Ambulance Types
What is an ambulance?











What makes an ambulance and what ambulance types are there? This is both an easy and a difficult question to answer. We have all scene ambulances racing down the street with their lights and sirens but we should know more if we are to be emergency services professionals.

The simplest answer to what is an ambulance is that it is a vehicle to transport a sick or injured person to a place where they can be treated. However this doesn’t really cover the subject. Wikipedia uses the following definition:

"An ambulance is a vehicle for transporting sick or injured people,[1] to, from or between places of treatment for an illness or injury. The term ambulance is used to describe a vehicle used to bring medical care to patients outside of the hospital or to transport the patient to hospital for follow-up care and further testing. The word is most commonly associated with the land-based, emergency motor vehicles that administer emergency care to those with acute illnesses or injuries, hereafter known as emergency ambulances. These are usually fitted with flashing warning lights and sirens to facilitate their movement through traffic. It is these emergency ambulances that are most likely to display the Star of Life,[2] which represents the six stages of prehospital medical care. Other vehicles used as ambulances include trucks, vans, bicycles, motorbikes, station wagons, buses, helicopters, fixed-wing aircraft, boats, and even hospital ships."

In days of yore, ambulances were even other human beings who carried the wounded on their backs. The development of different ambulance types parallels the history of war. The history of ambulances starts with the crusades.

Before the mid 1960's land-based ambulances were based on hearses and generally performed their jobs well. The issue before the Unites States was that the standard of care for ambulance attendants was widely varied across the nation. The US government sponsored a research project to determine the state of emergency medical services in 1965. This resulted in the now famous 1966 White Paper
The US Government, as a result of the 1966 White Paper, developed a basic set of guidelines of what is a land-based ambulance. In brief, an ambulance should be:

  • Temperature
    • The ambulance needs to be able to operate if the exterior temperature is between 0 to 95 F
    • The interior minimum temperature needs to be maintained at least at 50 F
  • Speed
    • The ambulance must be able to maintain a sustained speed of 65 mph
    • The ambulance must be able to pass at 70 mph
  • Acceleration from 0 to 55 in 25 seconds
  • Hills
    • The ambulance must be able to travel up a 3 % hill at 55 mph
    • In additional the ambulance must be able to travel up a 35% hill (steep) at 5 mph
  • Fuel
    • Range of 250 miles w/o refueling
  • Water Crossing (fording)
    • The ambulance must be able to make 3 passes through 8 inches of standing water without flooding at 5 mph for a distance of100 feet
  • Width less than 96 inches excluding mirrors
  • Loading height no more than 34 inches
  • Must undergo a static pull test
  • 2200 lbs static load test in all directions, front, back and verticle
  • No dynamic load tests
  • No crash test dummies

As you can see this is a very generic list of features. Of course the US Government can't leave things so simple. If a manufacturer of various ambulance types then they need to abide by the KKK specifications for land-based ambulances as set forth by the US General Services Administration (GSA). This is also referred to as the "Triple K" specificatio The current specification is KKK-A-1822F as of August 2008 (Warning! Opens a new window)
The short description of the KKK specification for ambulance types is:

  • Temperature
    • The ambulance needs to be able to operate if the exterior temperature is between 0 to 95 F
    • The interior minimum temperature needs to be maintained at least at 50 F
  • Speed
    • The ambulance must be able to maintain a sustained speed of 65 mph
    • The ambulance must be able to pass at 70 mph
  • Acceleration from 0 to 55 in 25 seconds
  • Hills
    • The ambulance must be able to travel up a 3 % hill at 55 mph
    • In additional the ambulance must be able to travel up a 35% hill (steep) at 5 mph
  • Fuel
    • Range of 250 miles w/o refueling
  • Water Crossing (fording)
    • The ambulance must be able to make 3 passes through 8 inches of standing water without flooding at 5 mph for a distance of100 feet
  • Width less than 96 inches excluding mirrors
  • Loading height no more than 34 inches
There are three general ambulance types with several subtypes. When you are specifying what type of ambulance you want you should know the general overall features of the ambulance. A Type I is a Cab Chassis with modular body. The Gross Vehicle weight over 10,001 pounds but less than 14,000 pounds.

The major feature of a Type I ambulance is that it is based on a truck style body with a separate driver compartment. Most heavy duty ambulances are of this type. There is a subclass to this ambulance type, aType I AD (Additional Duty) with a gross vehicle weight of 14,001 pounds or more with extra cargo capacity.

Type I Ambulance

Type II ambulances are a long wheelbase van type with an Integral cab design. The gross vehicle weight is between 9,201 pounds to 10,000 pounds.

Many long-distance transport services use Type II ambulances because of their increased fuel efficiency. In general they do not make for practical emergency services because of their cramped spaces.

Type II Ambulance Small

Type III ambulances are based on van chassis rather than truck chassis. The cab is an integral part of the ambulance. The gross vehicle weight is the same as for type I ambulances: 10,001 pounds to 14,000 pounds. Advanced Duty (AD) ambulance types are also available with gross vehicle weights over 14,001 pounds.

Bogota BA2 Type III

You will see the "Star of Life" on many ambulances. To display this symbol legally in the United States, the ambulance type must meet or exceed the KKK specifications described above.
Star of Life
This history of the Star of Life starts in 1973. Up to that time, many ambulances displayed a "Red Cross" on the side of the ambulance. The American Red Cross naturally complained that this implied that they approved of the ambulances. This is not an activity that the American Red Cross engages.

However the use of the red cross symbol can still be seen on military vehicles, hospital tents and buildings to protect wounded civilian and military personnel as per the Geneva Convention in times of war. 

The Star of Life was designed by Leo Schwartz (EMS Branch Chief at the National Highway Traffic Safety Administration ( NHTSA ) United States of America. ) The star of life was to help identify common emergency services and products related to emergency medicine.

The six barred blue symbol was adapted from the medical identification symbol and was registered on February 1,1977 with the commission of patents and trade marks in the name of the NHTSA. The trade mark expired in 1997. Each bar on the Star of Life represents one of six functions. They are as follows: 

  • Detection,
  • Reporting,
  • Response, 
  • On Scene Care,
  • Care in Transit,
  • Transfer to Definitive Care. 


The snake and staff in the symbol portray the staff of Aesculapius, son of Apollo, the staff represents medicine and healing. The Star of Life symbol can be seen as a means of identification on ambulances and ambulance equipment world wide. Its use on EMS patches in the US and other countries signifies the wearer has been trained to meet National or State Training Standards as laid down from time to time.


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