ambulance ambulance an ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. typically, out-of-hospital medical care is provided to the patient during the transport. fiat ducato ambulance in great britain queen elizabeth ii (then princess) next to british army ambulance in 1945 ambulances are used to respond to medical emergencies by emergency medical services (ems). for this purpose, they are generally equipped with flashing warning lights and sirens. they can rapidly transport paramedics and other first responders to the scene, carry equipment for administering emergency care and transport patients to hospital or other definitive care. most ambulances use a design based on vans or pickup trucks. others take the form of motorcycles, buses, limousines, aircraft and boats. generally, vehicles count as an ambulance if they can transport patients. however, it varies by jurisdiction as to whether a non-emergency patient transport vehicle (also called an ambulette) is counted as an ambulance. these vehicles are not usually (although there are exceptions) equipped with life-support equipment, and are usually crewed by staff with fewer qualifications than the crew of emergency ambulances. conversely, ems agencies may also have emergency response vehicles that cannot transport patients. these are known by names such as nontransporting ems vehicles, fly-cars or response vehicles. the term ambulance comes from the latin word "ambulare" as meaning "to walk or move about" which is a reference to early medical care where patients were moved by lifting or wheeling. the word originally meant a moving hospital, which follows an army in its movements. ambulances (ambulancias in spanish) were first used for emergency transport in 1487 by the spanish forces during the siege of málaga by the catholic monarchs against the emirate of granada. during the american civil war vehicles for conveying the wounded off the field of battle were called ambulance wagons. field hospitals were still called ambulances during the franco-prussian war of 1870 and in the serbo-turkish war of 1876 even though the wagons were first referred to as ambulances about 1854 during the crimean war. history early car-based ambulances, like this 1948 cadillac meteor, were sometimes also used as hearses. fire dept of new york ambulance, 1949 the history of the ambulance begins in ancient times, with the use of carts to transport incurable patients by force. ambulances were first used for emergency transport in 1487 by the spanish, and civilian variants were put into operation during the 1830s. advances in technology throughout the 19th and 20th centuries led to the modern self-powered ambulances. functional types ambulances can be grouped into types depending on whether or not they transport patients, and under what conditions. in some cases, ambulances may fulfill more than one function (such as combining emergency ambulance care with patient transport: emergency ambulance – the most common type of ambulance, which provides care to patients with an acute illness or injury. these can be road-going vans, boats, helicopters, fixed-wing aircraft (known as air ambulances), or even converted vehicles such as golf carts. patient transport ambulance – a vehicle, which has the job of transporting patients to, from or between places of medical treatment, such as hospital or dialysis center, for non-urgent care. these can be vans, buses, or other vehicles. ambulance bus – a large ambulance, usually based upon a bus chassis, that can evacuate and transport a large number of patients. charity ambulance – a special type of patient transport ambulance is provided by a charity for the purpose of taking sick children or adults on trips or vacations away from hospitals, hospices, or care homes where they are in long-term care. examples include the united kingdom's 'jumbulance' project. these are usually based on a bus. bariatric ambulance – a special type of patient transport ambulance designed for extremely obese patients equipped with the appropriate tools to move and manage these patients. rapid organ recovery ambulance collects the bodies of people who have died suddenly from heart attacks, accidents and other emergencies and try to preserve their organs." new york city is launching a pilot program deploying one such ambulance with a $1.5 million, three-year grant. psychiatric ambulance – ambulance dedicated to treat psychiatric emergencies. "psykebilen" ("the psych ambo") in bergen, norway pioneered the idea in 2005. other cities in norway and sweden followed suit when the evidence showed that an ambulance service with personnel specially trained in psychiatric treatment was highly effective, and reduced the use of force when treating patients in psychiatric crises. vehicle types in north america (us and canada), there are four types of ambulances. there are type i, type ii, type iii, and type iv. type i is based upon a heavy truck chassis-cab with a custom rear compartment that is often referred to as a "box" or "module." type i ambulances are primarily used for advanced life support (als), also referred to as mobile intensive care unit (micu) in some jurisdictions, and rescue work. a type ii ambulance is based on a commercial heavy-duty van with few modifications except for a raised roof and a secondary air conditioning unit for the rear of the vehicle. these types of ambulances are primarily used for basic life support (bls) and transfer of patients but it is not uncommon to find them used for advanced life support and rescue. type iii is a van chassis-cab but with a custom-made rear compartment and has the same uses as type i ambulances. type iv is for smaller ad hoc patient transfer that use smaller utility vehicles in which passenger vehicles and trucks would have difficulty in traversing, such as large industrial complexes, commercial venues, and special events with large crowds; they generally do not fall under federal regulations. ambulances can be based on many types of vehicle although emergency and disaster conditions may lead to other vehicles serving as makeshift ambulances: a modern american ambulance built on the chassis of a ford f-450 truck, with extensive external storage many modern canadian and european ambulances are built on the mercedes-benz sprinter chassis. some, like this niagara region example, use custom rear compartments. van or pickup truck – a typical general-purpose ambulance is based on either the chassis of a van (vanbulance) or a light-duty truck. this chassis is then modified to the designs and specifications of the purchaser. vans may either retain their original body and be upfitted inside, or may be based on a chassis without the original body with a modular box body fitted instead. those based on pickup trucks almost always have modular bodies. those vehicles intended for especially intensive care or require a large amount of equipment to be carried may be based on medium-duty trucks. car – used either as a fly-car for rapid response or to transport patients who can sit, these are standard car models adapted to the requirements of the service using them. some cars are capable of taking a stretcher with a recumbent patient, but this often requires the removal of the front passenger seat, or the use of a particularly long car. this was often the case with early ambulances, which were converted (or even serving) hearses, as these were some of the few vehicles able to accept a human body in a supine position. some operators use modular-body transport ambulances based on the chassis of a minivan and station wagon. motorcycle and motor scooter – in urban areas, these may be used for rapid response in an emergency as they can travel through heavy traffic much faster than a car or van. trailers or sidecars can make these patient transporting units.