Imagine, at the height of a hurricane or other natural disaster, having to evacuate 110 nursing home patients by ambulance--two at a time! The number of round-trips and the time it would take to make them is staggering.

That was the situation for one EMS agency on the Gulf Coast in Mississippi following Hurricane Katrina in 2005, says Jim Craig, director of the Mississippi State Department of Health (MSDH) Office of Health Protection. "It took a lot of coordination and a lot of units to move those residents, and that was at a time when the general population was also being evacuated and hundreds more were coming in from New Orleans," he says.

Hopefully, that problem has been solved since the MSDH partnered with the Mississippi State Department of Education, individual school districts and several county emergency management agencies in a program called "AmbuBus," where school buses are converted to ambulances with room for up to 18 stretchers, medical equipment and eight medical personnel.

"We first learned about them at a conference for emergency preparedness, where we met people from other states that had also faced significant challenges with having enough ambulances to move patients out of healthcare facilities during Hurricane Katrina," says Craig. "In reviewing several of the healthcare facilities' operating plans, we found that a lot of them were relying on the same resource to move their patients, so it was obvious we needed some flexibility and additional resources at both the local and state level. Immediately following the conference, we decided to look for federal funding, and both Alabama and Mississippi were successful in securing funding through the Assistant Secretary of Preparedness and Response (ASPAR) at the Department of Health and Human Services."

Using a quick installation kit from Chantilly, VA-based school districts can convert a school bus into ambulance-style transportation in about two hours.

"The conversion kit consists of the beams and I-bars that can be placed into the bus to secure the litters securely and safely," says Craig. "The gases and medical equipment are added after installation. Almost 50% of Mississippi's ambulance services are hospital-based, so a lot of times the county hospitals provide the equipment and staffing. Most districts are using a 44-passenger bus, which gives them maximum use of the system. In the larger cities that have mass transit, the city buses can also be used."