AMBULANCES, like accidents just don't happen, they are caused or
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created by people. Take the Department of Health and Social Services standard ambulance as an example: it is the creation of almost seven years work, a lot of research, discussion, experiment and experience. The end product will not only save money but may even become one of our export products.
Does it really matter to the patient being rushed to an emergency hospital reception what make and model of vehicle is doing the rushing? Is the unfortunate passenger even capable of being interested in the thickness of the grp construction of the body, and is it important anyway? Irrelevant as these matters might be to the patient they are very important to the Department of Health and Social Security. They first became important to the Advisory Ambulance Service Committee back in 1970.
The Scottish Ambulance Service has for many years operated a standard ambulance throughout the country. This was a less feasible prospect in England and Wales where the 14 regions operate 6,000 ambulances, all of them either to the specification of one of the major builders or to a version modified by the Area or Regional ambulance officer.
Each authority made its own purchases—some, like London, ordering in bulk annually, others ordering one now and again. DHSS saw the advantages of a standard vehicle and in 1974 it drew on the reservoir of information produced by ASAC and the London Ambulance Service to produce the DHSS standard specification.
It is based on a 118in or 126in wheelbase, and according to DHSS the only suitable chassis on the market are the Bedford CF and the Ford Transit.
The Leyland Sherpa and the Commer PB proved to be too narrow for the original specification. It seems unlikely that Leyland and Chrysler will make it on the revised specification now being prepared by DHSS since the wheelbase specification remains unchanged. The London Ambulance Service opts for a 146-inch wheelbase; the original DHSS specification calls for the 126-inch wheelbase.
This is the major difference between the London Ambulance Service and DHSS specifications although there are 49 other differences. Said a spokesman for the London Ambulance Service: "The others are mainly where to put reflectors and the like."' The importance of the wheelbase length should not be lost. The longer wheelbase allows stretchers to be slung between the wheel arches. The shorter means that the end of the stretcher butts against the bulkhead.
Another point of difference between the standard and LAS version is the use by DHSS of insulation between the grp panels. The LAS argues that fresh air is as effective, and cheaper and lighter.
The case for and against these points is not being argued here. This is only to illustrate the thinking which goes into the final specification.
Another example of what the joint discussion produced was the argument that the long wheelbase version was slower than the 126-inch wheelbase.
"While the lwb can top 70mph on motorway work, the swb is reputed to top 80mph," says _LAS.
Ofits 400 emergency ambulances LAS has 92 lwb
vehicles with more on order.
With such a large authority already going for the longer version DHSS may decide that it would be financially advantageous to change its specification. Bulk purchasing means bigger discounts.
The DHSS specification, although the concept is for domestic use, could find favour abroad. The LAS already has in Australia.
The -standard unit calls for glassfibre bodies which are less resonant than metal and the use of fire retardant resin.
Automatic transmissions are specified to eliminate clutch jerk and patient discomfort. This also takes acount of the different driving techniques of the three drivers who will drive the vehicle every 24 hours, The less downtime then the fewer "maintenance" vehicle that are required; it's another economy aspect which has not been ignored.
Emergency ambulances on average run 20,000 miles a. year on a daily three-shift basis.
They are replaced after 140,000 miles or seven years,. and cannot afford to break down in service. All the preventive measures which can be built into the specification are built in as a long-term efficiency and economy measure.
The maintenance schedules are all based on manufacturers, recommendations and this again is designed to give maximum "productivity."' The next time an ambulance passes with the klaxon in full song, have no thought of the patient being disturbed by the noise. The DHSS says that
inte.rnal noise levels are not a problem. Nevertheless, the vehicles are all petrol-engined as a precaution against noise and vibration.
The CF and Transits are purchased as chassis cowls only. This gives the bodybuilder scope even with the specification. Only the body is specified, the internal fittings are not included. "This is a medical matter, not a transport matter," said the DHSS spokesman.
The standard specification which can be met by the half
dozen ambulance bodybuilders is for eme-rgency ambulances only. It is understood that
another specification for "walking patient vehicles" is also under consideration.
The specification is expected to attract attention from emerg ing nations whose health ser vices are woefully under equipped. Even those who have the money are unlikely to go for the super-sophisticated models available in the USA or Europe. The UK version fills most bills.
Here at home the recognition that standardisation saves money without loss of efficiency is a welcome indication that the public services are not all the careless bureaucratic spendthrifts they are made out to be. The DHSS is shortly to publish a revised specification for the standard ambulance.
While it is preferred that the basic chassis cowl is provided with sliding cab doors, the following modifications are required, but they must be approved by the chassis maker and not invalidate the vehicle warranty.
• Jacking points made, of tubular steel sockets fitted to outriggers are to be fitted beneath the rear skirt. At the front similar points must be fitted and a mechanical or hydraulic jack, capable of lifting one corner of a fully laden ambulance, provided.
• Towing eyes fitted to the chassis frame below the body panel must be supplied, two to the front and two to the rear. These eyes must withstand normal towing and be able to accept a rigid towbar coupling. In addition they must be forward enough on the vehicle to prevent damage to the vehicle during a suspended tow. If necessary a suitably modified spare wheel carrier has to be incorporated with a , cover to protect the wheel stud holes and hub from road contamination.
• The chassis exhaust system has to be re-routed so that the gases are emitted adjacent to the offside rear-wheel.
• A screw-type filler cap with retaining chain has to be fitted and the fuel cut off tap re-positioned if necessary.
• As well as re-positioning the existing vehicle batteries if required, they must be fitted with a battery box, cover, new cables and a battery isolator switch.
• Each new addition to the chassis must be de-rusted and zinc chromate primed with a finish coat of gloss white. Where applicable draught excluding gaiters are to be fitted to gear and handbrake levers.
• The battery isolating switch and fuel cut-off tap must be located adjacent to the driver's footwell with the fuel tap visible from outside the vehicle. To avoid accidental damage the operating handles are to be as near flush as possible.
• Except where otherwise stated, the body should be con
structed from grp braced with mild steel, ash or aluminium alloy sections integrally bond ed. The grp panels must be produced using self-extinguishing resins and made so that adequate access is available for body repairs.
• All woodwork should be treated against rot and woodworm with bolted and synthetic resin joints. Each joint to be reinforced with metal gussets where necessary, wit the plates proofed against corrosion.
• A full height , and width pertition is to be built between the driver's compartment and
the patient area and twin full. height rear doors giving 3ft Sin access with a central rear step well are to be included.
• From the outside, the body should be contoured with a radiused roof at the sides and shaped front and rear.
• In order to maintain a low-floor level, mild steel under-frame outriggers bolted or riveted to the chassis frame side-members should be fitted.
Whenever possible the body should be mounted to existing body mounts and insulated to minimise vibrations.
This information is based on information supplied by the DHSS. • Bill Brock