Lexington County Council approved the purchase of a “mass casualty bus” during the March 24 meeting.

A mass casualty bus is a specialized vehicle used by emergency personnel to administer first aid services on a large scale. These buses can typically hold about 18 to 20 cots and are similarly equipped to ambulances.

According to the county’s agenda, council members reviewed the purchase requisition and voted unanimously in favor of the purchase.

The total cost is $758,524 from Matthews Specialty Vehicles Inc., based in Greensboro, N.C., according to a document from the county’s procurement services.

“We pray it is something that will rarely get used,” County Councilman Clifford Fisher said. “But in the event it is needed, time is of the essence, and that bus will be able to provide first aid services on a large scale.”

Other counties, including Richland County and Charleston County, also have mass casualty buses in their emergency vehicle fleets.

Charleston County unveiled its new mass casualty bus in March 2026. According to South Carolina Public Radio, the bus was formerly part of the Charleston County Public Library and was converted and equipped with EMS equipment using a nearly $200,000 grant from the South Carolina Department of Public Health.

Richland County’s mass casualty bus has been in service since 2010 and can often be seen on-site at University of South Carolina football home games. It is typically used 10 to 15 times per year, according to a 2017 report from WLTX.