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.
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.
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.
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.
“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.
“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.
“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.