A method of automatically actuating a powered roll-in cot to load a patient into an emergency vehicle includes supporting the patient on a powered roll-in cot comprising a support frame comprising front load wheels, pairs of retractable and extendible front and back legs, a cot actuation system and a control system. The method comprises raising the support frame to a position where the front load wheels are located at a height greater than the loading surface via the control system detecting an input signal and activating the cot actuation system, positioning the cot such that its front load wheels are over the loading surface, and lowering the support frame until the front load wheels contact the loading surface via the control system detecting an input signal and activating the cot actuation system. The method further comprises raising the front legs when the control system detects that the front load wheels are in contact with the loading surface, rolling the cot forward, and retracting the back legs via the control system detecting that the intermediate load wheels are above the loading surface. A method of automatically actuating a powered roll-in cot to unload a patient, and powered roll-in cots to perform the loading and unloading methods are also provided.