The Expanding Scope of Medical Ambulance Buses

When we think of medical ambulance buses in use in Emergency Medical Services, we normally associate it with some sort of disaster response. An approaching hurricane with a large-scale evacuation; an earthquake-devastated region with casualties beyond counting.

As the Emergency Medical Services industry evolves and the public demand for service rises, so too do the weapons in our arsenal. Revolutionary designs and new technology is putting equipment like MABs into the hands of agencies that once before could not budget for them.

The medical ambulance bus in its very definition is a vehicle retrofitted to treat and transport large numbers of non-ambulatory patients that require advanced life support care. These things are literally built from the ground up to effectively handle the ever-increasing demand of multi-ALS patient management. MABs are set up like a mobile hospital, and usually carry large, overstocked amounts of medical equipment.

But their use has now gone beyond the potential of their design. Agencies have deployed them for onsite triage and mobile care at high-profile events like marathons and concerts, and have also used them in hot/cold climate extremes where exposure at an event may become an issue.

We’ve also seen them used in large-scale nursing home evacuations during times of man-made or natural disasters, and serving as stationary surge capacity for patients at medical facilities.

Agencies have also deployed them to assist and test preparedness for disaster drills at hospitals and airports. Lately, MABs have been popping up to serve as the firefighter rehab sector even for smaller-scale operations. They can be deployed to a large, evolving multi-agency incident, in advance of events, or even sent off to an area post-incident to perform in a stationary capacity as a triage/treatment center and a field hospital.

mabThey have even been deployed at the behest of some charities, to take terminal patients on trips away from their acute care facilities while still maintaining their level of care.  Of course, MABs are great for mass casualty incidents and evacuation use because they can move high volumes of patients and provide ALS care at the same time, even if those patients are critical.

During Hurricane Hermine in late August, which made landfall in the Florida panhandle as a category 1 storm, but still stuck close enough to the west coast to cause significant damages, MABs were deployed to assist a local trauma center experiencing a facility-wide power failure thanks to the storm.

Pasco County saw $111 million in damage. The Regional Medical Center at Bayonet Point in Pasco took a lightning strike at the height of the storm, which caused a fire in their generator room and resulted in loss of primary and backup power to the hospital. Bayonet Point is one of the area’s trauma alert receiving facilities and also specializes in cardiac catheterization procedures; now they had 290 patients – some critical – and no way to get them out.

A combination of 70 ambulances and MABs came to provide mutual aid from as far away as Orange County to evacuate those patients and bring them to other hospitals, even as a total of 20 inches of rain was soaking the area. Pinellas County sent two of their brand new MABs, usually used for rehab and event standbys, into the convoy to get those critical patients to definitive care.

The operation was smooth even though it was labor-intensive; EMS and FD had to carry the patients from upper floor acute care units down flights of stairs to waiting transport units, while maintaining their ALS care throughout.  Admittedly, purchasing a medical ambulance bus is an expensive proposition for some agencies; they can cost up to $750,000 each. There are less costly options out there, though.

Conversion kits are one option. Several companies make these kits that are stored until an agency needs them; then they are installed in a school or city bus and deployed, handling up to 18 non-ambulatory ALS patients at a time. When the incident is closed, that school or city bus is returned back into its normal service and the kits go back into storage.

There are companies that also make permanent MAB kits. An agency can acquire a decommissioned school or city bus and purchase a kit that retrofits the bus into an MAB, to be left in standby mode at the ready for the next incident. Some kits have an adaptable option to handle CBRN (chemical biohazard radiological nuclear) incidents, and are capable of the quarantine and isolation of contaminated patients that still need ALS care.

Whatever their design, I think we’re going to see more innovative use of the medical ambulance bus as our calls for service in this industry rise exponentially. Recent large- scale incidents around the nation have already proven the need.

Disclaimer: The content in this article is the opinion of the writer and does not necessarily reflect the policies or opinions of US Patriot Tactical.

Leah Dallaire

Leah G. Dallaire is a highly accomplished freelance writer, editor and consultant with 28 years of experience. She has also concurrently been a paramedic for 20 years; the last 17 she spent serving the citizens of Pinellas County, Florida, which has a call volume of about 209,000 runs per year. She holds an M.A. and a B.A. in Writing & Literature from Union University. She has also just finished her first novel.
Leah Dallaire

3 thoughts on “The Expanding Scope of Medical Ambulance Buses

  1. You use the acronym “ALS” throughout the article without ever defining it. All Google comes up with is Lou Gehrigs’s disease, which can’t be what you meant. Please define your term.

    1. My apologies… the acronym ALS refers to advanced life support, as opposed to BLS, which means basic life support.

      Thank you for catching that!

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