So my agency is a smaller rural fire dept. We currently use a 2002 extra cab brush truck for medical responses but it's been problematic and is in need of being a strictly brush response unit.

First off, my chief will never purchase an ambulance. He hates the word and the association to transporting units.


So, for a while we've been considering a walk in rescue, but the latest discussion is a Suburban outfitted as an ALS unit with a reserved spot for a back board in case we need to take a patient to meet a Medivac or get them out of the weather.


Has anyone used Suburbans or Excursions as medical units and what was your thoughts on it.


I appreciate your feedback

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Are you a state licensed patient transport agency ??? If so, there should be state standards that should be followed. If not, then you should not be transporting any patients. By your post, it seems that you may be more of a medical first responder group. We are a small rural fire dept, with licensed medical first responders, and we all carry our jump kits in our POV, but are not allowed to transport according to the state and medical director.

We're not a transporting agency. The only movement we would do with a patient is from the scene to a helicopter LZ.


I agree with Bull, Know your state's laws.

We're not a transporting agency. The only movement we would do with a patient is from the scene to a helicopter LZ.

Is this not transporting?

There are a couple of departments near mine which run MR units. More expedient and less expensive than running an engine, but their purpose is for first response prior to EMS arrival. They can provide basic care and can be an extra attendant on the ambulance if needed. By law, they are NOT used for transporting patients, even if it is across the street. The penalties can run tens of thousands of dollars for violations.

That's almost all NJ ALS units use due to the law requiring hospital based non transport units. Any of the ALS hospitals can provide you pros and cons, along with best practices. Hospitals  to contact: Jersey City, Capital Health, Virtua, Atlantic Health, MONOC and Underwood to name a few. Google NJ MICU hospitals for contact information.

Im pretty sure the whole state of DE has some sort of medic chase units as well as southern PA and the Eastern Shore of MD

I was with a department in the Vancouver, WA area that is similar to the type of response area you described, and they purchased one last year. I was talking to my BC and Captain last week and they said it was a great purchase. They are probably 75-80% medical in the calls they get and have alot of tight driveways and roads to navigate. Financially it has been a good thing as far as maintenance and fuel costs. The crews love it and have had nothing negative about it at all. It's stocked with ALS equipment and set up with backboards in case of an absolute emergency to make a short transport if necessary, and still able to seat 3 personnel. AMR covers their entire county so they don't have any ambulances and were responding in the engines to all medical calls.

I have heard of departments using SUVs more and more for their low maintenance costs, manuverability and quick response cababilities. It is definitely something worth looking into for your department.

One thing they did was a lot of research with the crews to find the right size SUV that would be big enough for the needed equipment and personnel and still be capable of going off road when needed since they are a fairly rural area.

I think they might have gone with a Suburban. At least thats what was being looked at right before I left the department. But they looked at Fords, Jeeps, and FJ Cruisers too.

Several departments in this area, career and combination, use SUVs as their primary medical response units. Lots of space and the ability to transport 5 members.

Using a brush truck for EMS does put a strain on the vehicle and will always lead to increased wear and tear resulting in a shorter life as a brush truck.

My combo department uses a 4-door Ford F450 with a utility box at our staffed (busiest) station. We also keep a Ford Explorer there as the second out EMS response unit.

Our volunteer satellite stations use 2-door F450s with a utility box. One station uses an F450 with a 300-gallon skid unit on a smaller box, but that is the slowest station in terms of EMS calls.

There are some counties south of Washington DC that use Chevy Suburbans and Tahoes chase units for ALS ops one has a medium duty ambulance unit or mini squads.

While I was visiting a fire dept in a town where I lived as a child in North Carolina, I noticed they had a Ford Excursion medical unit instead of a ambulance. The county had a career ambulance service but the ambulance was based at another station in the area so they ran the Excursion out this station. I did notice the unit had a cot in the back which they told me was for situations when they have to move a patient to a main road or during bad weather.

When I joined our dept in the 70s, most depts had Cadys, Vans, Suburbans and a few had Swabs boxes. The first ambulance I drove was a Suburban plus the county had bought the commerical built Suburbans ambulances which had the rasied roofs. 

There is an ambulance service near me that uses suburbans and will even transport in them. Overall, they work, but can be a pain when trying to tube a pt or if the Shit hits the fan and you have to deal with a core.  As a first response, non transport medic unit I believe that it would work well.

  They work very well. Make sure you spec. one out to your needs.  As for transporting laws, I can't say anything about that.  Why?  Cause I don't live in your State. Plus I don't  care. 


  I have had to place patients in a rescue/squad. to take to an Ambulance or medivac.   Why?  Well terrain and weather. Here is the main reason we put them in a non transporting unit.  If we didn't, they would of..Uh, let me see what's the term I am looking for...Oh yes they would of F**king DIED!

    I hope this helps.


Briefly, our Dept (Dutton Fire Rescue) in Kent County, MI has used both; Suburbans and now a Ford Excursion.  Both units have worked well for medical first response calls which make up about 3/4 of our 500 or so calls per year.  My best advice is to consider what equipment you will need to carry and if it will be used for any other purpose.  we carry extra SCBA's and bottles in addition to our medical gear.  I would recommend, if possible, a 3/4 ton unit as you always end up with more sh... um... stuff than originally planned.  Lastly, we purchased a used unit from a neighboring department to "try before we buy".  If you'd like I could try to get some pics of ours, just let me know and stay safe.

Pictures would be awesome. Can email me at

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