The earliest 'ambulance' carriages

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The concept of ambulance service started in Europe with the Knights of St John who created the first ambulances. During the Crusades of the 11th Century, the Knights of St John received instruction in first-aid treatment from Arab and Greek doctors. They then acted as the first emergency workers, treating soldiers on both sides of the war of the battlefield and bringing in the wounded to nearby tents for further treatment. At this time it was common practice to pay small rewards to soldiers who carried the wounded bodies of other soldiers in for medical treatment.

Throughout history man has devised methods to transport the ill and injured. Hammocks were readily available and used for centuries. During the time of the Romans and Greeks, chariots served as ambulances. In 900 A.D. attendants used a wagon with hammocks in it. While this was a step forward, these wagons lacked effective brakes. In 1100 A.D. the Normans arrived in England with the innovative horse litter. These units consisted of two horses with special harnesses that suspended a bed between them.

Horse-driven ambulance of the 1900s

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Pack animals often served as ambulances. Horses, mules and camels carried the injured for care. Attached to them were litters or chairs, also known as cacolets. These held one or two soldiers. Over time the apparatus grew more elaborate as men sought to create safer and smoother rides.

The first motorized ambulance came on the scene in the year 1899. Made in Chicago, it weighed sixteen hundred pounds and traveled at sixteen miles an hour. It was donated by five businessmen to Michael Reese Hospital.

A 1916 Ford Model T ambulance

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In 1900, New York's St. Vincent Hospital obtained its first horseless vehicle. The first motorized ambulances had two horsepower electrical engines and had the capability of traveling as far as twenty to thirty miles. A well-known manufacturer of ambulances was Hess and Eisenhardt of Cincinnati, Ohio. They first began building ambulances in 1890 and produced a motor-driven ambulance in 1906.

When World War I began some ambulances were still horse-driven. When the United States entered the war they brought Model-T Fords with them that could travel as fast as 45 miles an hour and served well on the rough terrain.

During World War II various countries provided vehicles to use as ambulances. The United States converted a Dodge truck with a six-cylinder engine that had four forward speeds and weighed half a ton. The British used the Rover 9 on the front lines. It had space for two stretchers or one stretcher and three seated wounded or six seated wounded. Another British ambulance used by the Allied troops was the Bedford — a four stretcher capacity or could accommodate ten seated wounded. Another type of ambulance used during the war was the half-track configuration — these had wheels and tracks or were amphibious vehicles. The half-tracks were put to good use over rough terrain and along the beaches.

Rapid advancements took place in the late 1950s and 1960s in the way ambulances served the sick and injured — physicians came to the realize that treatment at the scene, especially for heart attacks, could make the difference between life and death.

As we enter the twenty-first century, experts continue to discuss changes for ambulances. With the possibility of bio-terrorism and naturally occurring communicable diseases, the air quality in the ambulance is receiving attention. Service workers are influencing the design of the unit in such areas as vehicle visibility, sliding side-entry doors and the needs of specialized units like cardiac or neonatal...