I’d been researching living “on the road” as far back as 2009. Initially, I was taken in by the classic looks of a polished aluminum Airstream trailer and my initial concept was to renovate something in the 35′ range. However, the hassle of needing a separate vehicle to tow it soured me on that plan. Over the next 10 years I’d occasionally revisit this germ of an idea and at various times considered everything from an RV to a schoolie to a Sprinter van to a sailboat. Any of those would suit many folks, but each had it’s drawbacks for me and caused me to shelve the idea again and again. In April of 2021 I came across a YouTube video of an ambulance conversion and I was smitten.
I quickly went down the rabbit hole of learning everything I could about ambulance conversions, stockpiling conversion ideas and starting the search for a truck. I gravitated towards medium duty ambulances primarily because, given my 6’2″ height, I needed all the headroom I could get. Admittedly, the thought of a big diesel engine, climbing up into a cab and playing with airbrakes had a big draw for me as well. Back in the 70’s and 80’s my Dad sold semi trucks and I have always had a bit of a fascination with them.
My primary criteria were a 6′ interior height, diesel engine, 4X4 and under 100,000 miles that had served in a southern or western state (to avoid rust.) I eventually dropped the 4X4 as it wasn’t as important to me as I had originally thought and those trucks are much more rare and correspondingly more expensive. While I plan to be taking my truck down fire service roads and two tracks, I have no intention to go truly off road. A tow rope, a winch and the skills to use them can get you out of almost any situation you might find yourself in.
I should also mention that a good 50% of the draw of this project for me was tinkering with a truck and doing the conversion work myself. There is absolutely nothing wrong with just wanting to hop in and go and have all the heavy lifting already done for you. However, I wanted to do all the conversion planning and work myself. I also very specifically wanted to learn how to work on diesel engines and trucks. I’ve always had a fascination with figuring out how things work, though prior to this, other than changing my oil and muddling through replacing brake pads and rotors, I had little or no experience in the automotive realm. Early on in this project I determined that I wanted to know my truck inside and out and be able to self-rescue should I have a break down. While never really doing any significant work on cars, I am mechanically inclined and combined with my IT background and analytical mind, I was rather enthused to proceed. After working on the truck for a few months, I can say that I have found few things more satisfying than washing my grimy hands, bloody knuckles included, with heavy duty hand scrub after successfully repairing some big greasy truck part or even just being able to chase down a problem to it’s source.
A bit of an introduction to ambulances is probably in order. They come in four basic flavors based on the chassis they are built on.
- Type I: Built on pickup truck chassis.
- Type II: Vans with a raised roof as opposed to a separate box module.
- Type III: Built on van chassis.
- Medium Duty: Built on medium duty truck chassis. These are your Freightliner, International, Chevy C4500 and Ford F650 platforms.
My truck is built on a 2011 International DuraStar 4300LP chassis. The ‘LP’ stands for Low Profile, which essentially lowers the truck a few inches to make it easier to get in and out of.
Calling the largest ambulances “medium duty” may be a bit confusing as most people are probably more familiar with the marketing efforts of Ford, Chevy and the like to label their pickups as “heavy duty” or “super duty”. However, “real” trucks have little in common with your average pickup. Today’s biggest semi tractors dwarf everything else on the road, with engines rated at 500+ horsepower and 1800+ foot pounds of torque. Even my truck, which weighs in at 17,000+ pounds and is rated at a modest 255 horsepower, has 660 foot pounds of torque and a towing capacity north of 40,000 pounds. The former are known as heavy duty so the latter are labeled medium duty. Once you get into medium duty ambulances you find all kinds of variations such as heavy rescues, command vehicles and bariatric ambulances, designed for transporting obese patients.
The following Pros and Cons are based on my experience and from my perspective.
Pros
- Incredible value for the money.
- Readily available inventory of used vehicles.
- Ambulances are often retired based on age, not a particular mileage or because they are worn out. It is not unusual to find trucks from the 90’s with less than 100,000 miles.
- They are often (but not always!) well cared for. My truck was owned by a city in Florida and operated by their fire department. When not on calls, it was housed in an air conditioned garage and received contractually mandated preventative maintenance, including oil and filter changes every 6 months or 300 hours. As anyone who is familiar with diesel engines will tell you, regular oil changes are the single best thing you can do for engine longevity.
- Extremely well built. Ambulances in the United States have to meet the unfortunately named KKK Standards, which dictate every aspect of their construction. Additionally, ambulance manufacturers seem to compete heavily on occupant safety.
- Most modules (that’s what the box on the back is called) are made out of aluminum.
- First rate manufacturing. The quality of the electrical wiring in my truck is simply amazing. I’m guessing it has thousands of feet of wires and every single one is not only labelled at both ends but in 1′ increments along it’s entire length. I was also fortunately provided the ambulance manual, which includes wiring schematics.
- Build quality is amazing. Aluminum diamond plate is used throughout. High quality, marine grade hardware and the best brands in components from castings to wiring.
- Typically already wired for 12V and 110V.
- Ambulance conversions are much more rare than other types of conversions (Sprinters, schoolies, box trucks)
- You gotta be a little bit nuts.
Cons
- With the rapid increase in the cost of Sprinter type vans, people are looking for alternatives. I recently saw one used ambulance dealer that was specifically selling one as a “van life” conversion opportunity for what seemed like an absurdly high price compared to 6 months ago.
- 4×4 models, especially the C4500 Kodiak, are rare and command a premium price.
- Be cautious of engine hours. Some trucks may have low miles but high engine hours, meaning they spent a lot of time idling. Based on my research, every hour of idling is equivalent to 25 miles of wear and tear on the engine.
- Must be decommissioned to remove emergency lights, sirens and other markings.
- Ambulances built since mid 2000’s will have what are called multiplexed electrical systems. This is opposed to traditional relay-based electrical systems, which are much easier to work on. With multiplexed systems, rather than a switch activating a relay, which in turn activates a device (or light, whatever..) the switch tells a computer to do it. Multiplexed systems are much more flexible as the computer can simply be reprogrammed to change what it does when a particular switch is pressed, but without the software to do so, it is not something the average person has the ability to modify. Additionally, these multiplexed systems frequently tie into the truck chassis, which is often itself multiplexed. For example, my truck will not allow the truck to move if any of the module doors or lockers are open. I have to be extremely careful about dissecting the module electronics. Removing the computer or blindly cutting wires could easily disable my truck.
- If you want a turn-key, get-in-it-and-go type of vehicle, a do-it-yourself ambulance conversion is probably not for you.
- You gotta be a little bit nuts.