The ambulance is among the most recognizable and unique vehicles on the road. The history of the ambulance is long and developmental, dating to 15th century when in Spain wagons were used for the transporting the wounded. The modern word ambulance derives the French word ambulant. It means “ambulant field hospital” and its first known use was in 1809. Since then, ambulance vehicles have undergone a vast transformation.
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Ambulances in the Civil War
Prior to the 20th century, most emergency transportation was done with horse-drawn carts or wagons. During the American Civil War, these wagons were used to transport wounded soldiers from the battle field. It wasn’t until William A. Hammond took control of the Office of the Surgeon General in 1862 ambulances saw common use in the war.
Hammond reorganized the control structure, such that the responsibility to transport the wounded was removed from line officers and given to the medical corps. A military occupational specialty (MOS) was created to designate ambulance-wagon-drivers. Eventually Hammond implemented a system that provided one ambulance for every 150 soldiers.
One example of the efficiency and effectiveness of ambulances during the Civil War was at the battle of Antietam, where ambulances removed 9,420 union soldiers from the field in one day.
Ambulances and Hospitals
Most people associate ambulances with a vehicle that transports patients to a hospital. The first known ambulance hospital service began in Cincinnati, Ohio in 1865. One of the most notable early ambulance services was at Bellevue Hospital in New York. When the service began in 1869-70, the city received approximately 1,400 emergency calls. By 1890, the New York ambulance vehicles were responding to nearly 4,400 calls per year.
Unlike the rugged wartime ambulance wagons seen above, ambulances that delivered patients to hospitals were typically more comfortable and focused on speed. New York ambulance service providers were on-call and could typically respond within 30 seconds of being called. The faster the service, the better the outcome. It was also at this time that ambulances began carrying appropriate equipment on board, such as splints, morphine, and of course, brandy.
Ambulance Vehicles Become Motorized
With the development of the automobile, ambulances received a revolutionary makeover. There were ambulances powered by steam, electricity, and eventually gasoline. With the power of a gasoline engine managing the load, ambulances got much larger, carried more equipment, and hauled more personnel. The first motor powered ambulance vehicle was brought into service at the Michael Reese Hospital in Chicago in 18991.
It wasn’t until 10 years later when ambulances joined the automobile craze as mass-produced vehicles. The first series was produced by the James Cunningham, Son & Company located in Rochester, New York in 1909. The four-cylinder, 32-horsepower ambulance vehicle was called the Model 774 Automobile Ambulance. It was vehicles like this that paved the way for ambulance vehicles used during World War I and beyond.
Ambulances as Mobile Hospitals
As medical science and technology developed ambulances took on a more important role. They were no longer seen as solely transportation vehicles, but mobile hospitals. Ambulances had come a long way but just as more makes and models of passenger vehicles began to hit the road, ambulance vehicle began to see great disparity.
In 1965 the white paper titled, “Accidental Death and Disability: The Neglected Disease of Modern Society” was published by the National Academy of Sciences. It was the first thorough investigation on the true efficiency and hazards of ambulance vehicles. The paper identified that there was no standard definition of an ambulance and often ambulance vehicles were based on a passenger vehicle that was simply converted to transport a patient. The paper also identified the varied qualifications of ambulance attendants. Today’s paramedic and nursing programs have greatly benefited from the initial recommendation set forward in this paper.
In 1966 the The National Highway and Traffic Administration set standards for the construction of ambulance vehicles. This led the way for ongoing standards and regulations for future ambulances.
Modern Ambulance Technology
Today’s ambulances are high tech mobile health units that can provide a wide array of medical services while on the move. Most modern ambulances have a larger cabin space and are built on truck and van chassis. Typically an ambulance is designed to accommodate one patient, but some high-capacity ambulance vehicles can transport multiple patients. Many modern ambulances are custom built. Features such as custom tail lifts, ramps, winches, cabinetry, lighting, seating, communication technology, etc. can all be tailored to meet the need of the client.
Ambulance vehicles have come a long way from rickety horse-drawn carts, but the purpose has remained the same. Ambulances are one of the most important vehicles on the road. The development of ambulances is evolutionary and the ongoing desire to build faster, safer, and smarter emergency response vehicles is what makes this history of ambulance vehicles so interesting.