblems of the Red Cross]] not to mount offensive [[weapon]]s, military ambulances are often unarmed.<ref>{{cite web|url=http://www.icrc.org/ihl.nsf/CONVPRES?OpenView|title=International Committee of the Red Cross policy on usage|access-date=2 June 2007|publisher=International committee of the Red Cross| archive-url= https://web.archive.org/web/20070706014427/http://www.icrc.org/IHL.nsf/CONVPRES?OpenView| archive-date= 6 July 2007 | url-status= live}}</ref> It is a generally accepted practice in most countries to classify the personnel attached to military vehicles marked as ambulances as [[non-combatant]]s; however, this does not always exempt medical personnel from coming under fire{{snd}}accidental or deliberate. As a result, medics and other medical personnel attached to military ambulances are usually put through basic [[military training]],<ref>{{cite web|url=http://www.armyjobs.mod.uk/jobs/pages/JobExplorerResults.aspx?category=6|title=UK Army information on basic training for medical personnel|access-date=1 November 2009|publisher=British Army|archive-url=https://web.archive.org/web/20090917085424/http://www.armyjobs.mod.uk/jobs/pages/JobExplorerResults.aspx?category=6|archive-date=17 September 2009}}</ref> on the assumption that they may have to use a weapon. The laws of war do allow non-combatant military personnel to carry individual weapons for protecting themselves and casualties. However, not all militaries exercise this right to their personnel.
[[File:USNS Mercy T-AH-19.jpg|[[USNS Mercy (T-AH-19)|USNS ''Mercy'']], a U.S. Navy hospital ship|thumb|left]]
The [[Israel Defense Forces|Israeli Defense Forces]] modified a number of its [[Merkava]] [[main battle tank]]s with ambulance features in order to allow rescue operations to take place under heavy fire in [[urban warfare]].<ref>{{cite web|url=http://www.defense-update.com/products/m/merkava-lic.htm|title=LIC Modeled Merkava Mk-3 Baz / Mk 4|access-date=2 June 2007|publisher=Defense Update |date=July 27, 2006|archive-url=https://web.archive.org/web/20070627140305/http://www.defense-update.com/products/m/merkava-lic.htm|archive-date=27 June 2007|url-status=dead}}</ref> The modifications were made following a failed rescue attempt in which [[Palestinian people|Palestinian]] gunmen killed two soldiers who were providing aid for a Palestinian woman in [[Rafah]].<ref>{{cite news|url=http://news.bbc.co.uk/1/hi/world/middle_east/3713585.stm|title=Three dead in fresh Gaza clashes|access-date=2 June 2007|work=BBC News | date=14 May 2004}}</ref> Since [[M113 armored personnel carrier|M-113]] armored personnel carriers and regular up-armored ambulances are not sufficiently protected against [[anti-tank]] weapons and [[improvised explosive device]]s,<ref>{{cite web|url=http://www.inetres.com/gp/military/cv/inf/M113.html|title=Technical data on armament of M113 APC Ambulance|access-date=2 June 2007|publisher=Inetres}}</ref> it was decided to use the heavily [[Vehicle armour|armored]] [[Merkava]] tank. Its rear door enables the evacuation of critically wounded soldiers. Israel did not remove the Merkava's weaponry, claiming that weapons were more effective protection than emblems since Palestinian militants would disregard any symbols of protection and fire at ambulances anyway.{{Citation needed|date=February 2010}} For use as ground ambulances and treatment & evacuation vehicles, the [[United States military]] currently employs the M113, the [[M577]], the [[M1133]] [[Stryker]]
Some navies operate ocean-going [[hospital ship]]s to lend medical assistance in high casualty situations such as wars or natural disasters.<ref name=ship1>{{cite web|title=US Navy Military Sealift Command – Hospital Ships|url=http://www.msc.navy.mil/inventory/inventory.asp?var=Hospitalship|access-date=17 June 2007|publisher=US Navy Military Sealift Command| archive-url= https://web.archive.org/web/20070629172753/http://www.msc.navy.mil/inventory/inventory.asp?var=Hospitalship| archive-date= 29 June 2007 | url-status= live}}</ref> These hospital ships fulfill the criteria of an ambulance (transporting the sick or injured), although the capabilities of a hospital ship are more on par with a [[Mobile Army Surgical Hospital]]. In line with the [[laws of war]], these ships can display a prominent Red Cross or Red Crescent to confer protection under the appropriate [[Geneva Convention]]. However, this designation has not always protected hospital ships from enemy fire.<ref>{{cite web|title=The sinking of HMHS Llandovery Castle |date=30 October 2000 |orig-year=1920 |url=http://www.gwpda.org/naval/lcastl11.htm|publisher=World War One Document Archive|access-date=27 June 2007| archive-url= https://web.archive.org/web/20070714232216/http://www.gwpda.org/naval/lcastl11.htm| archive-date= 14 July 2007 | url-status= live}}</ref>
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[[Toronto]] City Council operates a "Caravan of Hope" project to give retired Toronto ambulances a second life by donating them to the people of [[El Salvador]]. Since Ontario laws require ambulances to be retired after just four and a half years in service, the City of Toronto decommissions and auctions around 28 ambulances each year.<ref>{{cite web|url=http://www.sanlorenzo.ca/english/Supporting_Hope.html|title=Supporting hope|access-date=7 July 2012|archive-date=21 October 2018|archive-url=https://web.archive.org/web/20181021200005/http://www.sanlorenzo.ca/english/Supporting_Hope.html|url-status=dead}}</ref>
{{
==See also==
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