Ambulance: Difference between revisions

[[File:NHS_ambulance_rushing_London_SW10.jpg|thumb|An NHS ambulance in south-west London, 2011]]

An '''ambulance''' is a [[Medical device|medically- equipped]] [[vehicle]] used to transport [[patient]]s to [[Health facility|treatment facilities]], such as [[hospital]]s.<ref>[[Henry Alan Skinner|Skinner, Henry Alan]] (1949), ''The Origin of Medical Terms''. Baltimore: Williams & Wilkins. {{oclc|459611759}}{{page? needed|date=August 2022}}</ref> Typically, out-of-hospital [[medical care]] is provided to the patient during the transport. Ambulances are used to respond to [[Medical emergency|medical emergencies]] by [[emergency medical services]] (EMS), and can rapidly transport [[paramedic]]s and other [[first responder]]s, carry equipment for administering [[emergency medicine|emergency care]], and transport patients to hospital or other definitive care. Most ambulances use a design based on [[van]]s or [[pickup truck]]s, though others take the form of [[Motorcycle ambulance|motorcycles]], [[Ambulance bus|buses]], [[limousinehearse]]s, [[Air medical services|aircraft]] and [[Water ambulance|boats]].

* '''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.

* '''Horse and cart''' – Especially in the developing world, moreMore traditional methodsform of transport, includemostly horse and cart, usedseen in much[[Developing the same way as motorcycle or bicycle stretcher units to transport to a localcountry|developing cliniceconomies]].

[[File:American Medical Response AMR Ford Transit Ambulance (52794460376).jpg|thumb|A [[Ford Transit]] ambulance operated by [[American Medical Response]], a privately- funded service operating in parts of the United States]]

* '''Privately- funded service''' – Transport by ambulance is paid for by the patient themselves, or through their insurance company. This may be at the point of care (i.e. payment or guarantee must be made before treatment or transport), although this may be an issue with critically injured patients, unable to provide such details, or via a system of billing later on.<ref>{{cite web|url=http://www.amr.net/Patients-and-Family-Members/Payment-Policy.aspx|title=Payment Policy|publisher=American Medical Response|access-date=19 November 2009|archive-date=5 July 2011|archive-url=https://web.archive.org/web/20110705060624/http://amr.net/Patients-and-Family-Members/Payment-Policy.aspx|url-status=dead}}</ref>

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 Medicalmedical Evacuationevacuation Vehiclevehicle]] serve the exclusive purpose of armored medical vehicles. Civilian based designs may be painted in appropriate colors, depending on the operational requirements (i.e. camouflage for field use, white for [[United Nations peacekeeping]], etc.). For example, the British [[Royal Army Medical Corps]] has a fleet of white ambulances, based on production trucks.{{citation needed|date=April 2021}} Military helicopters have also served both as ad hoc and purpose-built air ambulances since they are extremely useful for [[MEDEVAC]].<ref>{{cite web|url=http://www.century-of-flight.freeola.com/Aviation%20history/helicopter%20history/M.A.S.H.%20Medevac%20Helicopters.htm|title=M.A.S.H. medevac helicopters|access-date=2 June 2007| archive-url= https://web.archive.org/web/20070617052953/http://www.century-of-flight.freeola.com/Aviation%20history/helicopter%20history/M.A.S.H.%20Medevac%20Helicopters.htm| archive-date= 17 June 2007 | url-status= live}}</ref> In terms of equipment, military ambulances are barebones, often being nothing more than a box on wheels with racks to place manual stretchers, though for the operational conditions and level of care involved this is usually sufficient.

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]] Medicalmedical Evacuationevacuation Vehiclevehicle (MEV), and the [[RG-33]] Heavilyheavily Armoredarmored Groundground Ambulanceambulance (HAGA) as treatment and evacuation vehicles, with contracts to incorporate the newly designed M2A0 Armoredarmored Medicalmedical Evacuationevacuation Vehiclevehicle (AMEV), a variant of the [[M2 Bradley Fightingfighting Vehiclevehicle]] (formerly known as the ATTV).<ref>{{cite book |last1=Hurd |first1=William W. |last2=Jernigan |first2=John G. |title=Aeromedical Evacuation: Management of Acute and Stabilized Patients |date=18 April 2006 |publisher=Springer Science & Business Media |isbn=978-0-387-22699-6 |page=55 |url=https://books.google.com/books?id=7JYMBwAAQBAJ |language=en}}</ref><ref>{{cite web|url=http://1-22infantry.org/history/forcexxiattv.htm|title=1-22 Infantry tests ATTV|website=1-22infantry.org}}</ref><ref>{{Cite web |url=http://www.dodig.mil/audit/reports/fy01/01012sum.htm |title=Bradley AMEV |access-date=6 January 2012 |archive-url=https://web.archive.org/web/20120916215904/http://www.dodig.mil/Audit/reports/fy01/01012sum.htm |archive-date=16 September 2012 |url-status=dead}}</ref>

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