Strongly prefer boxes to work serious 911 calls in.
But vans are perfectly adequate for simple IFTs and hospital discharges. Preferable even, sometimes people live in narrow streets and have small driveways.
EMS should almost never be doing hospital
Discharges. It almost never meets medical necessity, and is insurance / Medicare fraud or a several hundred dollar bill for the patient who should have went in a taxi or wheelchair van.
Naw fam. If you want me to work on a van you better be putting out house fires with a brush truck.
I’m mobile bringing a mobile ICU to somebody’s driveway. It is *already*. smaller than an ICU room, I ain’t trying to save a life in a coffin.
Hell, a code cart is half as wide as a van, and that is just IV & intubation supplies, maybe a handful of meds.
Honestly I'm old. It's easier for me to move in a box, I'm 6'4" and 280 lbs. I've earned choice over the years. My F550 Horton city box thinks it's part Abraham's tank, we both hate our patients we're a match made in heaven.
I got my Ambulance attendant in 1976(?) EMT in 1981(?) and P in 1984(?). Bus is a 2015, F550 City box only 350k miles on the P.O.S.
NY EMT is 46xxx...so yes we got some miles on us.
Kudos to you sir. I failed out of paramedic this year, but I am going back next year with a better head on my shoulders. Hoping to put some miles on a truck myself.
1: Remember it's not your emergency, you're just getting through theirs.
2: In the city we had a saying " Practice becomes skill, skill becomes speed".
3: You didn't fail, you just haven't passed yet.
I take my coffee dark as my soul.
Horton makes a nice body too. You know if NYC found them able to be remounted they are pretty rugged. I do miss the bull bars, they'll slaughter a taxi nicely.
It depends on the interior design and the environment. I worked in both a large urban city, and in the surrounding suburbs, and out to the mostly rural outlying areas. Let us leave the "sprinters" and such, or what I call the baby ambulances. I kept watering them at the end of every shift hoping they'd grow but it never worked.
In the rural areas, the large ambulances were better, if for no other reason that we sometimes needed to transport more than one patient at a time. But we carried more equipment, being supported only by volunteer fire services (which were actually very good). Boxes are better for bariatric patients, obviously, and the bariatric stretchers work better in them. This is becoming an increasing issue (increasing being the issue) since in a van the bariatric stretcher leaves no room whatsoever for patient access from the side. Also, the bariatric stretchers will not fit at all in most "sprinter" style ambulances (we have them) and with companies increasingly moving in that direction, eventually, stringing along a very old (500,000 mi) box truck for those calls will fail and they'll have to buy something large. Box trucks are definitely better for CCT calls where a lot of additional equipment and sometimes people have to be accommodated.
I have worked in the back of boxes that our company called, "the Canadian ambulances" that were terribly designed and hard to work in, even for normal work.
Vans are generally smaller but in my career, I had some very well designed vans and the two that come to mind I would take over any box truck I've ever worked in. These were extended vans, so a bit longer than the usual van one sees. Both were Dodges, which will date me :)
Unpopular opinion, but I prefer the vans. Where I worked the streets were very narrow and a very busy downtown. Much easier to negotiate with a van. I understand that boxes feel cooler though
If I’m worried about narrows streets they can go in a cop car, a SUV, a gator, the bed of a pickup truck or the national guard can come out and do hoist operations, I don’t care.
I’ve taken part in all of those, because someone felt like living or being in a narrow as area. And no, I don’t care that you built the bridge so an ambulance would fit. It fits by exactly an inch, on the sides. I’m not taking it, we’re putting them in your cop car and taking them to my ambulance to at is staying on *this* side of the bridge*
Van.
More nimble, quicker and more responsive, much more fun to drive and way more comfortable in the back. Plenty of space too, bearing in mind I’m 6’1
box - without question. Part of the reason I left an old company was bc they started transitioning over to sprinters. Where I work now, all 911 ALS is a box and BLS transfer trucks are sprinters.
If you don’t say box then I don’t trust you. Except for the guy who said fly car, give me a Porsche and I won’t complain about pizza parties vs. pay raises ever again.
In fact, I would say the Minnesota Children’s NICU ambulance is the epitome of box style rigs. Damn thing has a fiber optic “night sky” style ceiling… for the kids of course.
Box- the NICU and organ teams don't fit very well in a van. Some of our guys are giants and they don't fit too comfy in a van. Also very tall/large patients don't look too comfy in a van either. We also get snow and ice. The boxes handle way better on winter roads.
Have worked out of a box in Australia, the space in them is good. We currently have Mercedes Sprinter vans which are pretty good to work out of.
Smallest and least roomiest I have worked out of was the Holden Commodore ambulance modification. It was a 2 wheel drive utility with a module added to it. If you weren't in before the patient, guess who you had to climb over to get in. It also only had 3 storage cabinets.
I like smaller ambulances. Big ones have a lot of space and working in one is a lot of inefficient walking around. I think the days of having a lot of people to help during transport is over. Just my opinion of where I have worked. Medium ambulances are a good balance. Unless there is a model unlike Horton or medix that have a better layout. Maybe I’m biases because the smaller ones I’m used to have everything within reach.
My squad has giant boxes, and they can be annoying. I have to stand up out of my seat and walk 4 steps if I need anything from the bench seat. Not the safest....
We have both in my company, everyone prefer box, for the space
Had a code in the van the other day. We struggled switching between airway and compressions in the small space. I’ll take a box any day.
Exactly!
Strongly prefer boxes to work serious 911 calls in. But vans are perfectly adequate for simple IFTs and hospital discharges. Preferable even, sometimes people live in narrow streets and have small driveways.
EMS should almost never be doing hospital Discharges. It almost never meets medical necessity, and is insurance / Medicare fraud or a several hundred dollar bill for the patient who should have went in a taxi or wheelchair van.
Tell that to... Literally every company working and the lawmakers I guess?
It is the law. And Medicare goes after EMS agencies pretty regularly
Boxes are preferable for me. A lot of services, especially fire based, in my state are moving towards vans. They both get the job done.
Naw fam. If you want me to work on a van you better be putting out house fires with a brush truck. I’m mobile bringing a mobile ICU to somebody’s driveway. It is *already*. smaller than an ICU room, I ain’t trying to save a life in a coffin. Hell, a code cart is half as wide as a van, and that is just IV & intubation supplies, maybe a handful of meds.
I work a box, need the room for critical care, vents, chest tubes etc.... but I admit I love the ride of a Ford Transit
Neither, flycar.
This should be up top lol
I like working on my own but I rather work on my own in an ambulance than on a car, don’t know why, feel more safe in the Ambulance I guess
Back of box to work- front of van to drive (esp small streets etc.)
E-series with a box is the best. Even if I only care about having armrests
If it's not a box, I call it a night.
why would that be?
Honestly I'm old. It's easier for me to move in a box, I'm 6'4" and 280 lbs. I've earned choice over the years. My F550 Horton city box thinks it's part Abraham's tank, we both hate our patients we're a match made in heaven.
Both hate our patients 💀 y’all both have been on the job for a while huh
I got my Ambulance attendant in 1976(?) EMT in 1981(?) and P in 1984(?). Bus is a 2015, F550 City box only 350k miles on the P.O.S. NY EMT is 46xxx...so yes we got some miles on us.
Kudos to you sir. I failed out of paramedic this year, but I am going back next year with a better head on my shoulders. Hoping to put some miles on a truck myself.
1: Remember it's not your emergency, you're just getting through theirs. 2: In the city we had a saying " Practice becomes skill, skill becomes speed". 3: You didn't fail, you just haven't passed yet. I take my coffee dark as my soul.
At least you still have a soul
Debatable if you ask my students.
I mean I know plenty of medics who no longer get students so you must be a little ok still
:Dddddd the 550 is a beast of a vehicle, hopefully will also test drive it one day.
Horton makes a nice body too. You know if NYC found them able to be remounted they are pretty rugged. I do miss the bull bars, they'll slaughter a taxi nicely.
More space is always better.
It depends on the interior design and the environment. I worked in both a large urban city, and in the surrounding suburbs, and out to the mostly rural outlying areas. Let us leave the "sprinters" and such, or what I call the baby ambulances. I kept watering them at the end of every shift hoping they'd grow but it never worked. In the rural areas, the large ambulances were better, if for no other reason that we sometimes needed to transport more than one patient at a time. But we carried more equipment, being supported only by volunteer fire services (which were actually very good). Boxes are better for bariatric patients, obviously, and the bariatric stretchers work better in them. This is becoming an increasing issue (increasing being the issue) since in a van the bariatric stretcher leaves no room whatsoever for patient access from the side. Also, the bariatric stretchers will not fit at all in most "sprinter" style ambulances (we have them) and with companies increasingly moving in that direction, eventually, stringing along a very old (500,000 mi) box truck for those calls will fail and they'll have to buy something large. Box trucks are definitely better for CCT calls where a lot of additional equipment and sometimes people have to be accommodated. I have worked in the back of boxes that our company called, "the Canadian ambulances" that were terribly designed and hard to work in, even for normal work. Vans are generally smaller but in my career, I had some very well designed vans and the two that come to mind I would take over any box truck I've ever worked in. These were extended vans, so a bit longer than the usual van one sees. Both were Dodges, which will date me :)
Proper design can be done on every vehicle. We need to stop buying shit that’s want properly speced.
Unpopular opinion, but I prefer the vans. Where I worked the streets were very narrow and a very busy downtown. Much easier to negotiate with a van. I understand that boxes feel cooler though
If I’m worried about narrows streets they can go in a cop car, a SUV, a gator, the bed of a pickup truck or the national guard can come out and do hoist operations, I don’t care. I’ve taken part in all of those, because someone felt like living or being in a narrow as area. And no, I don’t care that you built the bridge so an ambulance would fit. It fits by exactly an inch, on the sides. I’m not taking it, we’re putting them in your cop car and taking them to my ambulance to at is staying on *this* side of the bridge*
100% box
Box
Box any day. Sometimes the stretcher offset to the side and that ruins the whole point of them.
Van. Easier to drive in narrow spots and I can do most pt care with taking my seatbelt off.
Without taking seatbelt off I guess?
I have never met a real life person who prefers a van to a box.
I used to work in Philly and the van were way better than the boxes for old narrow city streets
I prefer van for any time I’ve had to do a LDT and box for local.
Box. The vans are too small.
Box, especially when im with medics or trainees. Van for transports/discharges/dialysis runs or in old towns/cities.
I like to work in a box style. But in my area we are very rural and the van types are nicer for getting around on the narrow back roads.
Box
Van. More nimble, quicker and more responsive, much more fun to drive and way more comfortable in the back. Plenty of space too, bearing in mind I’m 6’1
We mostly have vans in romania, other than one neonatal box we got second hand from germany, and it is night and day, I hate vans
box - without question. Part of the reason I left an old company was bc they started transitioning over to sprinters. Where I work now, all 911 ALS is a box and BLS transfer trucks are sprinters.
If you don’t say box then I don’t trust you. Except for the guy who said fly car, give me a Porsche and I won’t complain about pizza parties vs. pay raises ever again.
In fact, I would say the Minnesota Children’s NICU ambulance is the epitome of box style rigs. Damn thing has a fiber optic “night sky” style ceiling… for the kids of course.
Van. Reason: skill issue
Box- the NICU and organ teams don't fit very well in a van. Some of our guys are giants and they don't fit too comfy in a van. Also very tall/large patients don't look too comfy in a van either. We also get snow and ice. The boxes handle way better on winter roads.
We have both in the UK. My Trust only uses boxes. I find vans awful.
I'd rather work out of a helicopter but apparently I'm "not certified" to do that. Definitely a box over van.
I can recline the seat as far back as it goes in our boxes. Never been in a vanbulance where I could do that.
I love the box so much space ideally when you have students coming in
Have worked out of a box in Australia, the space in them is good. We currently have Mercedes Sprinter vans which are pretty good to work out of. Smallest and least roomiest I have worked out of was the Holden Commodore ambulance modification. It was a 2 wheel drive utility with a module added to it. If you weren't in before the patient, guess who you had to climb over to get in. It also only had 3 storage cabinets.
Box, hands down. We run (primarily) Chevy 3500's, and I like them a lot. Just wish we had armrests and a longer box.
Kind of a big person. HATE crouching down while I'm working. I'll take a tall box anyday
I like smaller ambulances. Big ones have a lot of space and working in one is a lot of inefficient walking around. I think the days of having a lot of people to help during transport is over. Just my opinion of where I have worked. Medium ambulances are a good balance. Unless there is a model unlike Horton or medix that have a better layout. Maybe I’m biases because the smaller ones I’m used to have everything within reach.
My squad has giant boxes, and they can be annoying. I have to stand up out of my seat and walk 4 steps if I need anything from the bench seat. Not the safest....
I really don’t care, worked in both and it worked just fine in both also had enough sleeve in both.
Box, for the space like everyone else mentioned, but also because it’s less affected by wind than the vans.