This paper is an evaluation of the predicted safety performance of three USA prototype ambulance vehicles with aftermarket structural modifications. Expected safety performance was analyzed using existing and established automotive safety principles. Information on design and construction of the vehicles was identified, and evaluated via application of basic engineering crashworthiness principles and laws of physics, with a specific focus on countermeasure design for reducing harmful loading and injury causation potential in crashes or sudden decelerations. Data sources used for the analysis included:​ vehicle specifications, inspections, photographs, crash tests and published crashworthiness and injury mitigation literature.

Results demonstrated poor vehicle structural integrity and crashworthiness for these aftermarket modified ambulance vehicles. Assessed crashworthiness performance and occupant protection do not appear optimized even for the minimally structurally modified van. Current interior design features (seat design, patient transport device design, head strike zones and restraint systems) and layout, demonstrated predictable serious crashworthiness and occupant protection hazards.

These are projected findings, rather than actual crashworthiness tests – however this is the first comparative automotive safety evaluation of prototype ambulance vehicles. This is key information for a major fleet of vehicles globally which has had minimal automotive safety attention or input to date.

From this study it appears there are major deficiencies in safety design of these prototypes. Emphasis on a passenger compartment that has crashworthy features, effective seat design, based on existing literature and a clear focus on occupant human factors and equipment location and anchors, could provide for major safety enhancements for ambulance vehicles. There is need for vehicle safety researchers, ambulance industry and vehicle designers to recognize and apply these existing principles to reduce current failures in an important and essential service that appears to have a poor safety record, considerably below that of other passenger (Maguire 2003, Ray 2005, Levick 2006) and also other commercial vehicles (FMCSA).