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Medical Equipment - Vehicles

 

How do I set up my vehicle as an ambulance?

or 
'Everything You Always Wanted to Know About Using Your Vehicle as an Ambulance but Were Afraid to Ask"

I

f you are a GP or BASICS doctor and you want to be able to carry patients in your car, then all the information you need is on this page.
Which vehicles are large enough to carry a stretcher?  The best vehicles are long MPVs (or people carriers) such as the Chrysler Grand Voyager, Renault Grand Espace, Mercedes V class or Kia Sedona.  The shorter wheelbase MPVs such as the Ford Galaxy and VW Sharan are a bit of  a squeeze for a stretcher.  A van such as a Mercedes Vito is a cost effective if more basic option. Most estate vehicles are too short for a trolley stretcher but a folding stretcher could fit with the front seat pulled all the way forward.  
Where can I get a stretcher and other ambulance equipment from?  Ask your local ambulance service for any old stretchers they may have, or ask them who they sell their old vehicles on to as they often will pretty much give away second hand equipment.  Alternatively, for the less frugal, you can buy pretty much everything you need from SP Services.
You need to be insured as an ambulance to carry patients. Insuring your car as Business use, even for a doctor, is not enough to legally carry patients.  In fact insuring your car as an ambulance may be much cheaper than your normal insurance.  Only certain companies do special class insurance, although you will need to contact me for their details as the insurers were unwilling to let me post their details online.  Beware - you cannot transfer a private vehicle policy NCD to a special class insurance policy
Make sure you specify "any driver" cover.   This means that if you want to travel with the patient and have someone else drive your vehicle (such as a police officer or ambulance technician) then they are covered by your insurance.
How do I fit the stretcher? 
I removed the rear row of seats and the middle row seat behind the driver's seat.  This just left one seat in the back.  I have my trolley stretcher semi-permanently fixed in the back.  It is attached to the floor mountings for the seats that I have removed from the back.  I used strong load straps to attach it to these mountings.   Alternatively you can get mountings for the stretcher and have a coach builder fit it to the floor of the vehicle.  Expensive both at the time and when you come to sell the vehicle on, but essential if you are going to use the stretcher frequently for transfers.
How do I get the patient in and out of the vehicle?  I have a carry chair to get people to the vehicle.  If the patient cannot climb into the back of the car or sit in the carry chair, then I use a combicarrier scoop stretcher to carry them into the car.  This requires about four people to carry a patient safely (I'm not as generous with my back muscles as the ambulance crews!), so it is only an option if you have plenty of helpers at the scene (e.g.: the local fire service).  The advantage of this technique is that you can easily transfer them to another ambulance.
Can I register the vehicle with DVLA as an ambulance and avoid road tax?   Only if you use the vehicle EXCLUSIVELY to transport patients, although DVLA have told me that GP business use would also qualify as long as there was no personal mileage.
How much does livery cost?
If you want livery, Signs Express (offices throughout the UK) can provide a good livery for between £200 and £400.  The livery can be removed again when you want to sell on the vehicle, although you may have to pay for cleaning of the paint work.
standard BASICS livery involves reflective red / flourescent yellow chevrons at the rear and reflective green/yellow stripes at the side. 
Beware - Yellow and green chevrons at the side have not yet been authorised for BASICS doctor use (check with your local traffic police for advice).  The only reflective material you may only use at the back of the vehicle is red and may use any refelctive colour EXCEPT red on the rest of the vehicle.
How much does the light bar cost?   A full size light bar costs between £300 and £700 depending on what you want.  Strobes are more expensive than rotating lights but are more easily during daylight.  You should be able to fit the light bar without having to drill any holes in your roof.  I screwed mine throught the roof bars on the car and ran the cable in through the rear passenger side door.
Magnetic mount beacons cost from £40 to £200.  Contact Premier Hazard (0113 239 1111) for advice.
What is the legality of using green lights?   Any fully registered doctor can use a green beacon to ease progress though traffic if responding to a medical emergency call.  I count this as being any call where the patient is not in a safe environment, there is the POSSIBILITY of a life or limb threatening condition, or if the patient is in severe pain, but there is no standard definition.  Using a green beacon does not grant you the right to break the speed limit or treat a red light as a give way.  Discuss this with your local traffic police.  It is very unlikely that they will prosecute you if you are driving SAFELY.  In fact the most useful thing about green lights is to protect you at the scene of an incident.
Can I use blue lights?   That depends on how your local traffic police interpret the traffic law (see below).
Can I use a siren?   The law on blue lights and sirens is complicated and outdated.  Police forces differ on their interpretation of the various laws and clarification is expected in the next year or two. 
Some forces say that if your vehicle is used as an ambulance, even occasinally, then it can be fitted with blue lights and a siren for use when it is being used for ambulance purposes (ie: responding to an emergency call in which it will potentially be used to transport a patient).
However, some police forces interpret the law that only vehicles used SOLEY for transporting patients can be fitted with blue lights and a siren (this of course would make Paramedic Response units illegal, but the police can be very choosy in who they apply the law to!)
There is no provision in law for doctors' cars to use sirens at other times.  However, many BASICS doctors use sirens with the unwritten consent of their local Chief Constable. 
Again, discuss this with your local traffic police.
Do I need special driver training?   There is no requirement to have special driver training but I would say that an IAM or ROSPA advanced driving course is mandatory as a minimum.  Your local traffic police or ambulance college can arrange further training.
Is there any other training that would be useful? A lifting and handling course would be invaluable, and a week or more spent riding along with an urban ambulance is also well worth it.  If you are going to be spinally immobilizing patients without the aid of an ambulance crew you will need to familiarize yourself with the various extrication techniques that we tend to leave to the EMTs.  Try and go on a PHTLS course or talk to your local ambulance training officer. 

 

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