Guest guest Posted October 27, 2010 Report Share Posted October 27, 2010 Things seem to go in circles. In the late 80's/ early 90's many people thought that this would be the answer. Our department had one for over 10 years. It had a very rough ride. Has anyone proven that these units last longer, or are more cost effective or is it an opinion? Will the larger unit double as a rescue unit with some type of rescue equipment or will it be just a larger transport unit? As with everything, the added cost would have to be justified to approve the change. Steve My opinions are my own... From: texasems-l [mailto:texasems-l ] On Behalf Of Shaw, Kenny Sent: Wednesday, October 27, 2010 3:11 PM To: texasems-l Subject: Big Ambulances EMS Officials in Texas City Say Bigger Ambulances Will Help Drive Costs Down BY ROBIN PYLE Lubbock Avalanche-Journal, Texas In the case of ambulances, Lubbock EMS officials say bigger is better. They believe new bigger ambulances will help increase efficiency, lower maintenance costs and possibly provide more lifesaving opportunities, though it comes with a bigger price tag too. The new ambulances started rolling out on Lubbock streets late last week, said Teague, director of Lubbock's Emergency Medical Services. Within the next two weeks, eight of the nine units in the local fleet will be replaced by the much larger International Wheeled Coach ambulances, which span a little more than half a foot taller and a foot wider. While the cost is roughly $250,000 more to switch to the eight larger units, officials say the long-run cost savings derived from a longer life span make them a better financial decision. The total price tag is about $1.37 million. The first thing drivers might notice about the new ambulances is the driver's cab, which looks like those seen on a tractor-trailer rig. But the most significant improvements won't be seen from a driver's view in traffic, officials say. " It will benefit the public, " Teague said, noting improved conditions for medics and enhanced features will ultimately benefit patients. Others agree this particular ambulance is among the best on the market. Buzz Tallant, regional salesman for San Ambulance Sales, said the type of ambulance has become a popular option for bigger cities in the past eight to 10 years. For example, Austin has been using the same kind for more than 11 years. Lindsley, operations supervisor for the Austin- County EMS, said they've been well worth it. The bigger ambulances are designed to handle more and last longer, which is something larger cities need because of higher usage and demand. But while smaller towns generally have smaller ambulances, Tallant said, that doesn't mean those communities have inferior vehicles because they have what they need. Lubbock's needs are bigger now as the city continues to grow, Teague said, noting EMS call volume has more than doubled in the past 10 years, from 15,000 calls annually to 35,000. " We run more calls today, and (the old ambulances are) not able to keep up (as well), " Teague said. Better features The bigger size means more working and storage space for emergency personnel. Increased weight capacities also allow more equipment and personnel on board. The ambulances come equipped with mini-refrigerators, meaning medics will no longer have to rely on a cooler. But the fridges could have a more meaningful impact and actually could help emergency personnel save more lives. Teague said they will be able to store more medications and fluids inside because of the controlled temperatures, which opens up more possibilities for conducting more lifesaving procedures en route to the hospital. For example, local officials are looking into the possibility that medics can conduct hypothermia treatment aboard the ambulances for cardiac arrest patients, a proven therapy that increases the chances of surviving by lowering the core body temperature. Being able to do the procedure sooner might help save more lives. They'll be studying the idea and possibly be ready to offer it as early as January 2011, Teague said. Another bonus is the new ambulances also have hydraulic suspensions, which means the ambulances can automatically lower so crews can get patients in more easily. Teague hopes the new ambulances also will be more visible in traffic so residents are more aware of them. He didn't think there would be any problems with maneuvering them despite their size, noting that they actually do pretty well on the roadway. Lindsley said the vehicles in Austin have proven to be safer for emergency personnel because of their bigger size, though the same might not be true for another vehicle involved in a crash with the large ambulance for the same reason. Crashes involving ambulances are not common in Lubbock, and most are minor accidents involving residents rear-ending ambulances, officials say. Cost and savings The cost of each new ambulance was $172,000 compared to about $140,000 each for the old ones, Teague said. However, that was a reduced priced after trading in the old ones. That adds up to a difference of about $256,000 for the total purchase compared to if officials had bought the smaller ones. But Teague said that money will be saved in the long run because maintenance costs are expected to be lower since the bigger ambulances generally last longer and can handle more. They're known for running at least 200,000 miles without major problems -- about 70,000 miles more than the old ones. And because they have a nearly doubled weight capacity, they should experience less wear and tear on parts such as brakes and suspension. Previously those parts saw a lot of wear and tear because they were " constantly maxing out " on weight capacity, causing more strain to the vehicle, Teague said. " It's really going to save us a lot more money on maintenance costs, " he added. However, officials didn't yet know exactly how much maintenance would cost in comparison. The initial cost was already calculated into the hospital's general budget so the new ambulances aren't going to cause tax increases or take money away from other areas, said Greg Bruce, vice president with University Medical Center, which operates Lubbock EMS. The timing is right, he said, since most of the fleet needed to be replaced this year Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2010 Report Share Posted November 4, 2010 On Wednesday, October 27, 2010 23:15, " Lemming, Steve " slemming@...> said: > Things seem to go in circles. In the late 80's/ early 90's many people > thought that this would be the answer. Our department had one for over > 10 years. It had a very rough ride. Has anyone proven that these units > last longer, or are more cost effective or is it an opinion? It seems that another factor to consider would be the deployment strategy of the agency. Those who utilise SSM dynamic deployment tend to rack up a lot more numbers on their Hobbs than their odometer. Consequently, engine life cannot be simply evaluated by mileage life only. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2010 Report Share Posted November 4, 2010 I usually do not interject things on here, just a watcher. But since I am an ambulance salesman, I thought I would make a few points to consider. A medium duty ambulance has many practical uses. I have found though, that the same work can be performed in a Type 2 as a Medium duty. You may be more cramped, but so are helicopters. The bigger the chassis, the easier it is to work on because there is more room. True and not, because trying to get that motor out if it needs to come out for any reason is not an easy task. I haven't seen any evidence that the bigger chassis last longer, the life of the truck depends on the motor, how hard it is pushed, etc. The ride problem is actually an easy fix. A lot of that depends on which air ride suspension being used. There are some that are more suitable for the Medium Duty ambulances. Medium Duty ambulances have their place in the EMS world, you just have do a complete evaluation of your system to make sure they are suitable. Dudley has a perfect system for them. Ask him. Feemster RE: Big Ambulances On Wednesday, October 27, 2010 23:15, " Lemming, Steve " slemming@...> said: > Things seem to go in circles. In the late 80's/ early 90's many people > thought that this would be the answer. Our department had one for over > 10 years. It had a very rough ride. Has anyone proven that these units > last longer, or are more cost effective or is it an opinion? It seems that another factor to consider would be the deployment strategy of the agency. Those who utilise SSM dynamic deployment tend to rack up a lot more numbers on their Hobbs than their odometer. Consequently, engine life cannot be simply evaluated by mileage life only. Rob ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2010 Report Share Posted November 4, 2010 On Thursday, November 4, 2010 20:05, danielfeemster@... said: > Medium Duty ambulances have > their place in the EMS world, you just have do a complete evaluation of your > system to make sure they are suitable. Dudley has a perfect system for them. Great input, ! Thank you! I figured it had to be a choice tailored to the needs of a given system, and certainly not a universal thing. That's why I speculated on the deployment issues. If you or Dudley could give us more info regarding the types of systems in which their benefits are maximised, I would love to hear it. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2010 Report Share Posted November 4, 2010 Seems I picked a great time to check back in. We do utilize medium duty units. 2 of them do carry significant additional equipment (hydraulic generator, combination spreader/cutter hydraulic rescue tool, 20 gallon dry CAFS system, etc) but we purchased 2 before we went down the crazy rescue path. Our reasons for purchasing medium duty trucks were/are: 1. Our plan is to keep our vehicles for many years. Hopefully we can get 8-10 years frontline and 3 or more years as a reserve. The standard Type I and III chassis were not able to live this long 2. The majority of Type I and III ambulances are built right at their Gross Vehicle Weight, or in simpler terms, once built, they weigh almost as much as the chassis is designed to carry...or they operate near 100% weight carrying capacity at all times and this is before we add people and equipment. A Medium Duty Chassis is about 6,000 pounds below its GVW when delivered. 3. Not being at the max GVW provides a longer, easier life on the drive train. Our last Type III truck is on its 3rd transmission. None of our 4 medium duty trucks has had any significant drive train issues and our oldest has over 250K miles on it. 4. The truck is BIG...in most collision potentials, WE WIN! 5. The Ford 6.0 diesel engine 6. We believe we will have a larger resell value when we finally get rid of one. Not proven, but the one that we totalled is still getting inquiries on Ebay for a pretty significant amount of money. Cons of the Medium Duty 1. Standard maintenance is higher cost (oil is measured in gallons in a medium duty engine, not quarts) 2. The ride is rough, but recent changes in air ride suspensions by some manufacturers is improving this...Unfortunately, Type I chassis are also very rough riding trucks. There are very good after market air ride suspension systems for Type I trucks and Medium Duty Chassis. Plus, inquire how your builder balances and attaches your module to your chassis. This is also a significant factor. 3. The trucks are bigger, there is a training curve for a number of employees. It is not significant, but it is there. 4. The trucks do have a higher initial cost. Depending on what Type I or Type III chassis you are using, there could be a 20 - 40K initial cost difference. Just some ramblings this evening... Dudley > > On Thursday, November 4, 2010 20:05, danielfeemster@... said: > > > Medium Duty ambulances have > > their place in the EMS world, you just have do a complete evaluation of your > > system to make sure they are suitable. Dudley has a perfect system for them. > > Great input, ! Thank you! I figured it had to be a choice tailored to the needs of a given system, and certainly not a universal thing. That's why I speculated on the deployment issues. If you or Dudley could give us more info regarding the types of systems in which their benefits are maximised, I would love to hear it. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2010 Report Share Posted November 11, 2010 I agree with your points whole heartedly! Re: Big Ambulances On Thursday, November 4, 2010 20:05, danielfeemster@... said: > Medium Duty ambulances have their place in the EMS world, you just have do a complete evaluation of your system to make sure they are suitable. Dudley has a perfect system for them. Great input, ! Thank you! I figured it had to be a choice tailored to he needs of a given system, and certainly not a universal thing. That's why I peculated on the deployment issues. If you or Dudley could give us more info egarding the types of systems in which their benefits are maximised, I would ove to hear it. Rob ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2010 Report Share Posted November 13, 2010 Having worked in a system that utilized medium duty units, the biggest problem with this type of set up is fender judgement. The Austin toll both is a good example. Even a better example is arriving at a ER that has a small, narrow, covered unloading area and finding a medium duty unit parked right in the middle. Services that choose to utilize medium duty units need to have regular scheduled training on a driving course that will allow good fender judgement and vehicle handling.  Danny Denson Subject: Re: Big Ambulances To: texasems-l Date: Monday, November 8, 2010, 4:30 PM  Well - I agree with Dudley. You have to know how to use the GVW on the vehicle, and you absolutely must talk you your builder or dealer and figure out how they utilize the GVW, otherwise it can turn into a miserable situation. Dallas had bigger units at one point, but figured out, that as hard as they run, and the tight spaces that they have to get into (narrow streets, etc.) that the most common used apparatus, the ambulance, could go smaller. Austin is doing the same thing, going a bit smaller with an F-450, instead of a Medium Duty Chassis, if I am not mistaken. Like Dudley said, and he is the safety guru, in the bigger ambulances, in a collision situation, most often, you win. But, if you remember, Austin had an accident at a toll booth where that truck was peeled like a can of sardines. Miami - Dade uses big Medium Duty ambulances built by Braun, obviously a busy system, but the bigger trucks work well for them. Chicago uses Type 1 F-450's. You also have to consider the training involved to operate a big ambulance. Make sure that all people driving complete an EVOC course on any ambulance type that you use or are looking at going to. Just always make certain that you have the proper training in place for those that drive the bigger units, and document that training, and re-train them as often as neccessary because I may have a pickup, doesn't mean I can drive a school bus! Feemster Re: Big Ambulances On Thursday, November 4, 2010 20:05, danielfeemster@... said: > Medium Duty ambulances have their place in the EMS world, you just have do a complete evaluation of your system to make sure they are suitable. Dudley has a perfect system for them. Great input, ! Thank you! I figured it had to be a choice tailored to he needs of a given system, and certainly not a universal thing. That's why I peculated on the deployment issues. If you or Dudley could give us more info egarding the types of systems in which their benefits are maximised, I would ove to hear it. Rob ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2010 Report Share Posted November 13, 2010 Totally concur with what Danny said. Wes Ogilvie Sent from my iPhone > Having worked in a system that utilized medium duty units, the biggest problem with this type of set up is fender judgement. The Austin toll both is a good example. Even a better example is arriving at a ER that has a small, narrow, covered unloading area and finding a medium duty unit parked right in the middle. Services that choose to utilize medium duty units need to have regular scheduled training on a driving course that will allow good fender judgement and vehicle handling. > > Danny Denson > > > > > Subject: Re: Big Ambulances > To: texasems-l > Date: Monday, November 8, 2010, 4:30 PM > > > > Well - > > I agree with Dudley. You have to know how to use the GVW on the vehicle, and you absolutely must talk you your builder or dealer and figure out how they utilize the GVW, otherwise it can turn into a miserable situation. Dallas had bigger units at one point, but figured out, that as hard as they run, and the tight spaces that they have to get into (narrow streets, etc.) that the most common used apparatus, the ambulance, could go smaller. Austin is doing the same thing, going a bit smaller with an F-450, instead of a Medium Duty Chassis, if I am not mistaken. Like Dudley said, and he is the safety guru, in the bigger ambulances, in a collision situation, most often, you win. But, if you remember, Austin had an accident at a toll booth where that truck was peeled like a can of sardines. Miami - Dade uses big Medium Duty ambulances built by Braun, obviously a busy system, but the bigger trucks work well for them. Chicago uses Type 1 F-450's. You also have > to consider the training involved to operate a big ambulance. Make sure that all people driving complete an EVOC course on any ambulance type that you use or are looking at going to. Just always make certain that you have the proper training in place for those that drive the bigger units, and document that training, and re-train them as often as neccessary because I may have a pickup, doesn't mean I can drive a school bus! > > Feemster > > Re: Big Ambulances > > On Thursday, November 4, 2010 20:05, danielfeemster@... said: > > Medium Duty ambulances have > their place in the EMS world, you just have do a complete evaluation of your > system to make sure they are suitable. Dudley has a perfect system for them. > Great input, ! Thank you! I figured it had to be a choice tailored to > he needs of a given system, and certainly not a universal thing. That's why I > peculated on the deployment issues. If you or Dudley could give us more info > egarding the types of systems in which their benefits are maximised, I would > ove to hear it. > Rob > > ------------------------------------ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2010 Report Share Posted November 13, 2010 Totally concur with what Danny said. Wes Ogilvie Sent from my iPhone > Having worked in a system that utilized medium duty units, the biggest problem with this type of set up is fender judgement. The Austin toll both is a good example. Even a better example is arriving at a ER that has a small, narrow, covered unloading area and finding a medium duty unit parked right in the middle. Services that choose to utilize medium duty units need to have regular scheduled training on a driving course that will allow good fender judgement and vehicle handling. > > Danny Denson > > > > > Subject: Re: Big Ambulances > To: texasems-l > Date: Monday, November 8, 2010, 4:30 PM > > > > Well - > > I agree with Dudley. You have to know how to use the GVW on the vehicle, and you absolutely must talk you your builder or dealer and figure out how they utilize the GVW, otherwise it can turn into a miserable situation. Dallas had bigger units at one point, but figured out, that as hard as they run, and the tight spaces that they have to get into (narrow streets, etc.) that the most common used apparatus, the ambulance, could go smaller. Austin is doing the same thing, going a bit smaller with an F-450, instead of a Medium Duty Chassis, if I am not mistaken. Like Dudley said, and he is the safety guru, in the bigger ambulances, in a collision situation, most often, you win. But, if you remember, Austin had an accident at a toll booth where that truck was peeled like a can of sardines. Miami - Dade uses big Medium Duty ambulances built by Braun, obviously a busy system, but the bigger trucks work well for them. Chicago uses Type 1 F-450's. You also have > to consider the training involved to operate a big ambulance. Make sure that all people driving complete an EVOC course on any ambulance type that you use or are looking at going to. Just always make certain that you have the proper training in place for those that drive the bigger units, and document that training, and re-train them as often as neccessary because I may have a pickup, doesn't mean I can drive a school bus! > > Feemster > > Re: Big Ambulances > > On Thursday, November 4, 2010 20:05, danielfeemster@... said: > > Medium Duty ambulances have > their place in the EMS world, you just have do a complete evaluation of your > system to make sure they are suitable. Dudley has a perfect system for them. > Great input, ! Thank you! I figured it had to be a choice tailored to > he needs of a given system, and certainly not a universal thing. That's why I > peculated on the deployment issues. If you or Dudley could give us more info > egarding the types of systems in which their benefits are maximised, I would > ove to hear it. > Rob > > ------------------------------------ > Quote Link to comment Share on other sites More sharing options...
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