I'm interested in knowing how agencies choose their non-ambulance vehicle types, what equipment is carried, and how that fits the mission of the vehicle. It seems that some would be different for a supervisor vehicle, a fly car that is THE ALS resource on the call, or an APP with non-emergent responsibilities. But, in NC we are required to carry a bunch of stuff that doesn't match the mission, because the state has a "one size fits all" template.

It also seems that we tend toward very large vehicles like full-size SUVs for the most part. Yet in the UK, they do it with small sedans (and so do their police). What's the thought?

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Hi Skip, I have worked in 2 systems in which I utilized a Chevy Suburban and a Ford Expedition. From my experience the configurations were never really user friendly. I used the vehicles as an ALS First Responder as well as a Supervisory Unit. We carried equipment to support both ALS and BLS assignments. The only difference between both units was the addition of ALS equipment which consisted of a monitor, drug bag and an advanced airway bag if the operator was ALS certified. One vehicle had the pull out drawer system which made it difficult to carry extrication equipment, access the equipment and to secure equipment. The other had shelves and compartments which made it a bit easier to access equipment. Securing the equipment was better. The other concept of the vehicles were to transport personnel in the event manpower was needed at an incident, so the rear seats were kept. The vehicle with the shelves and compartments lost one seat in order to accommodate long boards, splints etc... therefore limiting the number of personnel which could be transported. But all in all we made them work. If I knew your mission which I doubt it is different than ours here in NY, maybe I could offer additional info. I hope this gives you an idea on which direction to take. Let me know what you decide. Have a good one!
I work for a system that has run what we call squads since 1989. The original units were Suburbans with cabinetry built into the back to hold equipment. Climate control for the drugs was a big issue for the Suburbans due to lake of air circulation through the compartments. We put water bed heaters in the bottom for warmth but did not do well with cooling in the summers. We now use pick up trucks, GMC's with Extendo-beds in the bed and a custom built climate control system in the back that runs both off a shoreline when in station and also while driving. The cap and bed are insulated with expansion foam.

We carry a full set of immobilization equipment, ALS equipment, a small amount of rope rescue equipment, some HazMat PPE.
We utilize the SUV style vehicles. They are supervisor units and rapid response vehicles. The state has regulations in the RS that must be met in order to be certified by the state EMS office. If you improve upon the state requirements that is all the better but you must meet the state standards.

We utilize them as follows:

Respond to all codes, house fires, and major incidents.
If no medic units are available respond to all calls and assist until a medic is available.
If a BLS/ILS unit is responding to a call that has been triaged as ALS respond to the call and ride in on the medic unit.
Go out of parish on mutual aid calls and standby until the other areas medic arrives. (If the other area states they are out of medic units we send a medic unit.)
Arrive on scene ahead of medic unit will triage and if medic is not needed will put the medic back in service.

We cover about 867 square mile area, We utilze them as a means of getting aid to the citizens more rapidly. Some of our area is very rural and volunteer help during a work day is almost none. This gives us an aditional unit that can rapidly deploy and provide ALS care until some type of transport can arrive.

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