Ambulance Guide, Meaning , Facts, Information and Description
An ambulance is a vehicle designated for the transport of sick or injured people. The first ambulances called by that name were horse ambulances used in the American Civil War. The first practical ambulances were created by Dominique Larrey, a French surgeon (1766-1842), for use in the Napoleonic Wars. Modern-day ambulances are typically large automobiless on a van or light truck chassis.
The first civilian ambulance is said to have been set up in Brisbane, Queensland, Australia, in September 1892, following a fall at the Brisbane Exhibition on August 7, 1892, which was witnessed by Seymour Warrian who went on to become the founder of the City Ambulance Transport Brigade. Today the Queensland Ambulance Service has become one of the largest ambulance services in the world. Alexander Graham Bell is also said to have played a part in spreading the news of this civilian ambulance service around the world as he travelled promoting his invention the telephone.
However, an ambulance can be any vehicle, including a bus, helicopter, or even a hospital ship. During the 1960s and 1970s, station wagons were used in some American cities (despite their limited space) and can be seen in motion pictures from that period.
Civilian ambulances use the symbol referred to as the "Star of Life," a blue six point star, originally designed and governed by the NHTSB. Any unit displaying this star is said to be qualified to render its specific level of emergency care.
Under the laws of war, an ambulance marked by a red cross is not to be fired on and is to be permitted to carry out its duties in spite of the fighting. An ambulance may not mount weapons, although the Israelis have produced a "tankbulance" that combines a Merkava main battle tank with ambulance features.
Ambulances in both the United States and Canada are defined by KKK-1822E requirements which defines several categories of ambulances.
1. Volunteer Ambulance Corps or services - like Volunteer Fire Companies, are the most common and may be found everywhere, from NYC to the smallest rural community. May be community owned or privately owned, usually non-profit.
2. Private Ambulance Service - Normal commercial companies of which the largest is AMR or American Medical Response. Most are usually only patient transfer services without an emergency capability although some are dual capable.
3. Municipal Third Service (city and some metropolitan counties) - Operate as a third service alongside fire and police departments.
4. Municipal - Usually fire department owned and operated, rare, or police department owned and operated, very rare. The former exist in only some large cities and the latter are so rare they defy categorization.
There is a continuous flux in terms of types of services due to constant efforts to improve efficiency and effectiveness. Indeed, many fire departments are fire-oriented only in name and are becoming all-purpose emergency services organizations.
Ambulances in the United States are usually staffed by at least one driver and one paramedic. Paramedics in the U.S. are professionally trained emergency medical technicians, a healthcare profession distinct from physicians and nurses.
Large American cities like New York and Los Angeles tend to have many distinct ambulance services representing all of the types mentioned above, so pedestrians and drivers must be alert for ambulances of many shapes, sizes, and colors. However, many smaller cities and suburbs are completely dominated by AMR, and AMR vehicles are virtually synonymous with "ambulance" in those areas.
In France, the most general term is "vehicle adapted to patient transport", the term "ambulance" only applies for some categories of patient transport vehicles.
The word "ambulance" is reserved to transportation on medical prescription, including oral prescription in case of emergency. It does not apply to first responders vehicles (most of times firefighters), although they also transport casualties; their vehicles are called VSAV–véhicule de secours et d'assistance aux victimes (rescue and assistance to casualties vehicle), or VPS–véhicules de premiers secours (first responders vehicles) in case of volunteers from associations. The VSAV and VPS are considered as vectors that bring rescue workers and devices onsite, the evacuation being only the logical following of this intervention but not their main duty.
There are therefore two kinds of ambulance providers: hospitals and private companies.
The reglementation classifies the patient transport vehicles in four types:
A VSAV has three professional1 CFR onboard, a VPS has five volunteer CFR.
The first responders of the VSAV and VPS are called secouristes and have 60 hours of initial education (plus additional continuous education) and perform non-medical, non-invasive acts. They use splints (including cervical collars, long spine boards and vacuum mattresses), oxygen first aid, and make the casualty lifting.
Note
There are two kind of hospital ambulances:
Private ambulance companies perform non-urgent transportation from home to hospital and back (e.g. regular dialysis, programmed surgical operation, this could be described as a "white taxi") or between hospitals. They also participate to the sanitary duty: they make interventions at home for relative emergencies (their response time is not compatible with "real" emergencies); the crew of a private ambulance is made of an ambulance driver and an ambulance technician.
The ambulance drivers do not legally need to have any first aid education, however, the boss usually demands at least the basic first aid training (10h, called AFPS–attestation de formation aux premiers secours).
The ambulance technicians (ambulanciers) have an education level a bit higher than first responders (160h including deinfection of the vehicle and legislation of patient transport, and 25 days of practical training); the diploma is called CCA–certificat de capacité d'ambulance (certificate of ability for ambulance). For the sanitary duty, the most serious bosses provide an ambulance technician as a driver (there are thus two ambulance technicians).
For simple transport (no care required), private companies also provide light vehicles (cars) called VSL–véhicule sanitaire léger, for seated transport. The crew has only one the ambulance driver. In this case, the driver must have the basic first aid diploma.
Neither the secouristes nor the ambulanciers can apply medical protocols. Medical acts are performed either by a Smur physician (specialised in emergency medicine), or by a firefighter nurse (ISP–infirmier sapeur-pompier): there are no specific profession such as paramedic in France.Ambulances in North America
Ambulance service providers come in several types in the USA:Ambulances in France
The A, B and C-types are called "specialy equiped" vehicles, and must follow the NF EN 1789 standard (december 1999).First responders vehicles
Hospital ambulances
The H-MICU is often a light rapid-intervention vehicle, i.e. a car carrying the personnal and the material to the casualty; the transport itself is made with a VSAV or a private ambulance equiped with the medical unit.Private ambulance companies