1. Introduction to Armored Ambulances
An armored ambulance is a specialized emergency medical vehicle used to provide prompt and efficient pre-hospital treatment and transportation of the sick and wounded during all phases of emergency situations. It is a platform to deliver good quality medical care to patients often in hazardous environments. These are highly specialized vehicles used for casualty evacuation during situations of war and armed conflicts. The International Convention for Red Cross (ICRC) Geneva Convention confers special immunity on ambulances that deliver different levels of protection to these vehicles from illegal attack and arrest under the Geneva Convention. The use of this term extends to the widely recognized conventions that govern the treatment of sick and wounded military personnel.
Armored ambulances are specifically manufactured for the evacuation of critical patients from hostile environments, mainly from areas of conflict, etc. The design of these vehicles is done in a way so as to ensure that not only are the patients transported safely and comfortably, but also the medical team accompanying the patients are also safe and protected at all times. All the necessary medical equipment like basic and advanced life support systems, patient care monitor, ICU arrangements, paramedic seat, etc., are fitted inside the ambulance. The external body of the ambulance is turned as per the required color and also customized in certain ways to allow its use and movement in hostile environments. The compartments in the ambulance are specifically designed using anti-bactericidal materials to prevent the chances of contamination. Also largely known as Buser (Bullet-Resistant, Safe, Convenient, Low cost) Vehicle. All windows are bullet-resistant up to the level of Threat level of the patient. Lorinser floor top of flooring with remount body sidewalls and wrap-around bumper. Standard ambulances can be built with or without the slide-out function.
2. Purpose and Benefits of Armored Ambulances
The purpose of an armored ambulance is to safely evacuate and care for patients from an area considered high conflict, be it through criminal activity, terrorism, or some sort of civil unrest or war. This presents its own set of unique challenges, many of which are not commonly found in regular medical settings. The primary concern will always be the safety of the people attending the emergency evacuations, so making the incident safe and secure is an important aspect. Armored ambulances also provide ballistic protection for the care staff and patients inside. This can either be a solution in itself or it might be combined with engineered metalwork protection to provide a 360-degree cocoon of bullet-resistant steel behind which the care staff are happy to work.
Any armored ambulance will generally exceed commercial ambulance regulations for robustness and safety implications. Where a standard ambulance may fail the end pen test with items such as oxygen cylinders flying around the interior in significant rear impacts, armored-built ambulances are generally built far more robustly to survive or reduce the incidence of loose equipment or fittings. Also, armored ambulances are allowed to exceed weights of a standard ambulance. Additional infrastructure can be added, such as air conditioning units, night vision systems, or additional redundant systems, such as improved battery capacity and run-flat systems that enable the vehicle to keep moving despite punctured tires. This can be very important in countries operating to a “golden hour” response time where the benefits of this additional infrastructure could save lives. On every project, the risk assessment will be different, and the trained salesperson can make suggestions on equipment with a sound basis. For instance, a stun grenade launcher will not be found on any vehicles used in Europe, but all those used in war zones need more protection for occupant safety, and training to be able to use these will have been provided.
3. Design and Construction Features
Basically, an armored ambulance is designed and constructed as a mobile medical facility, designed to fulfill functions similar to those of both an ambulance car and a medical vehicle. It is supposed to be armored to an appropriate protection level to preserve the life and health of crew members and patients, even in case of terror attacks. A specially constructed open bed vehicle moves patients on a carrying device, such as a stretcher, throughout the vehicle into the interior of the vehicle. The stretcher has a bendable end and is equipped with pistons to adjust the length and support, which can be shortened by over 20% during the transportation of patients on rough terrain. The seats are equipped with SRS airbags. The colors of the ambulance are most often red and white. All the interiors are padded with soft and comfortable materials to ensure comfort for all patients.
A typical hydraulic, electrically, or pneumatically adjustable lifting device is used. A hydraulically initiated vehicle leveling system ensures leveling of the vehicle to compensate for uneven surfaces. A complex NBB remote control will be used for controlling the clearances and for the driving and transporting process. The headroom is limited, as indicated, to provide as much room as possible for ambulance equipment. The seating is padded for hard impact. The seats are typically adjustable to permit rear entry in the ambulance with stirring or injured persons. The rear door is of the wagon type and will open and close vertically, either from inside the ambulance or upon arrival at the hospital, by skilled hospital staff. The top of the door will contain a special composite material as a specialized window for clear viewing. The rear of the vehicle will also include a clear window that is manufactured with a shatterproof composite.
3.1. Ballistic Protection
Bullet or shrapnel is a source of injury that can affect anybody, including first responders. Subsequently, part of making the cabins for protected levels is using materials that can protect against this threat as well. Traditionally, auto body parts tend to deflect bullets and shrapnel, but floorboards are very vulnerable to fatal injury. Additionally, shrapnel can tear through the auto body parts at an angle and possibly harm occupants. Unlike traditional add-on armor on tactical vehicles and armor plates on tanks, Armored Passenger Vehicles (APVs) have to offer ride comfort and safety while withstanding bullet penetrations at all realistic angles. The enviable goal of an attack is to distract occupants, injure them, or directly harm them. Firing into a crowd of people at a dining table in a restaurant would enable the attacker to increase injuries and fatalities.
Material systems used in vehicles can stop bullets before reducing spall hazards inside the cabin as a second line of defense using a complimentary back-face signature resin-coated multilayer linear energy killer. Ballistic materials will include a combination of ceramics, metallic screen materials, hybrid interfaces that are fire-resistant, and non-toxic environmental materials. To defeat bullets, the multi-layered tactile energy arresting system is highly desirable for use as armor in body panels, namely front body hinges, external guard rails, and driver-side or passenger-side doors, including swing doors and sliding doors. The energy-incapacitating system, also known as tactile armor, is capable of preventing deep penetrations of the automotive body to reduce casualties, injuries, rapid finger amputation, and abdominal fatality. Ballistic-grade metal foam armor provides superior deflection capacity, energy absorption, and elasticity for automotive armor, especially for high-impact rotating mechanical parts. Foamed metal is especially useful in the application of very high-speed fragments compared to solid materials. These functionalities are currently being widely studied and used for providing the mobility and mentoring for wheeled vehicles. In order to increase part protection, the foam metal layer can be laminated at least with one layer of glass fiber reinforced. Coverage: the concept of protection of the automotive parts is a percentage of the basic safety goal of the occupants. Armor the exterior of the vehicle to make automotive parts as bullet-resistant and shrapnel-free as possible. Government authorities travel in official vehicles with Government-Furnished Equipment (GFE) installed. The investigations were initiated following attacks on US Ambassador Blackwater convoys in Iraq. An armored vehicle convoys within launcher armor replacers, a panel that provides additional armor plating under the main vehicle floor and full-wheel well protection. A floor-mounted deflection plate is latched in place to defeat IED velocity and lead fragmentation forward of the two fuel bladders venting at speeds over 400 mph, same level used for driver seat protections, succession of body thickness and reference bullet tests, further plating to provide complete spall protection between the tires rewiring IED bombardment. IED grenade with fuel well-to-well defense to defeat a detonation device or penetration from the under vehicle to under passenger risks. The black armor appeared to at least disrupt IED blast downward causing at least part of the vehicle deflagration to blast upwards and away from the vehicle.
3.2. Medical Equipment and Facilities
Normally, the medical equipment and facilities of an armored ambulance comply with national staff regulations for emergency transport, search and rescue (SAR), and basic life support operations such as artificial ventilation, heart massage, and oxygen and drug administration. Additionally, more advanced diagnostics and treatment options could be considered. Standard equipment includes an electrocardiograph (ECG) and defibrillator, ventilation devices (intubation sets; fully and semi-automatic ventilators, including filters), vital parameter monitors, and mobility to transport patients. The configuration of armored ambulances operated in high-risk and combat zones will always depend on the assessment of the medical threat and the operational tasks. The assessment would not differ from the evaluation of medical support assets.
However, because of restrictions due to being actively employed, area access, risks, and available infrastructure, more emphasis on emergency assistance should be placed. The description and classification of the different types of pre-hospital trauma care in district (I), urban (II), rural (III), and countryside (IV) are mentioned in the Edinburgh Proposal for Pre-hospital Trauma Care, published by T. J. Hodgetts and co-workers. The stated methods describe the care throughout the U.K., where ambulance services are staffed by a professional first responder/qualified ambulance assistant level or by a professional first responder paramedic/qualified ambulance technician and controlled by the Medical Director with oversight of staff training and clinical governance. Operating armored ambulances in Somalia, Iraq, Russia, and the District of Columbia will be totally different, as will the necessary equipment and capabilities to care for patients.
4. Performance and Mobility Features
Off-road and on-road speeds, acceleration/hill-climbing performance, and the passage over obstacles (water fording, trench crossing, vertical obstacles) depend on the particular design. In general, off-road speeds of 5-10 km/h can be reached. Acceleration will vary but can range from 0.4-3.0 m/s. Upward slope gradients of 0.318-0.537 rad (18°-30°) have also been reported.
Propulsion can be through one, two, or four-wheel drive. Power pack locations and contents, including the engine, alternator, cooling system, steering pump, fuel, and oil tanks, affect the overall vehicle layout. Armored ambulances can be fueled by petrol or diesel, with the latter somewhat preferred because of its low volatility. The cooling system provides continuous cooling or shutdown protection to the engine. It can be liquid cooling (ethylene glycol or water with a silicate anti-corrosion additive and rust inhibitor) or air cooling through the use of fans and shrouds or venting plates. Auxiliary automotive veterans may also have self-sealing and run-flat tires and can be equipped with a central tire inflation system to automatically adjust tire pressures based on preprogrammed settings or as directed by vehicle operators.
Various means can be employed to alter the trajectory of an armored ambulance, including steering, inclining, skid steering, differentially controlled wheel pairs, and crab steering. Steering can be manual or power steering, with the power assistance provided by hydraulic pumps or electric motors. Heavy-duty steering or suspension systems may be installed to cope with higher loads or reduce road shocks to the occupants, respectively. Most ambulances have a minimum turning radius that allows them to turn around on the road without a reverse motion. Smaller turning circles are desirable both for urban maneuvering and in off-road areas.
4.1. Engine Specifications
The engine used in the armored ambulances is manufactured specifically to meet the demands of the vehicle’s operation. Since armored ambulances run on a higher gross weight than a factory ambulance, the engine is re-engineered to accommodate the excessive demand for performance along with retention of the fuel economy. Moreover, the engine’s maximum power, revolution per minute (RPM), and maximum climb can be optimized for heavy-duty applications. In maximum performance, the armored ambulances can reach an average top speed of 70 to 80 mph, a maximum gradient of 60%, and a cruising range of the range above 600 miles. This specification ensures the on-time arrival of the emergency crew to the healthcare facility located far away from the operation zone.
The engine has the technology to maintain compliance with the MAHLE Test System, which controls the admission and exhaust process for the willful regeneration of the Selective Catalytic Reduction (SCR), Diesel Particulate Filter (DPF), and Diesel Oxidation Catalyst (DOC) after the warning signals alerting on the dashboard. This gives extra edge for the customers operating in areas with limited/regional/regulatory compliant ground services as the diesel filter can be regenerated or heated without stopping the vehicle’s engine. Additionally, the engine exhaust does not produce high noise pollution than any other standard automobile vehicle.
4.2. Off-Road Capabilities
Due to the potentially rough environments and sudden health risks of remote international operations, armored ambulance users prefer to ensure the best possible mobility for their ambulance vehicles. All-terrain 4×4 ambulances are the obvious choice for geostrategic “hot spots” where ICU quality care may be very far away, not only in terms of mileage, but also due to jungle, steppe, or desert terrain. Such landscapes are challenging, with river crossings (with winch to exit the river), night driving systems, clearing paths through brush, mud, and sand (low PSI Run-Flats), or bouncing on interconnecting mountain roads.
Full North America specification vehicles with Anti-Lock Braking Systems (ABS) are capable of creating enough heat to clear pad sanding from front disks, driving in high ambient temperatures, in heavy humidity, with the Federal Refrigerant 134A (CFC-free). They also have a factory-installed Bypass-A/C Condenser because these environments can overwhelm or plug an A/C condenser and result in very poor A/C performance. Military independent axles mean you won’t be trapped or immobilized if you break an axle. Selectable front and rear axle differential locks or four-wheel drive and air-locking front and rear differentials.
Low volume emergency rescue coverage in remote location areas needs deep mud passage if overland travel is required, also known as “mud bogging”. The 12,300 lbs. GVWR (Gross Vehicle Weight Rating) and 11,900 lbs. production weight give you a low weight-to-torque and HP ratio that results in longer life for both your engine and drivetrain. The lower the weight, the lesser the load on the engine. And we have the largest disc brake rotors of any vehicle in this class! The air-locking outgoing driveshaft feature of the Transfer Case and the high approach/departure angles designed into the Fuso chassis ensure your ability to free yourself after bogging.
The possibility of both a standard auxiliary heating system without engine running and the optional ISRI multi-layered suspension with all-wheel drive are offered. An air conditioning system, which is optionally delivered with the roof emergency exit, is also available.
5. Safety Features
Armored ambulances are secure vehicles used for transferring patients under siege, fighting occupants, lawbreakers, and lawbreakers. They are also utilized in forceful living conditions where there are heavy dangers to life because of competing factions or opposition sentiments. These armored cars have been designed to protect those in the ambulance. A set of protective measures are in place to ensure that the car runs within the affected space so that no damage can occur to the passengers within. Vulnerable ambulances are used for serving in level zones liquidated or influenced by real progressing, communication, or geographical issues where the living consists of faction’s contravention. Charitable ambulances are accustomed to providing service to the normal people, however, in war-affected areas or places where resurgent factions are present, then ambulances should be armored.
SIDE WINDOWS: Drivers and passengers can watch out directly for sunshine or penetrate rain, sleet, snow, and other extremes of atmospheric conditions. There are multiple layers to provide good and fractional mirror coating with maximum visibility. There is also an optional heated front doorway window that clears frost, ice, and winter rain. The seats and seating use Roho® seat cushions for extra sitting comfort and diminished front seat fatigue. These cushions are inflated to fill the gaps and provide a smoother ride. Additional storage underneath the bench seat provides convenient storage for folders, books, and personal items. With the new wash-and-wear seat upholstery, anything spilled can be easily cleaned up. BUSS participates and delivers R&D style and engineering support for autonomous platforms like robot ambulances, driverless buses, and rail transport.
5.1. Emergency Exit Options
5.1. Emergency exit options. Being able to rapidly evacuate injured persons from an ambulance is critical in any emergency situation. For ambulances without armoring, it is quite common for additional exits to be included in the detailed interior layout and design. If another exit option may be needed, then any required harnesses, backboards, or gurneys or stretchers and patients may also be utilized to egress the vehicle. Some head trauma pads placed on the horizontal exit member can help prepare for rapid ejections or full roll-outs, and some “safety” or autoplastic helmets (which can function as head restraints as well as helmets) can also be stored within the ambulance to help increase head protection during rapid evacuations, which may not allow occupants any hands to support their heads to prevent them from hitting against ambulance components such as the horizontal bar in the exit opening.
At a minimum, at least one manual method should be used for gaining entry to and egress from any location inside the patient compartment of the ambulance, and the patient compartments of ambulances are no different in this regard than any other enclosed facility. If the likely evader(s) are human beings, then they may simply unbolt, saw, torch, or scrap and function (i.e., be available to support egress if necessary) over the life of the ambulance, including once the ambulance is refurbished. If the preferred evader(s) are something else such as fire, CO, or watery flooding, then this explanation does not pertain to this ‘Component’. Any manhook on any door must be a “pull-pull” type so that persons cannot be easily pulled out from the compartment through the door. Remember that doors will typically open outward (which is required for either Type II or Type III ambulances) under a simple manual light-pulling force of about 0.5 pounds of force, so this is not a violation of the requirement that the doors be able to be opened at all times with up to a 10-lb force. Although the roof hatches meet the minimum required size for any emergency exit in an ambulance, they are specifically only intended for emergency entry use and would not likely meet the letter of the law as a method for egress from the ambulance in many potentially life-threatening conditions.
5.2. Fire Suppression Systems
Armored vehicles are typically designed to prevent them from being pierced or penetrated by gunfire or explosives. However, powerpacks, fuel tanks, and fuel lines are vulnerable to the heat of an explosion and/or the subsequent fires. Depending on the severity of the fire and the location of the incident, egress may be impossible until the fire is suppressed.
Ambulances carry oxygen and volatile chemicals to treat and transfer the casualties of the explosions, increasing their risk of a fire. Given their increased level of protection, armored ambulances typically have a greater risk of internal explosion. 50% of explosion incidents are caused by fires.
There are two systems incorporated in all modern armored ambulances to extinguish a fire and ensure its non-continuation. Static Fire Suppression Systems are a combination of different detectors and extinguishing agents (FE-25, FE-36, and HFC-227ea) whose selection depends on weight, ease of use, and health risks. At the local level, there are separate fire extinguisher units with and without water-submersion systems. This explosion response combines remote and local control.
A Halon 1301 system is the only fire suppression system used by a government currently. Armored Mandela Garage performed an internal trade-off study to revise the Cook County fire suppression systems in an armored BLSA. Comparing whether a dry chemical or clean gas system would be more efficient overall. Safety with any new system (to include a wet chemical system) will be reviewed by the vehicle manufacturer prior to installation.
Loss of the vehicle operator will have a high impact on the armored ambulance crew, even though they are a lower rating cut NIOSH in comparison.
