Seattle's hybrid ambulances grabbed the headlines due to its uniqueness in the medical and rescue field. Seattle has led the nation in 911 emergency medical services (EMS) by providing an out-of-hospital acute medical care. Seattle has provided the transportation of patients with definitive care available on the ambulances.

Seattle's hybrid ambulances carry basic life-support services. The medical care is provided by the firefighters who were trained as emergency medical technicians. The responding units provide an advanced care performed by the paramedics. The Seattle Fire Department is now utilizing the hybrid ambulances as finalized by the EPA. The hybrid ambulances will be fueled by renewable fuel. The EPA approved it with the correspondence from its annual renewable fuel volume requirements as part of the Renewable Fuel Standard (RFS).

The total renewable fuel requirement to be blended into the national supply of diesel and gasoline has been raised from 18.11 billion gallons to 19.28 billion gallons a year. In 2017, the RFS will include a target of 15 billion gallons of "conventional" renewable fuels. Seattle made sure that their hybrid ambulances will be using a fuel that is safe for the environment.

Autoblog reported that the Ford E-450 ambulances have been retrofitted with the XL3 Hybrid Electric Drive System from XL Hybrids, resulting in a 23 percent improvement in the fuel economy over nine months of utilization. Furthermore, the ambulances' CO2 emissions have dropped by 19 percent, which will help the city's Drive Clean Seattle program to diminish greenhouse gas emissions in half by 2025. Seattle is pleased with the results and is ordering more retrofitted vehicles from XL Hybrids which includes Ford Transit vans for the Seattle Department of Public Utilities.

NGT News reported that the hybrid-electric technology does not require the fueling infrastracture with no special plug. Moreover, the technology does not require an extra driver training. The XL Hybrids system used in Seattle's hybrid ambulances can easily be installed in a few hours which will keep the original equipment's powertrain.

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