Ambulances

An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals.^[1] Typically, out-of-hospital medical care is provided to the patient during the transport, an ambulance looks like a big boxy truck.

Ambulances are used to respond to medical emergencies by emergency medical services (EMS). For this purpose, they are generally equipped with flashing warning lights and sirens. They can rapidly transport paramedics and other first responders to the scene, carry equipment for administering emergency care and transport patients to hospital or other definitive care. Most ambulances use a design based on vans or pickup trucks. Others take the form of motorcycles, buses, limousines, aircraft and boats.

Generally, vehicles count as an ambulance if they can transport patients. However, it varies by jurisdiction as to whether a non-emergency patient transport vehicle (also called an 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 emergency response vehicles that cannot transport patients.^[2] These are known by names such as nontransporting EMS vehicles, fly-cars or response vehicles.

The term ambulance comes from the Latin word "ambulare" as meaning "to walk or move about"^[3] which is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements.^[4] Ambulances (Ambulancias in Spanish) were first used for emergency transport in 1487 by the Spanish forces during the siege of Málaga by the Catholic Monarchs against the Emirate of Granada. During the American Civil War vehicles for conveying the wounded off the field of battle were called ambulance wagons.^[5] Field hospitals were still called ambulances during the Franco-Prussian War^[6] of 1870 and in the Serbo-Turkish war of 1876^[7] even though the wagons were first referred to as ambulances about 1854 during the Crimean War.^[8]

• 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 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 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) hearses, 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 and station wagon.
• Motorcycle and motor scooter – In urban areas, these may be used for rapid response in an emergency as they can travel through heavy traffic much faster than a car or van. Trailers or sidecars can make these patient transporting units. See also motorcycle ambulance.

• Bicycle – Used for response, but usually in pedestrian-only areas where large vehicles find access difficult. Like the motorcycle ambulance, a bicycle may be connected to a trailer for patient transport, most often in the developing world. See also cycle responder.
• All-terrain vehicle (ATV) – for example quad bikes; these are used for response off-road, especially at events. 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 or on campuses. These function similarly to ATVs, with less rough terrain capability, but with less noise.
• 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. 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 'Flying Doctors'), for patient transport over long distances (e.g. a re-patriation following an illness or injury in a foreign country), or transportation between distant hospitals. Helicopter and fixed-wing ambulances are discussed in greater detail at air ambulance.
• Boat – Boats can be used to serve as ambulances, especially in island areas or in areas with a large number of canals, such as the Venetian water ambulances. Some lifeboats or lifeguard vessels may fit the description of an ambulance as they are used to transport a casualty.
• Bus – In some cases, buses can be used for multiple casualty transport, either for the purposes of taking patients on journeys, in the context of major incidents, or to deal with specific problems such as drunken patients in town centres much faster than a car or van. Ambulance buses are discussed at greater length in their own article.
• Trailer – In some instances a trailer, which can be towed behind a self-propelled vehicle can be used. This permits flexibility in areas with minimal access to vehicles, such as on small islands.
• Horse and cart – Especially in developing world areas, more traditional methods of transport include transport such as horse and cart, used in much the same way as motorcycle or bicycle stretcher units to transport to a local clinic.
• 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.