MOTOR AMBULANCE WORK
Considerations of Design of Emergency Ambulances--Points to
be borne in Mind--Some Examples of Practical Designs now in
Service--The Work of Motor Ambulances at the Front--Scouring the
Battlefields--How the British Red Cross Society gets its Fleet.
Among military uses of motor vehicles, the motor ambulance probably
comes next in order of importance after the transport and supply
waggons. Evidently with the motor ambulance must be grouped cars
suitable for use in carrying wounded men who are not obliged to be
transported in a recumbent position, and even ordinary touring cars
when employed, as they are being somewhat extensively at the present
moment, for taking convalescent men on health-giving motor trips. This
last is a quite useful class of work in which even those motorists
can participate who are only able to offer their services and those of
their cars in the vicinity of their own homes and at specified hours.
In times of peace, the motor ambulance proper is, so far as its chassis
is concerned, more akin to an industrial vehicle than to a touring car.
The heavier examples, in some cases, run on solid rubber tyres, and
in others on twin pneumatics, while the lighter types are fitted with
single pneumatics of heavy section. In detail, the chassis is simple
and strong, and well adapted to be put under the charge of a driver
of only average mechanical ability. The principal points are that the
vehicles should be silent in running, not liable to derangement and
extremely well sprung. Owing to the first consideration, worm-driven
chassis are particularly suitable for this class of work, and owing to
the second a slightly modified light van chassis is generally to be
preferred to the highly-refined but more complicated touring car.
[Illustration: AMBULANCE DRILL OF THE CITY OF LONDON BRANCH OF THE
BRITISH RED CROSS SOCIETY, USING CARS FITTED WITH THE B.H.S. SPRING
STRETCHER-SUSPENSION.
LIFTING THE STRETCHER.]
[Illustration: LOADING THE STRETCHER INTO THE CAR BODY. IT IS
AFTERWARDS RAISED FORE AND AFT AND ATTACHED BY STRAPS TO THE SPRING
HOOKS PROVIDED. NOTE THE MEN RUNNING TO THE FRONT TO LIFT THE FORWARD
HANDLES.]
[Illustration: A TOURING CAR EQUIPPED WITH A FOUR-STRETCHER AMBULANCE
BODY BY MESSRS. BROWN, HUGHES AND STRACHAN, TO THE ORDER OF THE DUCHESS
OF WESTMINSTER.]
In time of war, the ambulance chassis is, roughly speaking, anything
big enough and sufficiently reliable that can be made available. For
example, motor omnibuses can be without much difficulty adapted to
this class of work, while touring cars are often quite suitable. The
qualifications in the latter instance are fairly ample engine power,
thorough reliability and strength for working over rough road surfaces,
very strong springs and ample wheelbase, so that the ambulance body
shall not overhang the rear of the chassis to too great an extent.
To form the complete vehicle, what is wanted at such times is not
necessarily a luxuriously-equipped conveyance, but is rather a quite
light and simple body sensibly constructed to bear its load, and
capable of standing any amount of jolting without either its component
parts shaking loose among themselves, or the body as a whole becoming
insecure in its connections with the chassis.
As regards the interior equipments, in most instances all that is
needed is provision for readily fixing in place two or four stretchers
as the case may be, and also for loading the stretchers on to and
unloading them off the body without difficulty, and without unnecessary
discomfort to the patient. The standard types of ambulance body
approved by the British Red Cross Society consist of simple but stout
wooden frameworks with all the joints reinforced by angle irons held
by bolts through the wooden members, and not merely by wood screws,
which are liable to work loose. Over this framework is stretched a
cover of waterproof canvas that has been treated with rubber, while the
front and back of the vehicles are covered in by waterproof curtains
of similar material, capable of being drawn aside or raised quite
easily so as to enable attendants, with the minimum of difficulty, to
lift the loaded stretchers into the vehicles. Medical experts who have
experience in the carriage of wounded men do not appear to be entirely
in agreement as to whether the stretchers in a motor ambulance should
be rigidly secured to the vehicle body, or should be carried by some
form of springing supplementary to that of the car itself. In some
examples of ambulances in regular use in this country, additional
springing is provided by suspending the body from the chassis by means
of semi-elliptical or complete elliptical springs. In many others, no
springing other than that of the vehicle itself is interposed between
the stretcher and the ground. One point at least on which there is
universal agreement is that on no account must any rolling motion of
the stretcher relative to the vehicle body be permitted, as motion of
this kind causes acute discomfort to the patient, and often leads to
physical effects similar to those occasioned by the rolling of a vessel
at sea.
Probably side loading is the ideal method of getting stretchers on to
an ambulance car, but it is difficult to realise the ideal in the case
of a simple and fairly cheaply constructed body. Consequently, the
system of end loading is far more common. In this case, the stretcher
is generally slipped in along the floor of the vehicle, and when right
inside the car, is raised to the necessary elevation to allow it to
be secured in position. The lower stretchers are afterwards slipped
in and similarly secured. A design in which this is possible is more
convenient than one in which the upper stretchers have to be raised to
their full height before the operation of sliding them into the car can
be attempted.
[Illustration: _“The Autocar” photograph._
A FRENCH MILITARY SEARCHLIGHT MOTOR. THE SEARCHLIGHT IS CARRIED ON AN
UNDERFRAME, WHICH CAN BE LET DOWN IN THE MANNER SHOWN. THE ELECTRICITY
IS SUPPLIED FROM THE MOTIVE POWER OF THE CAR.]
[Illustration: _“The Autocar” photograph._
AN OPEN TOURING CAR CONVERTED INTO A MOTOR AMBULANCE.]
A type of fitting which has been adopted for some of the two-stretcher
ambulances of the British Red Cross Society is that known as the L.X.R.
It consists of a simple steel-tubed framework, the corner members
of which are slotted to take the ball ends of cross bars from which
the stretchers are slung by very short ropes and straps. When in
position in the slots, the cross bar ends bear on the tops of strong
spiral springs which relieve the stretcher of a certain amount of
vibration but at the same time, not being free to move other than in
the vertical, do not set up any rolling motion. When these fittings,
which are manufactured by Messrs. Simonis, are used, no weight is
carried from any portion of the ambulance body except the floor.
Consequently, the remainder of the construction can be very light and
merely designed to support the waterproof covering. For four-stretcher
bodies the British Red Cross Society have at the time of writing been
employing two main types. In one of these, the stretchers merely slide
in, the upper ones on to shelves and the lower ones along the floor,
and are secured quite rigidly in position. In the other type, a system
of spring suspension has been adopted. This latter system--evolved
for the Society by Messrs. Brown, Hughes and Strachan--adapts itself
to the construction of a simple, strong, but quite inexpensive body,
to the main members of which are bolted iron arms which can be easily
arranged so that they can be swung to one side while the car is being
loaded, if it is considered that there is any risk of their interfering
with the ease of the operation. Each of these iron arms has a flattened
end, bored to take a vertical iron rod, the lower portion of which is
formed into a hook, while the upper portion carries a heavy spiral
spring concealed in a neat casing. The stretchers are carried from the
hooks by means of quite short leather straps, connecting the hooks
with the stretcher handles. It will be noted that the springs allow
of no movement other than one in a purely vertical direction, and
consequently that practically no rolling should result from the use of
this system, which has the advantage of giving an additional spring
suspension at a very small increase in the cost of the complete body. A
very considerable number of ambulances built on these lines have been
supplied by the makers to the Red Cross Society.
It is impossible to lay too much emphasis on the desirability of using
for ambulances, chassis with long wheelbase, in which the stretchers
are as far as possible carried between the wheels, and the patients
thereby protected from direct road shock. It is not to be expected
that short wheel-based chassis carrying ambulance bodies with a big
overhang at the rear, will prove durable over the broken roads of the
countries in which war is taking place. If wheelbase is not sufficient
to allow of the fitting of a four-stretcher body without these grave
disadvantages, the only thing to do is to put up with the smaller
accommodation of a two-stretcher body. The usual arrangement in this
case is to extend the body right forward towards the dash on the left
of the driver, and so to push the stretchers a couple of feet further
forward, the space inside the body behind the driver serving for the
carriage of luggage, for an attendant, or for one or two wounded men
who are not very seriously injured. One of the great dangers in this
arrangement is that of obstructing the view of the driver towards his
left. This is particularly serious when the car is for use in countries
where the rule of the road is the reverse to our own, and where traffic
in the opposite direction has to pass on the side upon which a free
view is obscured. A possibility is to take in the space below the
driver’s seat and that alongside of it, and to run in the patients
on their stretchers, feet first, alongside of one another on the
floor of the conveyance. In this way, about a foot of length can be
economised, and with a two-stretcher body of this type it is of course
not necessary for the super-structure to be either strong or high.
Another important point, if the cars are to go abroad and to be used
under bad conditions of road surface, is that any ordinary simple
method of attaching the body to the chassis must be very carefully
examined before it is approved. Something more than average security is
needed.
A fair number of touring cars are being changed into motor ambulances,
not by replacement of the body but by its adaptation. This method has
the disadvantage that it renders the old body subsequently useless for
other purposes. Further, it is likely to cause delay, since every case
has to be considered on its individual merits. Also, unless the chassis
is a long one, the adaptation will almost certainly involve a big
overhang.
[Illustration: _“The Autocar” illustration._
A TYPE OF EXTEMPORISED MOTOR AMBULANCE FAVOURED BY THE FRENCH AND
BELGIANS.]
These notes will serve to give the necessary information to those who
may wish to equip motor ambulances for any kind of use during the
war, and there does not appear to be any need to go into details of
all the various other varieties of ambulance body, many of them very
beautifully fitted and designed, but also very expensive. One other
type may, however, be mentioned, since it is being employed extensively
by the French and Belgian Governments. This consists essentially of a
stout floor carrying two iron frameworks of inverted V shape. Between
these two and stretching fore and aft is an arrangement similar in
principle to a squirrel cage, or to a water-wheel with four floats. The
place of each float is taken by the necessary apparatus for the support
of a stretcher, provision being made that all the four stretchers
retain their horizontal position whatever the position of the framework
supporting them. The stretchers can be loaded in from the side to the
bottom position, and the apparatus swung round so that this operation
is continued, the stretchers after being loaded being subsequently
raised by the rotation of the frame. It is stated that in Antwerp and
elsewhere this type of ambulance has been used extensively, and is
found to be very comfortable and very easy to construct.
Turning to the work for which the ambulances are being employed, much
of this is of an obvious character. Ambulance services are evidently
needed both at the military hospitals, and also further back at the
big base hospitals of the Red Cross Society on the Continent. They are
wanted again at all the various hospitals in this country to which
wounded men are brought. They are employed, for example, in London, to
meet the hospital trains and carry from the stations those men who are
not able to be conveyed in ordinary cars.
The requirement of motor ambulances nearer the front is almost
limitless. In the system of the R.A.M.C. in service, wounded men are
first removed by regimental stretcher-bearers to the “aid post,” where
medical attention is first given to them. Thence, they are carried by
the bearer sections of the field ambulance--and possibly, if roads
permit, by motor ambulances--to the advance dressing stations, whence
after treatment they are taken by the military ambulance waggons to
meet conveyances from the clearing hospital, which is usually situated
somewhere near the railhead. Upon this hospital falls the duty of
avoiding all overcrowding nearer the front, and this must be done by
employing all available means of transport. Evidently, motor ambulances
are the most suitable kind of conveyance for this work, since they
afford a reasonable degree of comfort to the patient, and even if their
speed capacities cannot be utilised to any great extent while they are
carrying wounded men, advantage can be taken of them while returning
empty towards the front for further load. Once the patients have been
taken as far back as the field hospital at railhead, their subsequent
conveyance to the Red Cross hospitals, or any other required points,
can be carried out by train supplemented by local motor ambulance
services from the termini to the hospitals.
Another and less obvious type of service is that which involves
thorough patrolling of all those districts in which battles have taken
place, with a view to ascertaining whether any wounded men are still
remaining in the villages and along the country-side, where they may be
given thoroughly kind, but possibly somewhat unskilled, attention by
the civilian inhabitants. Another duty of the drivers of the ambulances
carrying out this work is that of setting on foot minute inquiries with
a view to finding out whether any men killed in battle have been buried
by civilians without any record having become available which would
serve as a basis for certain information which can never be so terrible
as an almost hopeless state of suspense. This class of work, of course,
has to be carried out over roads which have in many cases been badly
broken up by heavy military traffic, and possibly even intentionally
destroyed by a retreating enemy. Consequently, it puts a very severe
strain on every portion of the chassis and body of the ambulance,
and makes the fact that the whole of the motor vehicles at present
employed by the Society have been freely given or lent by their owners
without reservation and without charge all the more noteworthy.
For some time past, the Society has been shipping ambulance cars, and
also touring cars, to the Continent as rapidly as means of transit have
permitted. The requirement seems to be enormous, but even so there does
not appear to be any likelihood of the supply falling short of it.
Many motorists have placed not only their cars, but their own services
ungrudgingly at the disposal of the Society. The usual practice is for
the Society, after accepting a car for service, to undertake to have a
suitable ambulance body put upon it in place of its own. In some cases,
however, motorists have even taken this charge upon themselves, and
whatever may be the disadvantages of dependence upon volunteer service,
it can at least be said that in this case such dependence has served in
some measure to show how many men, unable for one reason or another to
take up military duties, are only too anxious to expend their energies
and their money on any object of national value in connection with
which they are able to be of use.