The RAMM (Remote Access Medical Module)

[DocRamsay]

Now that it's officially passed it's ambulance certification, it's time to share the RAMM. Backstory, my buddy owns a company that provides personnel and equipment to the USFS for wildfire response. He has been using Type 1 Ambulances, 4x4 F450's with large ambulance boxes mostly, and they get absolutely trashed every season. They cost in the neighborhood of $200-300k and are designed for regular ambulance duty of picking up patients and dropping them off at hospitals, restocking out of the box to return to service on the streets. All of this is somewhat unnecessary on the fireline, where you're going to either be passing out bandaids or having a really fucking bad day. The latter means rapid evacuation over rough terrain if air is unavailable.

So my parameters were to design/build an ambulance that is:
1. Cheaper than a type 1
2. Easier to maintain than a type 1
3. Performs well off road
4. Durable enough "that even you can't break it"

Due to his fleet being mostly Ford already, and the SD60, I started with a 2020 F350 that we found from Texas (more on that later). Ordered some goodies, got back surgery, and waited for it all to get delivered while I worked on feeling my legs again.

 

[DocRamsay]

Being a Texas truck, I guess it didn't need a fucking windshield wiper. That was a fun discovery driving it to my place.

 

[DocRamsay]

For suspension I went with Camburg Radius Arms, King 3.0 coilovers up front and 2.5 shocks in the rear. I knew I was going to add more weight to the rear with the slide in, so I held off for the moment on spring packs vs air bags. Wound up doing air bags to be able to fine tune things, this is the prototype anyway. I really want to remove the ability for the FF/EMT to fiddle fuck with things.

The Camburgs are fuckin THICC

I always seem to block out days with the worst weather to work on shit in my driveway. It at least didn't snow on me this day.

Most certainly an upgrade. Also a fun learning experience was that the B&W gooseneck hitch totally blocks the passenger rear shock from being removed. Absolutely retarded design on their end.

 

[DocRamsay]

Taught the kid some new words while I removed the hitch and installed the passenger rear shock. This is her first full build, but the tool passing skills are coming along nicely.

She also scattered every socket I had in the gravel, still haven't found my 21mm.

It was a long day, snow started way earlier than it was supposed to and then melted turning me into a soggy mess. But, got the fronts done.

Next day was gorgeous and let me drive it around a bit to make sure everything got seated properly. Also remembered that when you grind/sawzall coil buckets off a truck in the rain/snow all the shavings rust and stain your driveway.

 

[DocRamsay]

Next step was to pick up the slide in. To say it was a fiasco would be insulting to fiascos.

Obviously it was going to need something to get rid of the squat, since we haven't loaded it down with medical gear yet, it's hard to guess. I will say that the Camburg arms gave it so much more ground clearance than the other options, and I have zero doubts about their strength.

Meanwhile USFS was in town to discuss contracts and I was given instructions to "Park it where people will have to walk past it". Done, and I took the keys with me. Also hid the squat until I got that sorted out.

 

[JD Mark]

Durable enough "that even you can't break it"

Challenge accepted!

 

[DocRamsay]

Next was wiring/plumbing the module. These are set up to run off the truck's battery, and that really wasn't an option for me. The back will be run off of a 100ah LiFePo4 battery, with solar on top and charge controller to supplement with the alternator. Start battery HAD to work and couldn't risk not being able to start the truck. There's also a starlink that he wanted mounted on the roof, enhancing comms with medical control in the event of no cell service or radio holes.

This module is also bolted to the frame through the floor. Kinda interesting design, and at least the brackets seemed to be designed for the Super Duty chassis.

Got it wired up for lights at least I could work in here at night now.

Then I turned myself into a fucking OSHA video. Turns out that the stool my wife said was dangerous to stand on, was. During my tumble I thought to myself "hey dum dum, you're not even two months out from back surgery, don't fall on your back". So my highly tuned athletic body with cat like reflexes decided to kick my legs out underneath me, which then tangled in the legs of the stool and I got some crunchy celery sounds out of my knee. I laid in my driveway for a few minutes, refusing to call my wife for help.

This is what we in medicine call "dependent lividity" and it's just as bad as it sounds. Also I have a cankle now, what a lucky boy I am. Turns out I tore my ACL again, and the PFL. Good news is that I've already hit my out of pocket max for the year, and my knee doctor went to Harvard and Stanford, the bad news is he said "it's pretty shitty in there" when referring to the images of the first operation he did, the reconstruction is set for late september.

 

[DocRamsay]

Anyway, you don't need two knees to wire shit up at least. I pulled the ceiling panel to route things, I also took the chance to add some Baja Designs work lights up high on the module for some scene lighting if needed.

The kid has really come along in her mechanical skills, not even 2 yet and is rocking this out in a kitty cat dress and monster feet.

I did change things up a little bit here and added a fuse and circuit breaker to each branch of the heavy gauge cable. I really really don't want my work to burn down. Also fabbed up a battery tray lined with foam for impact resistance.

 

[WaterH]

Being a Texas truck, I guess it didn't need a fucking windshield wiper. That was a fun discovery driving it to my place.

I pretty much rely on rainX. Almost never use wipers.

Neat build. Sorry about the leg. Heal up quick.

 

[DocRamsay]

And thats about it. Took it out to torture test it, and it has performed very very well. Very smooth over all the dirt roads I could bash it down, and the idea was that the vehicle will operate at like 25% of it's actual off road capability. Hopefully the operators wlll pucker and chicken out before they find the limit of this truck.

I'm also stoked to say that I've jumped an ambulance now. I've drifted many back in the day, but never actually caught air.

 

[rattle_snake]

Stool needs more triangulation.

sucks about the knee, don't fuck up the other one.

How is the box attached to the truck bed/frame?

 

[DocRamsay]

Stool needs more triangulation.

sucks about the knee, don't fuck up the other one.

How is the box attached to the truck bed/frame?

Bolted through the bed via the manufacturers instruction. 8 Carriage bolts through the floor/bed to a bracket that bolts through the frame.

 

[subybaja]

Nice build! That would make a hell of a camper.

I'll bet the slide-in isn't cheap?

 

[AK_F250]

Nice build! That would make a hell of a camper.

I'll bet the slide-in isn't cheap?

Looks like a tuffport or copy, their broverland version starts at something like 30K.

 

[westracing01]

For suspension I went with Camburg Radius Arms, King 3.0 coilovers up front and 2.5 shocks in the rear. I knew I was going to add more weight to the rear with the slide in, so I held off for the moment on spring packs vs air bags. Wound up doing air bags to be able to fine tune things, this is the prototype anyway. I really want to remove the ability for the FF/EMT to fiddle fuck with things.

The Camburgs are fuckin THICC

I always seem to block out days with the worst weather to work on shit in my driveway. It at least didn't snow on me this day.

Most certainly an upgrade. Also a fun learning experience was that the B&W gooseneck hitch totally blocks the passenger rear shock from being removed. Absolutely retarded design on their end.

Did you have to do anything else with the coilovers? Longer brake lines, track bar, etc?

I have a bent desire to put that shock package on my 450 for the fuck of it.

 

[DocRamsay]

Looks like a tuffport or copy, their broverland version starts at something like 30K.

Yup. However, in the world of ambulance shit, it's pretty cheap.

Did you have to do anything else with the coilovers? Longer brake lines, track bar, etc?

I have a bent desire to put that shock package on my 450 for the fuck of it.

I did all of it because I was unwilling to take that chance on this particular build. If I was doing it on my own truck? I don't think the Kings neeeeeeeed longer lines or dropping the track bar. Honestly I was super impressed with the Camburg radius arms and the Kings. It really went from driving around a skateboard to pretty decent road manners.