An ambulance functions as a mobile emergency department, designed to bring immediate, life-saving medical care to patients outside of a hospital setting. Equipment carried varies depending on the level of service provided, broadly categorized as Basic Life Support (BLS) or Advanced Life Support (ALS). BLS units are equipped for non-invasive treatments, such as monitoring vital signs and administering oxygen, typically staffed by Emergency Medical Technicians (EMTs). ALS ambulances, staffed by Paramedics, carry technology and medications that allow for invasive procedures and a higher degree of patient stabilization before arrival at a medical facility.
High-Tech Monitoring and Resuscitation Tools
The most recognizable specialized devices are the cardiac monitor and defibrillator unit, sometimes combined into a single device. These monitors allow personnel to continuously assess the patient’s heart rhythm through an electrocardiogram (ECG) and deliver a controlled electrical shock, or defibrillation, to reset the heart during cardiac arrest. Modern units can also perform non-invasive blood pressure monitoring, pulse oximetry (to measure oxygen saturation), and capnography (to measure exhaled carbon dioxide), which indicates ventilation effectiveness.
Airway and breathing management relies on specialized mechanical devices to support patients who cannot breathe adequately. This includes oxygen cylinders and various masks for supplemental oxygen delivery, as well as Bag-Valve-Mask (BVM) devices for manual ventilation. For patients requiring a secured airway, ALS units carry laryngoscopes and endotracheal tubes to perform intubation, placing a tube directly into the trachea. Powerful, portable suction units are also carried to clear the patient’s airway of blood, vomit, or other obstructions.
Trauma Management and Immobilization Supplies
Physical stabilization supplies manage injuries and prevent further harm during transport. Immobilization devices secure the spine and fractured limbs, including cervical collars to restrict neck movement and various splints for stabilizing broken bones. Specialized full-body devices, such as the CombiCarrier, are used for extrication and spinal motion restriction, often replacing traditional long backboards.
Controlling external bleeding requires wound care materials, ranging from simple gauze and bandages to specialized hemostatic dressings that accelerate blood clotting. Tourniquets are routinely carried to manage severe hemorrhage on extremities. Patient movement uses the primary ambulance cot, often a powered stretcher, or a stair chair or collapsible stretcher for tight spaces.
Emergency Medications and IV Access Kits
Advanced Life Support ambulances carry a substantial formulary of medications to treat a wide range of conditions. Cardiac agents like epinephrine and amiodarone are used in cardiac arrest protocols, while nitroglycerin manages chest pain associated with heart conditions. Respiratory medications, such as nebulized albuterol, treat patients experiencing severe asthma or other breathing difficulties.
Rapid administration of these pharmaceuticals and fluids is accomplished through intravenous (IV) access kits, which contain catheters, tubing, and bags of crystalloid fluids like saline or Lactated Ringer’s solution. If traditional IV access is impossible, ALS providers use an intraosseous (IO) device to administer fluids and medications directly into the bone marrow cavity. Controlled substances for pain management and sedation, such as benzodiazepines or opioids, are also carried to manage patient comfort and distress.
Operational and Crew Support Gear
Ambulances carry equipment necessary for safe and effective operation in unpredictable environments. Communication is maintained via two-way radios and mobile data terminals or tablets, allowing the crew to communicate with dispatch and hospitals and complete electronic patient care reports. Personal Protective Equipment (PPE) is mandatory, including gloves, masks, gowns, and eye protection, to shield providers and patients from infectious diseases.
Scene safety supplies protect the crew and the public, especially on roadways. This gear includes high-visibility vests, traffic cones, and warning flares to mark the scene. Specialized tools are also stocked for initial rescue and extrication, such as trauma shears, seatbelt cutters, and sometimes basic forcible entry tools.