Patient comfort, better gas mileage, and decreased maintenance costs are just three of the benefits from a Type II Transport Ambulance that was recently added to the Muscatine Fire Department (MFD) fleet.
“It is a much smoother ride,” Andrew McSorley, Muscatine Firefighter/Paramedic who worked with Battalion Chief/Emergency Medical Service Chief Ted Hillard in the purchase and outfitting of the new rig. “We have some long distances that we drive to take patients from one hospital to another. This unit is just a smoother ride for the patient and easier to drive down the road for the paramedics.”
The 2019 Type II Ford Transit, medium height roof, 3.7 liter gasoline powered van was purchased for $85,591.00 from Foster Coach with the purchase authorized by the Muscatine City Council in November 2019.
“Some of the feedback we get from citizens is that the modular ambulances are not a very comfortable ride,” Jerry Ewers, Muscatine Fire Chief, said. “The way this transit is built will provide a smoother ride for the patient.”
Hillard noted that there will be a cost savings in gas for the new unit and less overall maintenance costs for all of the ambulances in the fleet.
Earlier this year, the MFD had 12 trips to the University of Iowa Hospital in Iowa City or to Davenport in one day. Those trips amounted to over 1,000 miles accumulated on one of the bigger units in just a single day. That is extra miles that would be bettered served in response to 911 calls than in transferring non-critical patients.
Hillard said that the department gets roughly 200,000 to 250,000 miles on a unit before actually have to do major work on them.
“Once we get that high of mileage, it starts to nickel and dime us because of all the little things that start to go wrong,” Hillard said. “Plus we are constantly having to maintain them.”
Reliability is important along with maintenance costs when working with units that have high mileage, and MFD mechanics work hard to maintain the fleet and keep the ambulances in working order so that they are dependable and reliable for use.
“We do have a fleet replacement schedule that we follow when mileage increases and repair costs skyrocket,” Ewers said. “This addition to our fleet may help to extend the useable life of our ambulances and that will help keep costs down.”
The transit ambulance, Squad 356, has been in service for several weeks and the MFD has already had some feedback.
“We responded to a 911 call with our regular ambulance, drove the patient to the hospital, and then drove the patient to a different hospital in the transit ambulance,” Hillard said. “The patient said the ride was completely different in the transit and more relaxing.”
Relaxing while being transferred from one hospital to another may be a stretch in regards to patient comfort especially if the patient has a back or neck injury or something similar.
Anyone with non-critical injuries will tell you that being bumped around as you are in the bigger ambulances is not that relaxing.
“This is all about patient care and patient comfort,” Hillard said.
McSorley added that comfort is especially key when transporting psychological patients.
“Just being uncomfortable can set them off,” McSorley said. “So this type of transport is beneficial to them and to the paramedics with the patient.”
This type of BLS (Basic Life Support) ambulance is not meant to be used as an ALS (Advanced Life Support) unit but could be if the situation warrants. McSorely said that Squad 356 has not been used a lot yet with the MFD being rather selective on what calls the unit goes on. Predominately, the unit will be used for patients who are not critical, do not require medical treatment but still need some monitoring, and cannot be transferred by private vehicle.
While patient comfort, better gas mileage, and cost savings are key factors in the units use, there are some drawbacks. One of the bigger downfalls is that the attending paramedic cannot access the patient from both sides of the cot.
“While it is definitely more comfortable, when you get in the back you really see the difference between these rigs,” McSorely said. “However, the lack of room is not that big of a deal for a BLS transport.”
The unit is designed for BLS transport and not intended to be used for any 911 calls, but if something would go wrong, the unit does have ALS capabilities including an ALS monitor, certain medications, the ability to do IV’s and intubations, and much more.
“So even though this is for BLS, we can still turn it into an ALS transfer if we needed to,” McSorely said.
Squad 356 joins five ALS ambulances that have primary responsibility for responding to 911 calls. Four of those ambulances are housed at Station 1 in the Public Safety Building, and one is housed in Station 2 on the south side of Muscatine.
“This is a great investment in what we do,”McSorley said. “As many transfers as we are starting to get, this is the best option for us and for the patient. And, for the many long distance transfers that we have, we would rather go that distance with this rig than one of the other rougher riding rigs.”
Transit ambulances have been out for several years but not many departments utilize them because they are normally used for non-emergency transfers. Transit ambulances are not used for 911 calls since there is less compartment space, and there is less room for patient care especially when you have critical patients that may need the more enhanced ALS services. Non-emergency transport services have been using them and using them well according to Ewers.
“We are trying to fit it into our organization and evaluate to see if it is something that we can continue with or if it is something that we utilize now but does not have a practical application in our future operations,” Ewers said. “We will not know that fit until we have the opportunity to try some research, accumulate data and feedback, and see how it works within our organization.”
If it does work, the department would not rule out adding another transfer unit to its fleet, especially if a third station is built.
“This is our initial investment to see how it works for our department,” Hillard said. “Where we go really depends on how call volume goes, and the potential for building a third station on the north side.”
Hillard said the department is maxed out right now with all bays filled up at both Station 1 and Station 2. Squad 356 is housed at Station 1 where the transfers are dispatched from. The ambulance at Station 2 does not do transfers unless the transfer requires more critical care.
“Our odds of picking up a patient at the hospital in a timely manner is better from here (Station 1) plus this station is where our manpower is and it is easier to back fill staff when needed,” Hillard said.
A third station is being planned at the former Iowa Department of Transportation site on Lake Park Boulevard but construction for that site is still several years away from being implemented. A third station would allow ALS ambulances and fire trucks to be housed at that location and free up a bay or two at the main station for the potential of another transfer unit if the data warrants.
Unlike the bigger modular ALS ambulances, the transit ambulances cannot be refurbished and will have to be eventually replaced. The price difference between a Type 2 BLS transport ambulance and the Type 1 ALS modular ambulance may make replacement feasible.
“We are always trying to find alternative ways of providing services while still being cost effective,” Ewers said.
— City of Muscatine