Most people don’t think much about an ambulance unless it’s required in an emergency or you need to get out of the way of one.
The evolution of the ambulance followed improvements in the pre-hospital treatment of medical and trauma patients, and like the field of EMS (Emergency Medical Services), improved over time. Today’s ambulance is a well-equipped mobile emergency room capable of providing life saving interventions when a skilled medical provider is involved.
Early ambulances had basic requirements: a long, enclosed space for a patient to be transported to a hospital in a supine position — lying flat on their back, sometimes on a soft stretcher, suspended cot or a rigid litter. These were demands very similar to those of a hearse, and, indeed, many hearses pulled double duty as the local ambulance — a rather efficient if not macabre system.
As far back as 1909, when James Cunningham, Son and Co. displayed their first motorized ambulance at the Rochester, N.Y., automobile show, bespoke ambulances have been in production for the military and private hospitals. Cunningham’s quality and opulence translated well to their line of “professional cars,” which emulated their earlier horse-drawn conveyances complete with large carriage lamps and intricate wood carving. It was not uncommon for respected hospitals to keep a fleet of matched ambulances and “invalid cars” that were often built by Cunningham. However, unless living near a large hospital or in a metropolitan area, there was a good chance the local hearse was going to take you to the clinic or the morgue, depending on the severity of your condition.
Ambulances soldiered on through wars and peace, adopting equipment and procedures to accommodate the changing times and modalities, until a white paper released in 1965 explored the lack of standardization among ambulances and the potential hazard of this lack of uniformity, especially among passenger-car based units with little or no modifications for the demands of its critical mission.
This same paper shone a light on the need for standards among medically trained personnel, paving the way for the current EMS licensing system with levels, including EMTs and paramedics. In 1966, the National Highway Traffic Safety Administration set standards and regulations for the future ambulance manufacturing.
This brought us to the era of the stretched and modified, large car-based ambulance. Who can forget those high-roof Cadillacs and Oldsmobiles plying the roadways, the prolonged wail of their fender-mounted air sirens, and their rotating roof lights at all four corners rolling a warning to anyone in their path as they wallowed and pitched down the blacktop.
Coach builders with names like Superior, Cotner-Bevington, S&S and Miller-Meteor converted mostly General Motors commercial car chassis to accommodate the raised roof and added weight of equipment and modifications. It’s no coincidence that many of these same coach builders created other professional cars like hearses, limos and airport cars — stretched sedans and station wagons with multiple doors on each side.
These car-based ambulances were usually sparsely adorned with a few cabinets for medical supplies and a small, often folding single seat near the patient for the ambulance attendant to administer some basic care or monitor the patient. Despite the raised roof, there was no standing up in the back of these rigs.
By the 1970s, the writing was on the wall for these cushy transports with the 1974 passage of the 1973 EMS Systems Act, ultimately implemented in 1978. This new rule required ambulances to be based on a commercial truck chassis, tying federal funding for community EMS services to ambulances that met the new specifications.
These same rules are mostly still in play today. Modern ambulances are classified as Type I, or a pickup truck-style cab with a modular patient compartment behind; Type II — a raised-roof van; and Type III, which is the front of a van with a modular patient compartment on the back.
Passenger-based cars were purposely excluded from the 1973 legislation, presumably for safety reasons and patient care accommodations, ending an era.
The last car-based ambulance was built by Superior on a 1979 Cadillac chassis and purchased by an EMS advocate and doctor from the Mayo Clinic as a collection piece. It never carried a patient and remains preserved and in private hands.
Eric and Michelle Meltzer own and operate Fryeburg Motors, a licensed, full-service automotive sales and service facility at 26 Portland St. in Fryeburg, Maine. More than a business, cars are a passion, and they appreciate anything that drives, rides, floats or flies.