The Better Way in a Crisis
Toronto's ambulance buses have proved their mettle over the last two decades
From the National Post (October 22, 2002)

Anyone who's had one of Toronto's two ambulance buses whoosh past them has probably cringed with fear. If anything portends really bad news, it's the sight of a 10-metre-long bus hurtling down the street, lights ablaze. Take some small comfort, though, in knowing this oversized vehicle at the site of a big accident improves the survival rate of the injured.

The bus was born of a 1975 accident at Midland and St. Clair avenues, when a TTC bus collided with a train. Because of the many people injured, local ambulances simply ran out of equipment.

Later, John Dean, the commissioner of the city's Emergency Medical Services, decided a bigger conveyance was needed, replete with all the modern conveniences of an ambulance. So a TTC bus was converted into a super-ambulance in 1978.

Designed to house victims without critical injuries, it was the first such vehicle in North America -- and, like anything new, attracted the usual doubters.

"People thought we were nuts," says Peter Rotolo, the current manager of the Special Services Unit. "They couldn't understand why it was needed and thought it was a waste of time and money."

But a tour of an ambulance bus (a second was added in 1980), is enough to silence any skeptic. Inside, they look remarkably, well, bus-like, with ceiling mounted grab bars still in place. What sets them apart from the standard bus, however, is that both sides of the front section have double-decker stretcher berths with oxygen supplies. There's room for eight stretchers and seating for 10.

Each bus is paired with a containing emergency supplies, including advanced life-support kits, paper suits, and tarps for triage. The supply vehicle ensures that smaller ambulances won't run out of equipment during a large emergency. And having the bus to transport large numbers of patients takes the strain off the system, which usually has 100 ambulances on duty at all times.

The buses have been used for gas leaks and fires -- any situation where large numbers of people require shelter and care while conventional ambulances speed the most serious injuries to hospital. If things are really bad, Special Services can commandeer TTC vehicles to house people.

The support buses have proved themselves many times over. A search through news archives finds the ambulance bus serving vital roles at major events such as the Go Train collision at Union station on November 19, 1997, and the TTC subway accident that claimed three lives on August 11, 1995.

The buses have also been assigned to lighter duty, including a 1994 Polar bear swim at Bluffer's Park in Scarborough and special tours for children's organizations.

But they're deployed whenever there's a possibility of large numbers of victims with minor injuries, like a big car pileup. And that happens several times a day in Toronto. Last year, the two buses made 2,094 calls; by the end of June this year, they had made 1,245 calls.

The plan is to replace one later this year, the other in 2004.

The buses are the most visible element of the Special Services Unit, which Rotolo describes as "the abnormal side of the department. We educate and train and equip paramedics to deal with environments that they may not normally be in."

Over the years, paramedics have found their way on to boats (with the Police Marine Unit), on bikes (since August of this year they've been prowling the Entertainment district alongside the peddle cops of 52 Division) and inside riot gear (the Public Safety Unit is comprised of paramedics trained to deal with situations involving potential civil disobedience).

But the ambulance buses remain the biggest and most storied items in the Special Services Unit arsenal.

Other cities in North America are following Toronto's lead, most recently Edmonton. An ambulance bus will always look a little unusual, but the fact it's being copied by others vindicates John Dean's bold leap more than two decades ago.

And lest any wiseacres wonder, yes, the farebox has been removed. Exact change is not required to ride the ambulance bus -- just an OHIP card.

Journalism 101
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The Bigger and Better Way to Save Lives

Anyone who's ever seen an ambulance bus whoosh past can't help but cringe in fear -- if anything portends that something really bad has happened, it's the sight of a 35-foot long bus hurtling down the streets, lights ablaze. Take comfort, however, in the knowledge that the presence of this oversized vehicle at the site of a mass accident improves the survival rate of those injured.

The impetus for the bus was a 1975 accident that occurred at Midland and St. Clair, where a TTC bus collided with a train. Due to the number of injured, ambulances were running out of equipment. Then Emergency Medical Services (EMS) commissioner John Dean decided to try and address future situations by finding a way to provide transportation for a large number of casualties without depleting ambulance resources. The result the conversion of a TTC bus into a super-ambulance in 1978.

Designed to house low-priority patients, it was the first such vehicle in North America, and like most anything new, it attracted a number of doubters. "People thought we were nuts at the time," says Peter Rotolo, current manager of the Special Services Unit. "They couldn't understand why it was needed and thought it was a waste of time and money."

After a tour of both ambulance buses (a second was added in 1980), any skeptic would be silenced. Inside, they look, well, remarkably bus-like, with the ceiling mounted grab bars still in place. The right and left sides of the front section of the bus have been converted into double-decker stretcher berths with individual oxygen supplies. About eight stretchers and 10 sitting patients can fit into either bus.

Each bus is paired with a corresponding supply vehicle filled with EMS supplies including Advanced Life Support kits, paper suits, and tarps for triage. The supply vehicle means traditional ambulances don't have to worry about running out of equipment during a large emergency. And transporting multiple patients in a bus takes strain off the EMS system, which normally has 100 ambulances on duty at any given time.

The buses are most often used at large scale incidents, including gas leaks and fires -- any situation that requires shelter and care for a large number of people. If things are really bad, Special Services is also able to commandeer actual TTC vehicles to house people from inclement weather.

The buses have proved themselves many times over -- a search through Toronto news archives finds the ambulance bus serving vital roles at major events such as the November 19, 1997 Go Train collision at Union station and the August 11, 1995 TTC subway train accident that claimed three lives. The bus also does lighter duty including an appearance at a 1994 Polar bear swim at Bluffer's Park in Scarborough and providing special tours for children's organizations. Last year the two buses made a total of 2,094 calls, and as of June this year, 1,245 calls. The plan is to replace one of the buses later this year, and the other in 2004.

The bus is the most visible face of the Special Services Unit, which Rotolo describes as "The abnormal side of the department. We educate and train and equip paramedics to deal with environments that they may not normally be in." Over the years, paramedics have found their way onto boats (with the Police Marine Unit), on bikes (since August of this year they've been prowling the Entertainment district alongside the peddle cops of 52 Division) and inside riot gear (the Public Safety Unit are paramedics designed to deal with situations involving potential civil disobedience). But the ambulance bus remains the biggest and most storied item in the Special Services Unit arsenal.

Other cities in North America are following Toronto's lead, including, most recently, Edmonton. An ambulance bus will always look a little unusual, but that it's being copied by others vindicates the bold leap commissioner John Dean back in the late '70s.

And lest any wiseacres are wondering, yes, the farebox has been removed. Exact change is not required to ride the ambulance bus -- only an OHIP card.