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Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 255-256

Ambulance: The evolution of the emergency vehicle

Department of Emergency Medicine, Madhipura Christian Hospital, Madhepura, Bihar, India

Date of Submission17-Feb-2020
Date of Decision27-Feb-2020
Date of Acceptance07-Mar-2020
Date of Web Publication10-Jul-2020

Correspondence Address:
Ms. Anju Susan Kurian
Department of Emergency Medicine, Madhipura Christian Hospital, Madhepura - 852 113, Bihar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_16_20

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How to cite this article:
Kurian AS. Ambulance: The evolution of the emergency vehicle. Curr Med Issues 2020;18:255-6

How to cite this URL:
Kurian AS. Ambulance: The evolution of the emergency vehicle. Curr Med Issues [serial online] 2020 [cited 2021 Jan 17];18:255-6. Available from: https://www.cmijournal.org/text.asp?2020/18/3/255/289407

An ambulance is a vehicle that is used for treating and transporting patients who need emergency medical care to a hospital. The term “ambulance” comes from the Latin word “ambulare” meaning “to walk or move about.” With the increasing population in India, the medical services in general and emergency medical services (EMSs) in particular have lagged behind.

The concept of an ambulance was first introduced by Dominique Jean Larrey, a French military surgeon, during the battle of spires (battle between French and Prussians) where he used two or four-wheeled horse-drawn carriages to provide immediate first aid to the wounded soldiers on the battlefield and to rapidly evacuate them to the military casualty nearby.[1] This concept was approved by the Committee of Public Safety in 1794, after which they were during the Italian campaigns in 1796.[1],[2]

However, with the advent of automobiles in the 20th century, the first motor-powered ambulance was introduced in 1906.[1] Gasoline-powered vehicles were used to carry multiple patients during World War I. Slowly, motor vehicles completely replaced the horse-drawn carriages, as the need for quicker transport started growing.[2] Very soon, air ambulances also saw its inception during the war owing to the large distances between doctors and patients. After the war ended in 1918, well-equipped ambulances became operational. Procedures such as intubation, cardiopulmonary resuscitation, and defibrillation could be done during prehospital transfer.[3] Today's ambulances are designed according to strict government regulations based on the national standards. With time, many different types of vehicles were tried to transport patients depending on the scenario, land terrain, and the number of casualties involved. These include bicycles, all-terrain vehicles, golf-cart, bus, van, boat, ship, train, and fire engine.[3] One of the most efficient prehospital transfers employed in most advanced countries is the Helicopter EMSs with all resuscitation equipment and trained paramedics.[4] These ambulances are often deployed in mountainous terrains with minimal road connectivity and are also at the forefront in war-ravaged countries such as in the middle east, where the injuries sustained are often life-threatening and immediate first aid and evacuation to an advanced trauma center offers the only hope of survival.

Ambulances could be grouped into types depending on whether or not they transport patients, and under what condition and function they perform. They various types are as follows:

  • Emergency ambulance: The most common type of ambulance, which provides care to patient with an acute illness or injury
  • Patient transport ambulance: A vehicle, which help to transport patients to, from or between places of medical treatment
  • Response vehicle: Also known as fly-car, nontransporting EMS vehicle. This is a vehicle which is used to reach an acutely ill patient quickly and provide on-scene care till a transport ambulance arrives
  • Charity ambulance: A special type of patient transport ambulance service is provided for the purpose of taking sick patients away from the hospital to care homes where they would require long-term care
  • Bariatric ambulance: A special type of patient transport ambulance designed for extremely obese patients equipped with the appropriate tools to move and manage these patients
  • Rapid organ recovery ambulance: Collects the bodies of people who have died suddenly from heart attacks, accidents, and other emergencies and try to preserve their organs.

To summarize, over the past 3 centuries, ambulances have evolved from simple horse-drawn carriages mainly used for transporting patients away from the scene of the disaster to highly equipped land and air ambulances with well-trained paramedics, in which any life-saving resuscitation can be performed during prehospital transfer of any critically ill patient. This prehospital intervention could often be the difference between life and death of a patient.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Pál E. The history of ambulance services. Orv Hetil 1978;119:802-5.  Back to cited text no. 1
Ogel V, Duquesne JM. History of emergency medical services. Soins 1995;593:5-8.  Back to cited text no. 2
Felkai P, Debrodi G. The first ALS ambulance in the world. Int J Travel Med Glob Health 2017;5:113-8.  Back to cited text no. 3
Roberts K, Blethyn K, Foreman M, Bleetman A. Influence of air ambulance doctors on on-scene times, clinical interventions, decision-making and independent paramedic practice. Emerg Med J 2009;26:128-34.  Back to cited text no. 4


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