Road Ambulances
ICU ambulance with a ventilator, and what separates it from an ALS van
An ICU ambulance is a road ambulance configured as a mobile intensive care unit: a transport ventilator with its own oxygen reserve, a multipara monitor, infusion and syringe pumps, a defibrillator with pacing, and suction — staffed by a crew trained to run all of it while the vehicle is moving. It is the right vehicle when a patient is ventilated, on inotropes, or unstable enough that treatment cannot pause for the length of the journey. An ALS ambulance carries a defibrillator and oxygen but is not built to sustain a ventilated patient.
What is on board
Transport ventilator with independent oxygen
A ventilator rated for road transport, running on its own cylinder supply rather than the vehicle's, with reserve calculated for the journey plus a margin for delay. The reserve is the part that gets skipped: a ventilator with two hours of oxygen on a three-hour transfer is not an ICU ambulance.
Multipara monitor
Continuous ECG, SpO2, non-invasive blood pressure, respiration and temperature, with capnography where the patient is intubated. End-tidal CO2 is what tells the crew a tube has displaced over a speed breaker, and it is the single most useful trace on a moving vehicle.
Infusion and syringe pumps
A patient on inotropes or sedation needs those rates held precisely for the whole journey. Gravity sets do not hold a rate in a moving vehicle, which is why pump count — not pump presence — is the question worth asking.
Defibrillator with external pacing
Manual defibrillation, synchronised cardioversion and transcutaneous pacing, not an AED. An AED is designed for a bystander to use on a collapsed adult; it cannot cardiovert a peri-arrest arrhythmia in a monitored patient.
Suction, airway and emergency drugs
Portable and fixed suction, a full airway kit sized for the patient including a rescue supraglottic device, and the emergency drug box checked against the manifest before the vehicle leaves.
A crew trained to run it in motion
The equipment list is the easy half. What distinguishes the vehicle is a crew that can manage a ventilated patient in a moving cabin, where auscultation is useless, lighting is poor and every intervention happens one-handed.
When this is the right call
The patient is already ventilated
Any patient being transferred on a ventilator needs an ICU ambulance. Hand-bagging a patient for a journey of any length is not a transfer plan — it produces uncontrolled tidal volumes and unmonitored CO2 for the entire trip.
Inotropic or vasopressor support is running
A patient on noradrenaline, adrenaline or dobutamine needs pumps, invasive monitoring where it is already in place, and a crew that can titrate. An interruption of minutes is clinically significant.
Post-arrest or peri-arrest
After a return of spontaneous circulation the patient needs monitoring, temperature management and a crew equipped to re-arrest en route. This is the transfer most often attempted in the wrong vehicle.
Inter-hospital escalation to a higher centre
Moving from a district hospital to a tertiary centre for neurosurgery, cardiac intervention or dialysis usually means moving a patient the referring hospital cannot stabilise further. The vehicle has to be able to do what the ward could not.
How the transfer runs
Clinical handover before the vehicle is assigned
The dispatch desk takes the patient's current support — ventilator settings, infusions running, last blood gas, airway — before choosing the vehicle, because those facts decide whether an ICU ambulance is needed or an ALS ambulance will do. Sending the wrong vehicle costs a second dispatch.
Receiving bed confirmed first
A critical care transfer does not begin until a named bed at the receiving hospital is confirmed. A ventilated patient circling a city looking for admission is the worst outcome in this whole process, and it is entirely preventable at the booking stage.
Written fare before the vehicle moves
The full total is stated on the call, including oxygen, equipment and the crew. There is no night, festival or emergency premium in the system, and the figure quoted is the figure invoiced.
Transfer onto transport equipment at the bedside
The patient moves onto the transport ventilator and monitor while still in the referring ICU, with the ward team present, and is observed on transport settings before the trolley moves. Problems found at the bedside are manageable; the same problems found in a lift are not.
Bed-to-bed handover with documentation
The crew hands over at the receiving bed to the accepting team, with the transfer record, the observation chart for the journey and the drugs given en route. The family receives the same documentation.
ICU & Ventilator Ambulance
Questions people ask before booking
What is the difference between an ICU ambulance and an ALS ambulance?
An ALS ambulance carries a defibrillator, oxygen, airway equipment and a paramedic who can give advanced life support. An ICU ambulance adds a transport ventilator with its own oxygen reserve, infusion pumps, capnography and a crew trained to sustain a ventilated or inotrope-dependent patient for the length of the journey. If the patient is ventilated or on vasopressors, an ALS ambulance is the wrong vehicle regardless of how short the trip is.
How do I know the ambulance sent is genuinely an ICU ambulance?
Ask three questions on the call: is there a transport ventilator, how many hours of oxygen are on board for this route, and how many infusion pumps. A vehicle described as an 'ICU ambulance' that cannot answer the second and third is an ALS van with a monitor. Ask for the vehicle class in writing on the quotation — we state it there, so what was quoted and what arrives can be compared.
Does a doctor travel in an ICU ambulance?
A doctor escort is arranged where the clinical picture calls for one — most commonly for a ventilated patient on multiple infusions, a paediatric critical transfer, or where the referring consultant asks for it. Many ICU transfers are safely run by a trained critical care paramedic. Tell the dispatch desk what support the patient is on and you will be told plainly which is appropriate, and what each costs, before you decide.
Can an ICU ambulance do a long-distance inter-city transfer?
Yes, and the constraint is oxygen and crew duty time rather than distance. Beyond roughly six to eight hours of road travel it is worth comparing a train ambulance or an air transfer on both cost and clinical risk, because a long road leg in a moving cabin is itself a physiological insult to an unstable patient.
What does an ICU ambulance cost?
The ALS/ICU class runs on our published rate card at a fixed fare for the first 10 km and a published per-km rate beyond it, with the ventilator, monitor, oxygen, pumps and the paramedic included rather than itemised as extras. The full total is stated on the call before the vehicle is dispatched, and it does not change at night, during festivals or at peak demand.
Related reading
Arranged in the cities we serve
This page describes what an ICU road ambulance carries and when it is the appropriate vehicle. It is not clinical advice, and the decision to transfer a critically ill patient rests with the treating clinician.
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