EXPLORING THE BENEFITS AND CONSIDERATIONS OF 4WD AMBULANCES

EXPLORING THE BENEFITS AND CONSIDERATIONS OF 4WD AMBULANCES

1. Introduction to 4WD Ambulances

4WD Ambulances; The immediate and long-term exposition of ambulance providers, design engineers, recovery personnel, and patient customers within the emergency ambulance vision pyramid of the role, operation, benefit, co-benefit, costs (including life and death), warranty, unique needs, and mission of 4WD ambulances is also predictive of better ambulance service delivery and ownership. In the global concept of evidence-based special and pressed mobility EMS response capacity, 4WD ambulances stand out as a unique vehicle type that spans road, soil, sand, and water environments, including bridges, cities, hills, mountain areas, and human settlements throughout the world. Their incorporation as the functional type of emergency ambulance provides significant public, professional, and political values. Four-wheel drive ambulances bring basic economic benefits, social benefits, personal benefits, political benefits, security, and ecological benefits. Their discretion-over-ground operation also doubles emergency rescue technicians as mobilizers for other response platforms in areas that present predominant capacity gaps and may not even sync with available resources to support the health sector.

Four-wheel drive (4WD) or all-wheel drive (AWD) ambulances are purpose-designed and fabricated ambulance types for overland emergency medical services (EMS) in varying terrains, locales, climatic conditions, patient injury and illness types, response settings, community infrastructures or health facility connectivity, and threat environments. These ambulances are usually necessary for underserved and under- or unaddressed in-hospital, out-of-hospital, primary, emergency, and special urban, rural, remote, and resource-poor emergency medical services globally. 4WD ambulances provide flexible, reliable, and safe emergency medical services through personnel, equipment, and medical product transport sensitivity to diverse terrains, locales, mission and patient load profiles, medical evacuations, disaster deployments, crisis settings, and connectivity to specialized health facilities to improve population health outcomes with high-quality and timely emergency medical care delivery.

2. Advantages of 4WD Ambulances

In addition, 4WD ambulances can meet the need for high top speed, which can respond more quickly to timely responses, but most 4WD ambulances have a top speed capacity of 100 km/h and are also suitable to meet the needs of ambulance services with reduced drive axle loads for remote areas. Overall, these 4WD ambulance values can help improve patient outcome in a life-threatening event, minimize vehicle recovery costs, and emergency call response time.

Another advantage over 2WD models is the ability to drive confidently in steep gradients, which is a feature that can be accessed through certain gear reductions and graduation versions. Although fuel is a prerequisite for ambulances operating in remote areas, limited payload and the risk of becoming stranded for an extended time without the ability to maintain or produce a reliable fuel supply can still require access to the more economic fuel vehicles, such as diesel fuel for 4WD vehicles.

In contrast to the 2WD ambulance, 4WD ambulances are better at maneuvering remote areas, rough tracks, rough terrains, and/or roads which can have steep gradients compared to 2WD models. An advantage of a 4WD ambulance with greater suspension travel is that it can provide a smoother ride and reduce patient and staff fatigue, while also providing more effective shock absorption over unseen obstacles such as boulders, logs, bridge approaches, trenches, and drainage ditches.

4WD ambulances have several benefits over 2WD models. Not only do they have the ability to access remote areas under natural conditions, but they also offer better traction in winter driving conditions. As a result of the improved traction, the ambulance can continue to provide a service in difficult driving conditions that the 2WD ambulance would have difficulty or be unable to continue.

2.1. Enhanced Off-Road Capabilities

The development and enhancement of specialty 4WD ambulances—vehicles that are part of the ambulance fleet, as well as others, that are designed for the purpose of cross-terrain operations—is an efficient response to the unique challenges to guarantee structure stability while traversing different terrain types. The ability of the 4WD ambulance to reach the injured and related injuries more efficiently than traditional ground ambulances can increase the likelihood of survival by orders of magnitude. The use of 4WD vehicles that have advanced and quick mobilization abilities is a cost-effective investment and can be valuable to trauma patients, even though 4WD vehicles are not specifically recommended among the American College of Surgeries consensus-based guidelines. This is noteworthy at a time when countries around the globe face rising healthcare expenses, including those involving trauma patients.

The first and most widely recognized asset available with the use of off-road capable ambulances is the ability to reach the scene of the injured. For instance, an ambulance may be associated with ensuring that the patient is located as soon as possible, thereby providing greater chances of survival. In more inaccessible zones, such as off-road, speed is of the essence. Arriving off-road via the standard ambulance may lead to a delay in the rescue mission; in some cases being mere minutes can spell the difference between life and death. If the on scene support arrives via 4WD, an additional advantage may be presented—often the patient must be taken to a primary caregiver, and not the receiving hospital, as defined in the brief. This relies on the possibility of organizing the patient for transport to a first-response facility operating in stable and controlled conditions, in non-emergency conditions. This availability of emergency care on the scene can be considered supplementary as it has the potential to contribute positively to the outcome, result, and overall recovery period, as demonstrated by various studies utilizing this supplemental response factor.

2.2. Improved Traction and Stability

Though two-wheel drive (2WD) fire apparatus has served dependably in many areas of the country for decades on both structure and wildland fires, wet or icy conditions present significant challenges, leading to a preference for 4WD vehicles – especially for those in cooler climates. So, what are some of the benefits and considerations of using a 4WD cab and chassis to assemble an ambulance that can ensure medical care to those in need and the personnel making the call?

Many emergency medical calls take ambulances into adverse environments where poor traction or ground clearance could pose a significant risk. These environments could be construction or industrial sites, off-road trails, or even areas of awful traffic, such as Southern California freeways. Having a vehicle that can deliver people to prevent further injury must go beyond the basic 2WD van or chassis-based ambulance. Driving around Southern California highways and streets and answering more than 100 pages for a 2WD ambulance, the driver does have a significant appreciation for some of the calls they have been on (and many more that they did not respond to) and the varieties of units that showed up.

3. Considerations Before Purchasing a 4WD Ambulance

Topography should be of paramount consideration. In mountainous, rough, and/or forested areas, four-wheel drive becomes a worthwhile consideration. Because four-wheel drive systems are relatively expensive to maintain and add weight to the vehicle, predominantly flat, well-maintained surfaces do not warrant the use of a 4WD ambulance. Four-wheel drive systems can lead to a false sense of security in some individuals, with significant numbers of EMS providers becoming involved in accidents while responding to calls in different emergency response vehicles using 4WD or all-wheel drive systems.

There are several considerations the EMS provider should undertake before purchasing a 4WD ambulance. The first important decision is to establish why the vehicle may be needed. If the agency has a high call volume in an area which is difficult to traverse using a traditional ambulance, further consideration is warranted. In some cases, either a snowmobile or walking in and using a snowcat or all-terrain vehicle may be more efficient.

3.1. Cost and Budgeting

Currently, the AWS (all-wheel drive system) ambulance can be expected to cost approximately 7-10% more than the 2WD equivalent ambulance. The only additional vehicle cost, at purchase, is the transfer case (approximately $1,500-$2,000, off list, with quantity discounts available). Limited numbers of 4WD system vehicles require the purchase of higher priced 4WD transmissions instead of the cost-effective markdowns offered on a system comprised of widely utilized assembly line components. Over time, system cost and quantity discounts will likely decrease as 4WD vehicle popularity continues to increase. The next generation of ambulances is more likely to be heavier and more expensive, in part because of next-generation safety, emission, and fuel-economy standards.

When considering a 4WD ambulance, cost is always a primary element. Whether upgrading a current 2WD fleet or purchasing a 4WD vehicle for a non-profit charity organization, the factors typically considered in ambulance purchasing decisions, such as initial cost, ease of service and maintenance, and fuel usage will weigh heavily in the decision-making process. Cost-benefit studies are one of many tools useful in evaluating the 4WD vehicle option. To be effectively utilized during the purchasing phase, such studies require input from those charged with maintaining any future 4WD vehicles. Recruiting mechanics or maintenance personnel from local dealers or repair facilities in order to obtain unbiased and accurate information is advisable.

3.2. Maintenance and Repairs

It’s true that more moving parts result in more wear-and-tear. However, experienced fleet managers argue that the benefits of 4WD ambulances easily outweigh their slight additional maintenance requirements. “U-joints are a prime example of a high wear item on any four-wheel drive system,” explains Powell. “But components are evolving rapidly. The service life of new 4WD unitised steering knuckles are now much longer, and the follow-on repair and replacement costs are much less than they were with the earlier designs.” Furthermore, as with any motor vehicle no matter what type of powertrain it may have, timely preventive maintenance is essential to keep the vehicle in good operational condition. 4WD-equipped ambulances are hardly unique in the system components they rely on, each of which has a recommended service interval. At the normal preventive inspection period, the recommended service is simply completed when it is due. By keeping up with the recommended service intervals, operators of 4WD ambulances can maximize the reliability and durability of their vehicles.

“In the long run, 4WD ambulance systems save the municipality money in repairs,” explains Norm Powell, industry advisor to Owasco Distributors, a sales and service dealer located in Oshawa, Ontario. “Having ambulances off the road for repairs costs a great deal. When the alternatives are as good as they are, it only makes sense for an emergency vehicle to be able to handle the types of terrain that are encountered in many municipalities.” While the incremental costs for 4WD systems – both in purchase price and maintenance – may be slightly higher than they are for traditional 2WD ambulance systems, these costs are quickly offset by the ongoing savings that result from reduced repairs and improved fuel economy. Additionally, a four-wheel drive BHU vehicle gives you added functionality as a bad weather vehicle – in other words, you won’t have an ambulance that cannot make all the calls.”

4. Popular Models and Features of 4WD Ambulances

The Ford Super-Duty E-Series van is large, capable, versatile, and proven in long-duration operations. These Super-Duty E-Series 4WD ambulances underwent rigorous testing by influential members of the EMS community and have importantly performed in reliable fashion in the real world operations of Land-Sea-Air-up-a-mountain-Ky and hillbilly wilderness rescue operations or crowded mass-casualty incidents. The features of these units are superior and the list not only meets Gen II 4WD ambulance design criteria, it greatly exceeds our expectations. Highly respected and highly visible EMS consultants have played significant roles in the design and performance enhancements. As new vans improvements in capability are released from big 3 light truck manufacturers, the designers have worked with their EMS customer base to convert full-sized light truck 4WD variants into ultimate-EMS battlespace Chevrolet and Dodge ambulances.

Over the years, there have been many makes and models of ambulance chassis converted to 4WD. The FMC (Foote, Meyers, and Company) was one of the earliest 4WD conversions. The powerful early Dodge M43 was another notable early model utilizing a 4WD conversion kit. Four-wheel drive ambulances never really became popular until the Ford van chassis was released, where multiple independent conversion vendors had access to the leaps and bounds advancements in suspension, power, and drivetrain amenities when they utilized the one chassis model. Four providers, Economy Truck Equipment (Crowsley), All Terrain Ambulance, Quigley Motor Company, and a relatively unknown niche sports car builder called IMSA, had built and deployed over 2,000 4WD conversions on the modern Ford Van and E-Series/Super-Duty E-Series.

5. Conclusion and Future Trends

Grant research funding, resources, and research manpower at four research institutes GP01, GP02 and a research group (RG), and proposed four topics for robotic research topics, major research items, and topics. According to the results of the research plan over the six-year research period, and summarizing our research achievements, a robotic research project R01 was presented, focusing on task categories, research contexts, and research themes. The main contribution of this project is to conduct research and engineering development related to the proposed topics. In addition, since the successfully developed four human living robots have been demonstrated in prototype form, the design of the robot prototype and related peripheral device systems for providing users with actual services under real-world emergency or disaster scenarios are effectively applicable accomplishments.

For the proposed four-wheel drive (4WD) ambulance prototype, since the 4WD ambulance has demonstrated its superior mobility and reliable capability to transport medical personnel and patients to emergency and disaster sites, the 4WD ambulance can be considered to be efficiently applicable for relief transport operations. Furthermore, as the vehicles were introduced, the implementation of unmanned missile launch cars, high-speed mobile missile launching vehicles, or remote control bomb disposal vehicles has all been implemented through integrated software and hardware capabilities, resulting in unmanned control missile launch cars, high-speed mobile missile launch vehicles to minimize the time to seek battle goals and reach critical areas without detection, or rapid deployment of remote control bomb removal vehicles to remove road obstacles and achieve smooth passage. In addition, the robotized tele-surgical support system has also been proposed for remote tele-surgical support.