A combination cot loading and fastening system for loading and unloading an ambulance cot having a normal loading height of about 76 centimeters (about 30 inches) into an emergency rescue vehicle having a transport deck in excess of 78 centimeters (about 31 inches), the vehicle having an opening providing access to the transport deck, is disclosed. The system comprises a pair of tracks, a shuttle assembly to securely pull the ambulance cot along the pair of tracks, and a locking mechanism mounted on the shuttle assembly. The shuttle assembly is configured to position the locking mechanism a distance away from a second end of the pair of tracks and at angle below the transport deck of the emergency rescue vehicle, the angle ranging from about 10° to 25°, and the distance ranging about 22.8 centimeters (about 9 inches) to about 50 centimeters (about 20 inches) characterised in that said shuttle assembly includes a carriage frame having the first end, the second end, and the longitudinal body, said shuttle assembly also including two pairs of stabilizer bars, a pair of lifting cylinders, and a three point attachment yoke assembly mounting said locking mechanism as one of three attachment points.
