Paramedics rely on specialized vehicles and sophisticated equipment to safely move patients from an emergency scene to a hospital. The goal is to ensure patient safety, stability, and comfort throughout the entire transport sequence. This process involves navigating the patient from their initial location into a mobile treatment space where care continues without interruption. This system requires distinct types of vehicles, devices for moving patients from confined spaces, and gear to stabilize injuries during transit.
The Primary Transport Vehicle
The vehicle used for ground transport, known as an ambulance, functions as a mobile medical treatment room and is categorized into three main types. The Type I ambulance is built on a heavy-duty truck chassis, featuring a separate cab and a square, modular patient compartment in the rear. This robust design offers increased storage and a stable platform for Advanced Life Support (ALS) operations, making it suitable for demanding conditions.
The Type II ambulance uses a commercial van chassis with a raised roof to maximize interior working space. In this configuration, the cab and patient area are connected, making it more agile and fuel-efficient for navigating urban environments. The Type III ambulance combines the modular patient compartment of the Type I with a cutaway van chassis. This versatile setup is widely used for both Basic and Advanced Life Support missions, balancing maneuverability and workspace.
On-Scene Patient Movement Equipment
Paramedics use specialized equipment to safely move patients from the scene of injury before loading them into the ambulance. The primary device is the main stretcher, or cot, which secures the patient and locks into the ambulance floor. Many modern cots are power-lift models, featuring hydraulic systems that raise and lower the patient, significantly reducing physical strain on the paramedic.
For navigating narrow hallways, tight corners, or multi-story buildings, specialized devices are employed. The stair chair is a compact, wheeled chair designed to move patients in a seated position down flights of stairs. A scoop stretcher splits vertically into two pieces, allowing it to be slid under a patient lying on the ground or in a confined space. For extremely tight terrain, a flexible stretcher, such as a Reeves stretcher, can maneuver a patient around obstacles where rigid devices would not fit.
Specialized Transport and Immobilization Gear
To prevent further injury during movement and transport, especially in cases of suspected trauma, paramedics use gear focused on stabilization. Immobilization devices restrict movement of the spine and extremities, which is important for patients with potential spinal cord or long bone injuries. The traditional long spine board, or backboard, is a rigid platform used to temporarily secure the entire patient, often paired with a rigid cervical collar.
A modern alternative is the vacuum mattress, which conforms to the patient’s body shape when air is evacuated, offering superior full-body support. For lower body injuries, a traction splint (such as the Hare or Sager splints) is designed for mid-shaft femur fractures. This device applies steady pull to the limb, helping to realign the bone ends, reduce muscle spasm, and decrease pain.
When ground transport is impractical due to distance, terrain, or the time-critical nature of the injury, alternative modalities are employed. Rotor-wing aircraft, or helicopters, are used for rapid transport of critically injured trauma patients over short to moderate distances, often flying directly to a specialized trauma center. Fixed-wing aircraft are small airplanes equipped as flying intensive care units, preferred for long-distance inter-facility transports between hospitals.