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Insider North

Insider North Volume 1, Issue 3
Front page...

A Mercedes ambulance for Cadillac care
Nightingale nominee's advice: “Step back, think critically. Think BIG”
Getting ready for life
Want a hamburger? That will cost you extra in the cafeteria
A road map for the Epic journey
Joint Commission survey “smoothest yet”
Cancer patient, helmet camera give first-hand look at advanced treatment
Taking the Asthma tiger by the fiery tail
The extended journeys of Alene Nitzky
Hospital video updates: July 25, 2012
HomeGrown flourishes, puts fresh fruit an vegetables in locals' hands

A Mercedes ambulance for Cadillac care


New ambulance a step toward reduced fuel, maintenence costs

The new Mercedes ambulance is the first in the fleet to sport the UCHealth name and logo.
EMT Chip Bailey with the 6-cylinder Mercedes ambulance that gets about twice as many miles per gallon as the 16 ambulances in the fleet.
First ambulance used by PVH. Circa late 1920s.
By Gary Kimsey

The Mercedes brand calls certain adjectives to mind: high-quality, exclusive, powerful, fuel-efficient, high performance.

But, when we think of high-end vehicles, Mercedes and ambulances typically don’t go together.

They do now at UCHealth in northern Colorado, where in early July a new ambulance with a Mercedes chassis joined the 16-ambulance fleet. Those 16 ambulances were built using engines of two of the top three American vehicle manufacturers and have presented a variety of maintenance and fuel challenges.

The Mercedes ambulance is easy to spot on the road because it’s the first to carry the UCHealth logo and name. Ambulances in the rest of the fleet will be repainted with UCHealth identifiers one-by-one as they are taken offline for routine maintenance.

The story of the acquisition of the Mercedes is a good example of Emergency Medical Services’ ongoing employee-led quest for excellence, safety and cost-consciousness.

First, details of the ambulance…

UCHealth chose the Sprinter model of the Mercedes ambulances, which includes a chassis and customized interior stocked with state-of-the-art emergency medical equipment, with room enough for a patient and emergency responder.

Steve Main, EMS manager, says the department purchased the ambulance with the goals of enhancing the fleet’s dependability, safety and fuel economy.

“We’re attempting to maximize the capabilities of our ambulance fleet,” he points out. “Our research shows that Mercedes ambulances are bullet-proof” -- by this, he means they are extremely durable -- “and they hardly ever break down. They have better mileage and offer safer conditions for the patient as well as the paramedic or EMT caring for the patient during the ride.”

Ambulances with Mercedes engines have been commonly used in Europe, Australia and Canada for the last decade, but they had little presence in the United States until recently. The $119,800 UCHealth ambulance was assembled by American Emergency Vehicle, North Carolina. The Mercedes cost less than a $134,000 ambulance purchased last year from a different manufacturer.

Main says the Mercedes ambulance is expected to help the department save on fuel costs. The current fleet averages 7.3 miles per gallon, which translated into a fuel expense of about $175,000 in 2011. The 6-cylinder Mercedes gets about twice as many miles per gallon, making it a sweet deal on fuel costs, Main says.

The Mercedes’ 14 to 15 miles per gallon is good for an ambulance, but, of course, not so much for a car. On average, the average American passenger car gets 22 miles per gallon, but they don’t face the daily rugged use that ambulances do. Nor must the typical car carry the weight that an ambulance does. Most cars weigh less than two tons; ambulances tip the scales at five tons.

First contact

UCHealth’s EMS in northern Colorado provides the first contact many patents have with Poudre Valley Hospital and Medical Center of the Rockies -- and much of the first contact comes through emergency ambulance rides. With 53 paramedics, 30 EMTs and 100 community volunteer EMTs, EMS responded to 15,279 calls in 2011 and covers about 2,200 square miles in the northern two-thirds of Larimer County.

That’s a lot of people and territory to cover, which is why the health system has traditionally tried to remain at the forefront of ambulance technology.
The ambulances of today are a far cry from what they used to be. The first ambulances were horse-drawn wagons used in the Civil War to transport wounded soldiers. Today, some smaller hospitals, especially in rural areas, use station wagons customized into medical transport units. That’s on the low end of the scale for emergency medical transportation technology. From there, the styles, quality and durability of ambulances vary widely, largely depending on what health agencies can afford in relation to the frequency of use and types of emergency care needed in their area.

The northern Colorado ambulance fleet grew hand-in-hand with expanding patient volumes at PVH and MCR. Originally, back when PVH was a new, small-town hospital, the fleet consisted of a mere one ambulance that resembled a gangster car out of the Roarin’ Twenties.

Then came a modified station wagon, followed by the trend of ambulances with van shapes -- bulky, but with enough room for emergency equipment, a medical responder and a patient. These had severe limitations -- a small patient-care interior and chronic inability to adequately meet the enormous power demands required to run the engine and medical equipment.

“We were far behind the curve,” recalls Main, a 24-year EMS veteran.

So, starting in 2006, the health system began transitioning into the current look of ambulances -- more box-like, with a pickup-style chassis upon which the “box," the enclosure where medical care is given, sits.

When the chassis wore out and needed to be replaced, all that had to be done was remove the box, purchase another chassis and place the existing box on it. This was a cost-savings idea that at the time seemed logical.

“It was great on paper,” Main admits, “but we found that fuel and maintenance costs were significant.”

The big catch -- and this was significant in terms of cost and performance -- was that each ambulance needed two engines. One engine powered the chassis; the other, medical equipment. “That meant we had two engines that could break down,” Main says, “and they did.”

Employee input invaluable

About a year ago the time had come to start upgrading the fleet. A group of EMS employees was convened to research ambulances and make recommendations. The group was charged to “look outside the box,” Main says, and equally consider such features as performance, maintenance, cost, miles per gallon, and safety.

It didn’t take long to learn that the Mercedes model was making major inroads into the American ambulance industry. Numerous U.S. ambulance services had begun using the model, including Acadian Ambulance, the nation’s largest privately held medical transportation company, and the Ambulance Service of Manchester, which serves the Hartford and Manchester region in Connecticut. The service has 48 ambulances, 33 of which are Mercedes built by American Emergency Vehicle, the manufacturer of the UCHealth ambulance.

“We couldn’t be happier with our Mercedes ambulances,” reports Wayne Wright, president and CEO of Ambulance Service of Manchester. “We’re happy in every respect. They handle well. Patients and our employees like them.

He says he expects the company’s Mercedes ambulances to get about 300,000 to 350,000 miles during their service life, compared to the other makes’ averages of 185,000 miles.

Considering the time of year -- Connecticut has just experienced more than two weeks of 90-plus, muggy weather -- Wright points out an advantage that many people except emergency responders and patients may not even consider: air conditioning.

Other ambulances have two air-conditioners -- one for the driver’s area, the other for the patient area -- and the units often have problems during heat spells. The Mercedes, though, has one air conditioning unit that jointly cools both sections. “The crews really notice the difference,” Wright says. “It can get as cold as an igloo if the crews want it.”

“I’ve been stunned that everyone else has been so slow afoot to start using the Mercedes ambulance,” he adds.

When the UCHealth employee group asked an Acadian representative about the need to make repairs on the Mercedes, Main says he replied, “What repairs? We just service them and they keep running.”

Main notes that the Mercedes has other benefits. One is that power to the entire vehicle -- chassis and patient area -- is supplied by only one engine. “So there is no second motor to fail,” Main adds.

The Mercedes is more compact in size and lighter in weight. This is a double-edged sword. It means the fuel-efficiency will be better, but it also means the patient area is slightly smaller.

Unlike the bench seats in the older rigs, the Mercedes seats allow the medical provider to face forward and have lap and shoulder belts, providing greater safety. In addition, a provider can attend to a patient without having to strain to reach medical equipment, a benefit not only for the provider but also the patient.

Main and others in EMS intend to keep close track of performance, maintenance, safety and other features to see how the Mercedes compares against the rest of the fleet. So, in the future, there may be more Mercedes ambulances on the road for paramedics and EMTs to provide their Cadillac care.

Gary Kimsey works in UCHealth's Marketing Department in northern Colorado and oversees Insider North.
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