Development of a
next generation emergency Ambulance
Mobile Intensive Care Unit (MICU)
type C EN 1781 baseline
The urban challenge & systemic resilience
Cities are changing, and emergency response vehicles must perform under real constraints: congested streets, tight access routes, and increasing expectations for resilience and sustainability. Current developments often focus on optimizing the status quo – making vehicles larger or adding more equipment. However, this project asks a fundamental question: Is the current EMS architecture still aligned with the needs of a modern, holistic health system?
A Holistic Approach to Development
Instead of refining a 50-year-old concept based on box-body conversions, this interdisciplinary study integrates medical requirements, technical constraints, and ergonomic design into one coherent concept.
We focus on the synergy of three core pillars:
- operational agility
Designing for the “last mile” in dense urban environments, ensuring that compact dimensions do not compromise high-acuity capabilities. - clinical continuity
Ensuring the MICU acts as a seamless extension of the Intensive Care Unit, where data, ergonomics, and medical standards allow for uninterrupted patient stabilization. - systemic delegation
Clearly defining what the high-acuity unit must achieve on-site and what it should delegate to other service layers – such as telemedical support or specialized logistical tiers – to maintain a lean, high-performance profile.
The Goal: An Optimized Overall System
The result is a solution where patient needs, vehicle performance, and crew workflow reinforce each other. By adopting the “Mobile Medical Service” philosophy, we shift from “isolated improvements” to a Mission-Ready Platform. This next-generation emergency ambulance ensures that even in the most congested urban centers, the quality of care remains uncompromising, agile, and fully integrated into the broader clinical rescue chain.
Key Design Parameters (Holistic Integration)
| Pillar | Focus Area | Goal |
| Medical | High-Acuity Intervention | Maintaining ICU standards within a mobile Type C environment. |
| Technical | Urban Resilience | Sustainable, compact drivetrains capable of navigating restricted access. |
| Ergonomic | Workflow Optimization | Designing the interior around the movement of the crew to reduce cognitive load. |
| Holistic | Network Integration | Active delegation of tasks to specialized service layers and digital networks. |
This aimed university project is conducted as an interdisciplinary study that integrates medical requirements, technical constraints, and ergonomic design into one coherent concept. Instead of treating these aspects separately, the project links insights from each domain and translates them into shared design parameters. The goal is a solution in which patient needs, vehicle performance, and crew workflow reinforce each other – resulting in an optimized overall system rather than isolated improvements.
defining the mandate
What an Emergency Ambulance should and does not need to achieve
Based on these international insights, the mandate for a Type C MICU must be clearly defined:
What it must achieve:
- Clinical Stability
Providing a high-acuity environment that allows for complex medical interventions during transport. - Superior Ride Quality
Protecting the patient from dynamic transport stresses (vibrations, noise, and swing motions) by positioning the patient low and centrally. - Agile Accessibility
Ensuring rapid access through congested urban environments by utilizing compact, standardized vehicle platforms. - Resilience
Operating emission-free and remaining functional through standardized, cost-effective maintenance.
What it should not be:
- a “catch-all” transport
It should not be utilized for low-acuity service tasks that can be handled by more efficient Service Ambulances. - an oversized workshop
It should avoid unnecessary bulk and weight (e.g., box-bodies over 3.5t) that hinder maneuverability and increase structural costs without adding clinical value. - a pure logistics tool
It should move away from being a “delivery van for patients” and instead become a focused, ergonomic workspace for seated, secured care.
By addressing the system question first, this project creates a foundation for a vehicle concept that is not just a better version of the past, but a necessary tool for the future of preclinical medicine.
Ambulance design
This university project will develop a “Next Generation Ambulance” concept based on an EN 1789 type C baseline and translates clear design priorities into a coherent vehicle and interior architecture. Emergency services need ambulances that reach patients reliably in real streets, protect patients and crews during transport, and remain operational under changing conditions. This interdisciplinary university project develops a “Next Generation Emergency Ambulance” concept using EN 1789 as the baseline for a Type C ambulance, while systematically rethinking key design priorities:
- access in congested urban environments
- patient-centred ride quality, and
- cost-effective standardisation.
Instead of relying on wide custom box-body conversions, the concept is based on a commercially available panel van platform (Renault Master E-Tech, L2). The project investigates how a compact vehicle width (maximum 2.10 m) can improve access through narrow and obstructed streets and simplify procurement and maintenance through standard parts and existing service networks. In parallel, the project explores emission-free operation using locally available renewable electricity and stored energy, increasing resilience against disruptions in fossil fuel supply chains.
A central innovation is a stronger focus on the patient’s transport experience. Current ambulance interiors are often designed around standing workspaces, while the dynamic effects of transport—noise, vibrations, and swing motions—receive less systematic attention. This project evaluates how patient ride quality can be improved by positioning the patient as low as possible and as close as possible to the vehicle’s dynamic centre (between the axles), and by rethinking the interior workflow around seated, restrained care.
Project Structure
Three integrated research areas
1. Technical Research
- Reduction of swing and vibration exposure for the patient by comparing a conventional stretcher position with an optimised position near the vehicle’s dynamic centre and as low as possible.
- Evaluation of transport orientation: Feet-First versus Head-First, assessed from a ride-quality.
- Technical benchmarking of a compact electric panel van (Renault Master E-Tech L2) versus a conventional ambulance based on a Mercedes Sprinter with a custom box body, including interior/exterior dimensions, turning circle, loading and entry height, weight and payload, and practical access in narrow streets.
2. Medical Research
- Use EN 1789 Type C equipment requirements as the baseline and evaluate whether each required item is necessary in practice, how frequently it is used, and whether it should be vehicle-installed and/or carried as mobile equipment.
- Define additional equipment needs beyond the standard list, based on current clinical practice and patient safety.
- Define ensuring continuity of care from first contact to transport in terms of medical equipment
- Provide medically grounded criteria to support the Feet-First versus Head-First evaluation and the ride-quality assessment (noise, vibration, swing motions), with attention to patient tolerance.
3. design research (interior + exterior)
- Interior layout and workflow:
- Positioning of the stretcher in relation to patient access and workflow
- Positioning of two crew seats next to the stretcher (seated care concept)
- Positioning of equipment needed at the patient (monitor/defib, oxygen, suction, ventilation, meds, consumables)
- Positioning of further equipment needed inside the cabin (storage logic, hygiene, weight distribution, reachability)
- Vehicle marking and visibility concept:
- high-contrast blue information on white body with high-recognition “Emergency Ambulance”, Star of Life and “Emergency 112”, “Non-emergency 116 117”, “Service Ambulance 19 222”, plus potential additional information
- A fluorescent red or compact Battenburg belly-band concept (e.g., 280 mm) for strong visual recognition with efficient application
- Retroreflective contour marking to improve vehicle outline recognition at night
Expected Outputs
- A coherent ambulance concept design (vehicle platform + interior architecture + marking concept) aligned with EN 1789 baseline requirements.
- A transparent design rationale with measurable criteria and a structured evaluation approach, enabling iteration and comparison.
- High-quality visualisations (exterior livery and interior layout) supporting communication with practitioners, authorities, and the wider public.
This project aims to demonstrate that patient-centred ride quality, operational resilience, and cost-effective standardisation can be achieved together—by integrating medical requirements, technical performance, and ergonomic design into one optimised overall system.
key points
Resilient without fossil fuel dependencies
The concept is designed to operate independently of foreign fossil fuel delivery, diesel production, and petrol station availability. This increases resilience against disruptions in fuel supply chains.
Zero-emission operation with locally available energy
An emission-free drivetrain is enabled through locally produced renewable electricity and stored energy, supporting clean operation in cities and reducing local air and noise pollution.
Patient-centred ride quality
The interior and vehicle layout prioritise the patient: reduced noise, vibrations, and swing motions, with a focus on calmer transport and improved tolerance for vulnerable patients.
Compact access in real streets (max 2.10 m width)
Instead of wide box-body builds, the concept is based on a standard panel van (max 2.10 m width). The goal is simple: better access through narrow streets and congestion, fewer blockages, and more reliable arrival in dense urban environments.
Cost effectiveness
Rather than an expensive custom box-body solution, the concept aims to use a commercially available panel van platform. This can reduce purchase and maintenance costs, simplify procurement, and improve serviceability through standard parts and existing repair networks.
medical research
- medical equipment review (EN 1789 baseline)
- evaluation of which items are truly required for patient care in practice, and where equipment requirements may be over-specified, rarely used, or better provided in a different form
- identification of additional medical equipment that may be necessary beyond the standard list, based on medical practice and new equipment development
- definition of what must be carried as mobile equipment (e.g., backpacks) for first contact and treatment outside the vehicle, and what must be fixed inside the vehicle.
- specification of the handover logic: outdoor care → loading → continued care inside, ensuring no critical gaps (e.g., oxygen, monitoring, airway equipment).
- categorization of equipment inside the ambulance into potentially
- immediately needed at the patient (critical within seconds to minutes)
- needed during transport (routine access)
- rare (must be available but does not need prime position)
- definition of minimum quantities
- patient ride quality during transport
- evaluation of feet-first vs. head-first
- evaluation of low swing motions of a low and centered patient center of gravity vs a conventional swing table
technical research
- Patient ride dynamics (swing reduction)
- comparison of patient swing exposure on the stretcher in two configurations:
- conventional stretcher position (typical current layout)
- optimized patient position as close as possible to the vehicle’s dynamic centre (between the two axles) and as low as possible
- definition of measurable criteria (e.g., vertical acceleration, jerk, pitch/roll-related motion)
- comparison of patient swing exposure on the stretcher in two configurations:
- vehicle platform benchmark
- comparison of the technical parameters of a next generation electric van (Renault Master E-Tech L2) with a conventional ambulance based on a Mercedes Sprinter with a custom box body
- evaluation parameters must include:
- external and internal dimensions (width, height, usable cabin space)
- turning circle / manoeuvrability
- loading and entry height
- gross vehicle weight, payload, axle loads