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Motolance is a generic term for a combination of bike and ambulance together in one system. However, this particular Motolance is ‘DRDO’s Ultraswachh enabled technology’. The primary technologies that get embedded into this Motolance include: (a) Taaran (Safe Passage) Patient Transfer System- Wheelchair model is transferred to (i) Chair-cum-Stretcher type ambulance and; (ii) Stretcher only type ambulance within sidecar; (b) Anti-microbial coating (compatible with Viscoelastic gel – generic name: Covid Coat+ referred as Sustainable Infection Control; (c) Tapas Aasan (Viscoelastic Gel with CC+): an accessory of Ultraswachh technology and; (d) Ultraswachh-Ucchvasita Oxygen Concentrator for continuous oxygen support. Even in advanced variants, Vayuswachh technology-enabled sidecar is also included. All these technologies are the Ultraswachh series of DRDO launched in October 2020.

Considering Emergency Medical Technician or Paramedics are trained in the management of patients’ medical and surgical emergencies, annual refresher courses are needed. In addition for the excellent operation of Motolance(s): “specialized driving skills” and “single handle emergency operations at a remote location with/ without telemedicine support”.

Fuel mileage is one of the criterions for evolution of Motolance, however, more critical one is presence of narrow lanes in urban areas, in accessible remote locations, terrain from hilly, desert, dense forests to coastal regions as well as affordability issues.

Yes, it is beneficial to use SM over BLS (4W) based on the following attributes: (1) less coverage area of SM in comparison to BLS (4W); (2) Less space required to turn or maneuver; (3) Essential medical devices in addition to portable oxygen is provided with SM; (4) Less fuel consumption thus cost-effective in terms of recurring cost; (5) Increase in a number of medical devices/ assistance support system is easy as vehicle remained a constant cost; (6) SM even has rear seat free for patient’s caretaker; (7) SM’s fast mobility from narrow lanes and multi-terrain Bike (350 CC) allows its universal usage and; (8) Less maintenance cost as compared to its counterpart.

Motolance, unlike, 4-wheeler ambulances could be chair-cum-stretcher type with 2-wheeler or Stretcher type with 3-wheeler style models. In comparison, the base motorbike remained same though their category to manage patients is increased. Motolance takes less space on road and higher maneuverability that can allow transfer of patients at faster speed. Motolance can easily be deployed in highly dense areas as it doesn’t occupy higher parking space. Motolance is cost effective as compared to their 4-wheeler counterparts. Motolance is ‘All Terrain’ ambulance which is not feasible in 4- wheeler ambulance. In general, Motolance is a concept to value adds fleet of existing ambulances though it has its own niche & specified functions.

Motolances can be used for patient stabilization & transfer at fastest speed from: (a) inaccessible areas owing to narrow lanes & high density of inhabitants; (b) Highways as can be deployed at more extraction points than 4-wheeler ambulance being cost effective; (c) Within small townships/ villages from home to first response clinics; (d) Naxal/ terrorism inflicted zones especially mountain ranges & forests in which either Motor Bikes have more access; (e) Border zones to carry injured solider for first medical post; (f) Fast extraction from rescue zones due to natural disasters like earthquakes or any man-made disaster with contaminated air (provided necessary protective clothing is available to driver & care taker). In general, it can be used almost all places wherever 4- wheeler ambulance is useful though not present/ deployed.

'Third Eye' is a LCD monitor in front of the driver fitted into mild steel or equivalent grid preferably with a cover and this monitor displays all the vital parameters and other information directly to the driver while driving itself.

All the Motolances are registered in Delhi or UP/ site of manufacturing address and then transferred by buyer on his/ her location address and accordingly fitness certificate will be taken by buyer on annual basis.

The concept of Motolance is a sustainable solution as whenever a manufacturer increases the number of medical devices to enhance the probability of patient survival, the base cost of the motorbike as well as its recurring cost remained the least variable. The same is not feasible with 4- wheeler ambulances as the cost of the vehicle itself will impact this process. Hence on the question of sustainability, a single 4-wheeler Advance Life Support (ALS) is equivalent to 2-3 Motolances with similar capacity to manage.

The most attributing reasons for the non-availability of Motolances on a large scale since Independence include: (1) Non-availability of regulatory codes; (2) the Disaster Management Act was enacted in 2005 after which Guidelines for Mass Casualty Event Management that outlines ambulances for emergency use; (3) Evolution of vehicles towards Multi-Terrain Bike that can take load of patients & other devices to transfer from one point to another; (4) Telemedicine and other advancement(s) with satellite connectivity are new additions. All these technological advancements led to the generation of an ecosystem that can support the development of Motolances.

Motolance is often used as a combination of two terms i.e. Motor Bike and Ambulance. This is referred to as all those vehicles (s) which are not 4-wheelers and are being used as Ambulance.

Stretcher-based Motolance has a coverage space area of 5850 sq inch [90” X 65”] which occupies ~1.7 times lesser space than BLS [10368 sq inch- (144” X 72”) ] while ~3.36 times lesser space than ALS [19656 sq inch- (216” X 91”)]. Further due to its design, it requires less space to turn or maneuver though it has 350 CC engines, the ability to go faster with loaded weight is higher. The optimal usage of the available area on the bike and attached patient convener unit provides all relevant equipment to stabilize and transfer both medical emergency patients and surgically traumatized patients safely to definitive health care. In light of this information, it is clear that the space occupied with additional benefits provided by Motolance makes it fit into the requirements of urban, rural, semi-urban and highways, etc.

Stretcher Motolance has a sidecar with a complete shield to protect the patient while PPEs (like Protecton) are provided to patient to protect against rain showers.

The Motolances are registered and approved as modified vehicles with respect to a particular vehicle, its brand, and specific vehicle number only. Hence, it is not legally recommendable to detach the ‘patient convener unit’ and attach it to another vehicle, though feasible to do so. It is important to understand the center of gravity and other balancing options are adjusted as per the original vehicle only, replacing it with a less capacity or differently designed bike, is a matter of occupational and patient safety too.

Yes, it is definitely economical especially on following aspects: (a) Net cost of Motolance is lesser than their counterpart 4- wheeler ambulance; (b) recurring cost in terms of fuel and maintenance is significantly lesser; (c) easily deployable & transferable to other site is cost effective; (d) can be pooled and useful in International peace keeping missions in no time & at least probable cost. Hence, due to many contributing fronts, the Motolance is an excellent and economical option.

Yes, Motolance is safe for emergency patient transfer. The term safety is relative, hence we compare 4-wheeler ambulances to Motolance(s), and the safety of 4-wheeler is always higher. However, if we consider the perspective of time to transfer a patient from a crowded or inaccessible area, the ideal and safe choice is Motolance. Hence their functions are complimentary and safety is considered on priority while developing it.

Yes, EMT might need to drive vehicles too and should be trained to drive with an attached side car. As EMTs/paramedics will be alone while transferring patients hence training to transfer patients single-handedly is required. Trained in provisioning first aid/ emergency care should be extended to include bike ambulance as patient’s platform. The last training aspect is (a) behavior; (b) the ability to monitor, talk and drive simultaneously and; (c) telemedicine usage while managing critical patients & definitive healthcare unit is at distant location.

Multi-channel parameter analyzer provides real-time information about Non-Invasive Blood Pressure (NIBP); Pulse Rate by Pulse Oximeter, partial oxygen saturation (SPO2), Electro Cardio Gram (ECG), and Respiration Rate (RESP). In addition, Motolance provides devices for physical examination that can be monitored remotely too. The smartwatch doesn’t provide information about oxygen saturation ECG & Respiration Rate. However, smartwatches are preventive health care devices while these monitoring devices are emergency alert devices & required for their stabilization/ resuscitation while patients are being evacuated.

The average mileage of Motolance on 350 CC bike is 25-30 Km / liter which is nearly three times lesser than Advance Life Support and 2.5 times lesser than Basic Life Support 4-wheeler ambulance.

All these Motolances are modified patient transfer systems and accordingly get registered commercially in ‘customized/ modified’ vehicles category in their primary resident state. The annual insurance will be taken covering all aspects will be taken by manufacturer for first year of purchase. Subsequently buyer needs to insure it from next year onwards.

No, not directly, however, if portable Neonatal transfer chamber is available, it can be loaded in Stretcher ambulance.

Motolances are being maintained in three levels: (a) basic maintenance of bikes from their OEMs; (b) warranty provision of each third party electronic/mechanical device and its AMC as applicable individually; (c) Load structure (patient convener) is being maintained by the manufacturer of Motolance directly. Even all the maintenance aspects mentioned above are coordinated/owned by the manufacturer of Motolance(s). Thus, if you are buying from a retailer, ask for Manufacturer’s details. The challenges of such maintenance contracts are remote locations; inaccessible areas; lack of knowledge and training etc.

According to Guidelines for Mass Casualty Management- Preparedness- Chapter 4: Capacity Development point number-(xii) “Hospitals on national highways passing through disaster-prone areas, will have specialized care facilities. An ambulance for trauma care supported by trained manpower and equipment will be placed every 50 Km and a trauma care center at 100 Km under a national highway trauma care project”. These are guiding principles for the development of Motolance ensuring low-cost live-saving solutions for this challenge. Being guidelines are concurrent in nature, the same is applicable to State Highways too.

Motolance (Stretcher) belongs to Category B as per existing nomenclature however some of its features belong to the advance or D category i.e. Live Ambulance.

Only in Stretcher Ambulance, a relative of the patient can accompany by using a rear seat, however, in a few variants, this is not plausible.

Patient’s stabilization protocol and procedures are in accordance with ‘Standard Emergency Evacuation Procedures via Ambulances’ and it is not specific to type of Motolance(s). Paramedics are trained to manage and stabilize patients.

Multi-Terrain Motolance refers to ambulances fitted with Bike such that bike is able to take necessary load and has capacity to be on any type of terrain. Accordingly these Motolances are developed on 350 CC bike (Royal Enfield) which is multi-terrain bike. In ALS or specifically for hilly regions with high elevation, stretcher only motolance can be switched to 650 CC to provide necessary power if required by the buyer.

In general basic life support Motolance, there is no alternative support available other than an oxygen cylinder, however in a higher variant, a ‘Ucchvasita’ oxygen concentrator will be provided (the integration process is under active R&D at present). A portable oxygen cylinder (5 kg) lasts nearly 5-6 hours based on continuous or with a pulse dose regulator. However, Motolance is deployed generally to support a maximum evacuation time of 4-5 hours to definitive health care, though, with remote location deployment, advance variants will be more effective.