Type II ambulances are built on a van-type chassis and have been an ambulance mainstay for EMS agencies for many years. The popularity of the Type II ambulance is usually attributed to three things: lower initial cost, better maneuverability in congested areas and a more comfortable ride for the patient compared with Type I or Type III ambulance.

Type I and III ambulances have a square patient compartment that is mounted onto the chassis. The only difference between Type I and III is in the chassis. Type I is mounted on a truck like chassis, whereas a Type III is mounted on a cutaway van chassis.

Enter the "vanbulance." The first of these newer and smaller Type II ambulances first made their appearance in the United States as the Dodge Sprinter but are now sold under the Mercedes-Benz brand as it has since the Sprinter was first introduced to European countries in 1995.

Rear doors of a Ford Transit van/ambulance (Image by Greg Friese)

More recently, the Ford Motor Company has brought its Transit model van — popular in Europe for use in ambulance conversions — across the pond.

Sprinter ambulance conversions are common in Australia, Asia, Europe, Mediterranean countries and South Africa. Canada has a developing market for Sprinters but their use in the U.S. has been somewhat limited by the large number of manufacturers using American-sourced cab-chassis and vans.

Safety improvements

As with any ambulance purchase, the details are found in how the functions of the patient care compartment are incorporated into the vehicle chassis. This is where variances can occur from one ambulance outfitter to another.

Here are some reasons to consider a vanbulance for your next ambulance purchase.

Safety for the provider in the patient compartment has been enhanced by removal of the side-facing bench seat. In its place is a captain's chair type seat located next to the stretcher in a forward-facing position with lap and shoulder belt restraint system.

Ambulance outfitters have taken the smaller patient compartment and redesigned it so that it's more akin to the inside of a medevac helicopter.

Using work ergonomic design, the necessary patient care equipment is located so the medic can reach it while seated and belted rather than walking around the patient compartment. Equipment storage compartments are designed to prevent their contents from becoming projectiles in a crash.

Dollars and cents

From a fleet-management standpoint, selecting a vanbulance is a sound business decision. These vehicles have better fuel economy, more leg and headroom, substantially decreased maintenance costs and a longer service life.

The automotive technology itself is a big plus for potential buyers, according to Mark Van Arnam, president of American Emergency Vehicles.

"We do a lot of work with the Sprinter chassis and the on-board safety systems like the electronic stability and load adaption help the driver adjust to the conditions on the road and people [patient and crew] inside," said Van Arnam. "[Mercedes-Benz] have continued to improve an already good ABS (automatic breaking system) that's evolved into a very effective acceleration skid control system as well."

In 2014, a new safety feature was added that helps to protect drivers from sudden side-wind gusts. This safety system calculates the vehicle's current speed, load and driving characteristics to warn the driver when those factors are coming together to increase the vehicle's susceptibility to being pushed or blown over by a cross wind.

Also in 2014, Mercedes-Benz started using the first certified SULEV-diesel engine in the world, delivering up to 90 percent fewer emissions than equivalent gasoline-powered vehicles. Super ultra-low emission vehicle (SULEV) is a U.S. classification for passenger vehicle emissions.

Outfitted

The key to getting any ambulance that will meet your department's expectations starts with selecting the right outfitter — the company that will take the stock vehicle and convert it into an ambulance.

"Most of the reputable ambulance outfitters today have been certified by the vehicle's OEM (original equipment manufacturer) as master outfitters," Van Arnam said. "Mercedes-Benz, as do most of the other OEMs like Ford and GM, has a very strict program where they come in and give your entire operation a thorough review to ensure that you've got the technical expertise and infrastructure to do the work.

"Once they've certified you as a preferred upfitter [the Mercedes-Benz designation], they make sure that you always have the most up-to-date technical information and work methods to work with their product."

Other automotive manufacturers are starting to make a bid for the emerging market for this new Type II ambulance, among them the Ford Transit. The Type III ambulance (patient care box on a cutaway van chassis) is also getting an upgrade.

"We've already had inquiries from a couple of large municipal EMS departments in Florida who are looking to have the Sprinter chassis used to construct their new Type III ambulances," said Van Arnam.