1. Introduction to Ford Transit Ambulance
Ford Transit Ambulance Manufacturing; Road traffic, its speed, and its intensity comprise an important part of modern cities. However, road traffic may also give rise to different types of traffic accidents such as daily accidents and acute large-scale disasters. These disasters may cause casualties and injuries. In this context, people need clear, calm, and quick interventions in order to maintain the existence of acute victims. Emergency contradicts the time and movement concern of daily life. Road traffic vehicles and transportation is an emergency concern of time and space. To fulfill the emergency concern in the best manner, emergency service vehicles and tools should be manufactured in consideration of transportation experts’ suggestions. Ambulances are the most important vehicles for the transportation of injured and casualties. Such vehicles should be designed considering speed, interior comfort, first intervention tools, medical leadership, septic features, and important technological development. High transport standards of these tools provide quick and safe patient transportation.
Ambulance vehicles are expected to be well-designed specialized vehicles for emergency medical interventions, pre-hospital treatment, and transportation of patients to healthcare institutions. Ambulances are the most important type of medical transportation vehicle. Ambulances, which have a longer history compared to other types of emergency vehicles, are vehicles that are equipped with many medical, medical diagnostic, and life-support equipment designed to provide life-saving transportation of injured, critically ill, or acutely injured patients for treatment. Today, such vehicles are fully-fledged intensive care units that have been developed with state-of-the-art technology and are equipped with medical equipment. Transporting injured and ill persons to medical institutions in the shortest time can be a matter of life and death in terms of the survival and treatment of the person. In this context, ambulance vehicle design becomes much more important. Such vehicles need to be built in a manner to meet the requirements of patient care personnel during the transportation and treatment of the injured and the sick. Thus, vehicles must be brought to fully equipped intensive care unit standards. In this context, Ford Transit brand vehicles may be preferred for the purchase and production of special ambulances.
1.1. History and Evolution of Ford Transit Ambulance Manufacturing
Ford Transit Ambulance is a vehicle which has been used in hospitalizing acute-critically ill or wounded people and transferring them to healthcare institutions. They are used in taking injured or ill people from the scene to the hospital or from a healthcare institution to another. Ambulances are one of the commonest vehicles and also emergency-response vehicles used in the world. The meaning of the term “Ambulance” comes from the French ‘ambulance’ meaning ‘movable hospital’. It originated in Latin with “ambulare” meaning ‘to walk or move’. Towards the end of the 17th century, an early form of ambulance was developed in the royal household of King Charles II in The Hague, which was described in the following manner: The so-called carriage of recovery maneuvers through ceaseless precautions, the universal and unforeseen accidents in such a way that patients quickly, without unfavorable consequences, are transported from the sites of accidents either to the royal palace or, if it is considered necessary, to the hospital.
Ford Transit Ambulance Manufacturing, less well-organized attempts at transporting patients had taken place, including one recorded from 1487 in the city of Bruges, and these early missions took place both by wagons full of hay and beds as well as by waterways, facilitated by a lack of urban terrain and the existence of moats. In the world, the first years of the 19th century, many states had their own battle forces and provided extra protection for their settlements with “civilian and military” ambulances. Also, Nicholas P. Colquhoun, Chief Medical Officer at the Sevenoaks Dispensary and Fever Hospital, had already published a paper ‘The Use of Gas in Destroying Nuisances and Destroying Contagion in Cases of Epidemic Diseases’ in the Medical Times.
In the early part of the 19th century, there were no synthesized materials to produce special ambulance vehicles within the borders of the countries. Therefore, physicians, who knew their social responsibilities, used the vehicles and data in a nomadic state or civilian institutions or in their own properties, which were the closest features to present principles. As a result, Horse-Drawn Carriage, Mobile Laboratory, Wheel-Litter, Hand-Litter, and Basket Stretcher appeared as the first components of the ambulances. A moving hospital (en-route hospital) that took care of the wounded on their way to the hospital was established by the new troops of the Ottoman Empire Army, called Nizam-ı Djedid (New Order), which was raised by the reforms made by Sultan Selim III around 1804-1806. It is noteworthy that they were familiar with the works of other states before implementing their work, which is early for this period. The mother of Sultan Selim III, Mihrimah Sultan, is one of the few women physicians in the history of medicine. She provided medical education and service in Arabanophilia. Ambulance Services of the European countries were only concerned with carrying wounded soldiers. Non-transportable walkship surgeries are not their fields of work. There were three types of Ambulances in those years. These are First Ambulance, Mobile Ambulance, and Armored Ambulance. These ambulances were developed separately for three different categories as Medical-Humanitarian Ambulances, Walkship, and Field Ambulances. The ambulance phase, as unified under one roof, was named Ambulance Service by Physicians after the invention of the Motor Driven Ambulance. Ford Transit Ambulance is one of the most preferred models in ambulance services in the world.
1.2. Importance and Role in Emergency Medical Services
Ford Transit Ambulance Manufacturing, huge technological developments, as well as improvements in access to health services, have been seen. Especially due to changes in people’s lifestyles, there has been an increase in road traffic accidents, occupational accidents, and sport-related accidents. Developed countries have motor-driven ambulances and air ambulances, which allow people who have suffered accidents or diseases to reach health institutions in the shortest time possible. This enables a total approach to emergencies in a very short time, resulting in better recovery than before.
In our country, Turkey’s eastern regions are very rich in tourism. However, there are many deaths in this region due to the lack of emergency medical services in many parts. In cases where an ambulance is required, it has to be sent over a distance of 150-200 km.
These types of disasters are considered unfair because it is impossible to react to accidents and deaths in a timely manner. Cars, motor-driven ambulances, air ambulances, and caravans are used to bring health services closer to people. Although caravans provide advantages in reaching hard-to-reach places, they are not as useful as ambulances and do not meet the need for emergency services due to the lack of emergency lifesaving equipment in the vehicle. The term “ambulance” is frequently used in Europe, while “hearse” is used in the U.S.A. for a similar vehicle. The Ford Transit is the most preferred model of vehicle, with over 90% of luxury vehicles being Ford Transit models.
The aim of this study was to present the manufacturing and control stages of Ford Transit ambulances from the beginning to the last stage, the problems faced during the studies, and how they were solved. The goal of this study is to provide assistance to engineers who are interested in the production of this type of vehicle by answering the questions of “where” and “how”. The awareness of the importance of time in emergency health services has been emphasized to control units and to increase the quality.
2. Design and Features Ford Transit Ambulance Manufacturing
The proposed design had 5 seats for personnel, but according to the simulation results, it was considered that there was a possibility that the model could be changed to 4. The control panel in the front compartment was designed as “organizer” totally independent of the body and also designed as “the small front console” integrated with the minimalist barrier (Fig. 1). The handrails of the minimalist barrier were positioned on the lateral ends of the dashboard and console, reducing the number of items, and hence weight. The design of the partition wall was also revised, featuring a lower shelf to better organize the vehicle’s items, since the previous version only had small compartments in the front of the wall for small items such as masks, mobile phones and others. On the shelves both in the central part of the wall and on top of it, the medical kits, serum and electrodes could be placed in an organized and easy way.
The pump control was built into the console and can be directed and re-directed to the back seat if necessary. The electrical distribution of batteries, CP and maintenance were easily accessed in this design. The installation and positioning of medical equipment including an automatic blood pressure monitor, defibrillator, nebulizer, transport bags, stretcher and a more prominent table to use as an emergency table were readjusted and inserted in the model to make possible an optimized operation. At the bottom of the vehicle, spare parts of pre-hospital care, various kits and other necessary things were stored. Inside the cockpit, a spray with chemicals and cleaning products was attached to the door. Taking into account the aerosols that the driver and assistant use to themselves, such as alcohol and moisturizer gel, and also the water required to wash their hands and faces in specific care situations, the door design was modified with small drawers for these items.
2.1. Interior Layout and Equipment Ford Transit Ambulance Manufacturing
There are a variety of equipment and compartments in the ambulance interior. Hence, all of the required medical equipment and materials should be present in the ambulance. Obtaining an interior with all necessary standards is not an easy task during the initial assembly. It usually requires a lot of effort and study. The interior of the vehicle should be redesigned because the existing stands in the vehicle are almost not equipped with equipment, the existing interior has not been used to its full capacity, and certain equipment is not available or is far from the bed. An additional power system is required for the medical equipment inside the ambulance.
Ford Transit Ambulance Manufacturing; Powder alloy coated high strength steel sheets were used in the production. The twelve volleys and the rear side walls of the vehicle are composed of this material. The passenger compartment is covered with linen plywood panels. Sound insulation mats are used inside the retrieve cups and above the vehicle compartment. The air supply pipe for the retrieval and stretchers is created from special steel profiles. The control panel of the patient has been assembled with plywood and designed with special supports. Two adjustable shelves have been designed and manufactured for the medical material to be kept on. It has also been designed and manufactured through a three-step ladder squeezed down the passenger compartment. The main vehicle and tools were assembled in this vehicle. There is a two-camera system in the rear parking area of the vehicle. The top one is sticking with the base of the direction of the maneuvering and the top one is sticking to the first heating direction.
2.2. Exterior Design and Safety Features Ford Transit Ambulance Manufacturing
Exterior design of an ambulance is crucial in distinguishing an ambulance among other vehicles and also in providing safety and comfort for patients. Under its sub-tasks, the term ambulance implies that the vehicle is designed for safe, fast, and efficient transportation of critically ill patients requiring immediate medical treatment in a medical institution. The present study for the structure of the vehicle that is used for the fast, secure and efficient treatment of seriously ill patients includes Ford Transit ambulance design and safety tests performed for this vehicle.
A structure was created as a result of a comprehensive study on the simulation based on the Finite Element Method called FEA (Finite Element Analysis), with linear static analysis techniques using the ANSYS TH customer optimization to be performed according to the stress and the required safety factor (safety coefficient). In the optimization process to be carried out, the stress values formed on the vehicle are aimed to be lower than the yield strength material upper limit, and the densest possible weight may occur. Transit type that Ford Motor Company introduced first in 1965, and had many renovation designs. Lowest model, Firefighter Cutaway, promise quite high while gasoline powered turbo-diesel engines are fairly getting increased performance with diesel engine promises in the short term. Ford Transit, due to its large and spacious interior, is one of the number one vehicle choice to convert it into a wheelchair or medical vehicle. While a standard transit vehicle is not inherently suitable for use as a medical transport car, it may be converted to a medical transport vehicle using conversion packages. In our study, an alternative design has been developed for the vehicle to adapt to medical transport. Ford Transit vehicle is easily adaptable in many ways for adjusting medical staff and patient requirements.
3. Manufacturing Process Ford Transit Ambulance Manufacturing
Ford Transit Ambulance Manufacturing; When the theoretical and experimental studies on the components of the ambulances manufactured for the health sector in Turkey and their connections are examined, it is seen that a redesign is needed for the existing ambulances, and a comprehensive study is needed to produce the high performance required in use. The high number of laws, regulations, and practices related to ambulance design show that there is an application error in practice, and there is a need for a comprehensive research study to ensure harmony between these studies. The application errors reported from the ambulances in the field need to be treated comprehensively and solved geometrically with theoretical and experimental results. During this study, the shortcomings of the existing ambulances in terms of thermal, acoustic, structural buildings, ergonomic, and production performance criteria have been determined by reviewing international design criteria, the legislation and standards on ‘ambulance design’ in Turkey and almost all of the ambulances produced in Turkey were researched after operated in the field about the occurred deficiencies.
Basic performance standards are determined considering the qualifications acquired and reflected in ambulances operating in developed countries to date. A comprehensive design and production study was initiated to contribute positively to human health and the national economy. As a result of the study carried out, it is aimed to determine the requirements of the 1217 legislation principles in accordance with the legislative requirements, and to propose a prototype design that will provide higher performance within the scope of the design approach that will meet the standards that provide quality, easy-access and will be prepared as the basic platform.
Ford Transit Ambulance Manufacturing; The design and production of a medical cabin to be integrated into a domestic vehicle such as an emergency medical technician specially designed for first aid and medical transportation, taking into account standards related to the level of ambulances of international vision models in the design and realization of all ambulance service vehicles that provide service at the basic and advanced level and which have the features that enable high-level medical intervention and comprehensive treatment, with all factors taken into account. The structurally dense steel compartment is used to provide the necessary resistance against vibration and earthquake loading, to isolate the medical environment from negative environmental effects, and to ensure that it acts as a living space for doctors and nurses for the duration of the transfer. It is necessary to pay attention to interoperability in functional equipment such as sockets, fetal monitors, defibrillators, portable auto-ventilators, portable suction devices, and mobile drug lock/heating cabinets, which allow the continuous and easily accessible use of all necessary medical devices especially in the equipment in the medical cabin.
3.1. Assembly Line Production
The main philosophy of the assembly line is to divide the production process into several stages, increasing in difficulty level. Then, systematic, continuous, and standard operations are performed in a series line using special assembly tools, work centers, and force production line process. In other words, an assembly line system is created for line production using “work centers” such as working stations, belt conveyors, transportation V-rays, and product carriers.
Ford Otosan is one of the biggest industrial companies in Turkey. Engaged in automotive production, the Gölcük Kartal Sales & Marketing Office is responsible for the sales of vehicles produced by Ford Otosan’s Kocaeli manufacturing plant units. The Gölcük Kartal Sales & Marketing Office is engaged in the electric, electronic, and electro-mechanic assembly and testing of high technology products, such as the Transit Connect model vehicle’s electric, electronic, and electro-mechanic materials. In the plant, the conveyor system is designed. This system works with the motor reducer, drive belt, and sprockets. The system operates on the assembly control software and controls the height of the products to the equilibrium line. In emergency situations, the product is reduced to the desired height by the operation of the vertical drive unit.
3.2. Quality Control Measures
In terms of reliability, every department is responsible for a specific process and product. The most important aspects of these are quality control and early and precise detection of errors. They lead to better prevention technology rather than error correction mechanism. Internal quality is usually checked by the person responsible for the department through the form filled. Each employee regularly fills in where each omission is collected and the employees take the necessary measures as much as possible. Reports are accepted by taking appropriate measures. Every job order is subject to random control by the quality managers for quality control purposes. Outside of internal controls are done upon request from the secretariat. The supervisor in the customer service department is checking the quality for this department.
Customer satisfaction is provided with fast and accurate services. The institution as Ford is constantly monitored and updated on product defects, corrective, and preventive repairs. The resource is requested from the authorized dealers or imported from the Ford Manufacturing Centre. Each year, a set of shared satisfaction is done by the production process, a developing organization with products to be taken for the quality produced. They follow their after production. The service unit receives new cars directly from the production line. Immediately team comes to the service department to make changes requested by the client, as well as to correct the defects and errors found during the check. They install exhaust equipment on demand. Provide transportation to load for external transformation inside. Small changes and defects are completed inside of transformation. The vehicle then returns to the service department for a quality check. This leads to the safe transformation of customers regardless of the range and quantity of work. Quality products are vital for institutions as a result of high clientele satisfaction and social responsibility objectives.
4. Market Analysis and Trends
The development of the Turkish economy has always been parallel with increases in social health benefits. Living conditions are the basic indicators of the standard of a country’s economy, and the United Nations has defined the standard of social health as “a means of living in dignity and good health”. With these accepted basic criteria, it can be seen that making progress in the treatment and care services by using technology in the health sector is among the essential matters.
Every developed and developing country has to ensure that treatment conditions are provided within a certain standard as a welfare state’s first duty, so taking care of these needs is inevitable. Therefore, providing adequate space for ill people to rest, receive treatment, and to ensure the treatment they receive is of the required standard should be a priority. The entire responsibility for meeting this requirement is placed on hospitals, and with the plans prepared for hospitals, equipment should be selected in line with treatment requirements and up-to-date treatment conditions.
Population increases bring with them increased healthcare needs. These increased needs should definitely reflect the health budget. Turkey’s development since 1923 under Ataturk’s leadership has especially been quite remarkable. However, despite the efforts made to provide health services in line with the general standard in cities, meeting healthcare needs in some rural areas is still difficult.
After its establishment, the Republic of Turkey had very high infant mortality rates and similar health problems, and it was necessary to solve these problems through both infrastructure and staff promotion. The United Nations has accepted free healthcare service as a basic human right. This right is valid for the prevention of diseases and for the treatment of all health problems needing therapy. It is the obligation of the state to lift this burden from the shoulders of citizens, so as to ensure.
Lately, there has been a big increase in the demand for ambulance services, and because of this increase, ambulances have become an important part of transport in order to meet their needs. As it can be seen from research into this topic, and due to rapid advances in technology, Mercedes, Fiat, Peugeot, Renault, and Volkswagen are all making use of automobile chassis for ambulance purposes. Of these, the Mercedes Sprinter is gaining ground every day for ambulance transfers, with products taking full-place ambulance vehicles that meet Turkish ambulance standards being produced.
With increased demand for market-oriented vehicles and the ease of the vehicle to be manufactured, Fiat offers several solutions to the market with its Ducato vehicle system. Volkswagen’s T series, with its long wheelbase version and a large carrier compartment, is not preferred for ambulance manufacturing. However, due to its seating capacity, it is preferred for emergency response services. Renault’s ambulance Transport agency provides infrastructure-appropriate solutions with long and short wheel-based Ambiance vehicles. Manufacturers are doing their best to produce affordable, reliable, and convenient lightweight-type vehicles with brands. The prices of these vehicles are different and are preferred because they are suited to their special conditions.
5. Future Innovations and Technologies
Manufacturers are beginning to think about how some of the latest technologies can be employed in ambulances. CAD and the advertising of the requirements of the vehicle at the design stage will cut down on many of the problems of modifying vehicles with the equipment. Today’s CAD software is so sophisticated that it could be used to visualize just how difficult to operate a complex piece of equipment would be (and where it should not be located).
Modern communications are something of a headache for the ambulance designer. On the one hand, aerials clutter the appearance and can be dangerous when attending incidents on motorways or clearing airfields. On the other hand, it is necessary to communicate with the remote body of the ambulance. Satellite communications are an interesting, albeit expensive, technological advance. They require the complete isolation of the patient compartment from the body of the vehicle, the ‘Polaris’ ambulance having shown that a physically separate patient compartment is best. Data transmission is vitally important, especially during critical stages of the patient’s treatment. As digital communications develop, new services will emerge, such as the remote reporting of ECG traces to hospitals so that emergency cardiac units can be alerted. For tactical communication, digital technologies are increasingly available, but both consumers and manufacturers must take care in the non-standard use of manufacturer-specific systems. The P800 has a telecommunication data capability that is, in theory, capable of transfer from an on-site paramedic to a remote hospital server, enabling the patient to be admitted effectively in advance of the ambulance’s arrival. A private provision of such a hospital-based facility could generate potential financial and patient throughput benefits for an ambulance trust.
