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Expert Analysis

Updated federal ambulancestandards are step in the right

direction

By Arthur Hsieh

If you ever wondered why the insides of ambulances in the United States look remarkablyalike, you can thank the federal “KKK” standards for

that. As this article explains,when EMS systemsbegan developing in the early 1970s, the U.S.General Services Administration (USGSA)developed a series of ambulance standards thatwere used by states to purchase ambulances withassistance from federal block grants. The standardshave essentially remained the same since then.

Without evolution, these standards may becontributing to unne cessary injuries or even thedeaths of EMS providers.

For example, do you wear a seatbelt in the back of the rig? Chances are very likely that you do not,and the answer for why is simple – you can’t doanything with the patient once you’re belted. Looseitems on the bench or shelves become missileswhen airborne. And, let’s not mention that theseemingly solid side walls of the box are anythingbut protective – there’s enough photos on the web

to show how easy the ambulance walls crumpleand split in a crash.

Continue reading Updated federal ambulancestandards are step in the right direction

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15 ambulance changes

Load capacity will be 171 poundsper seated position.

A seatbelt monitoring system thatsenses when a seat is occupiedand a seatbelt attached. Audibleand visible warning devices willtrigger for cab and patientcompartments if the parking brakeis released and the transmissionis not in park.

Tire-pressure monitors.

Designate health care provider seating positions that areadjustable to within 6 inches of the cot.

12/10/2014

Understanding the NFPA 1917 ambulance standard

A look at w hat NFPA 1917 means for ambulance design and how we got here

By Robert Avsec

For about as long as there has been EMS in the United States, there has been the "Triple K" specifications for ambulances. The KKK-A-1822 specifications were first developed and published by the U.S. General Services

Administration in the 1970s as the purchasing specifications for federal ambulances.

At that same time, b lock grants were in vogue as a means for distributing federal money to communities, and those blockgrants required that vehicle purchases must comply withfederally approved specifications.

Very quickly, as things tended to happen in the early days of EMS, EMS agencies and local, state, and federal officials usedthe KKK-A-1822 for ambulance purchases under block grantsas it was the only document available. And thus, KKK-A-1822became the de facto ambulance standard in the United States.

In recent years, two developments have prompted the search

for a more applicable ambulance standard.

First was GSA's decision that it would no longer continue tomaintain the specifications that were originally focused solelyon a vehicle purchasing decision. Although GSA has revisedand routinely extended the KKK specifications over the past40-plus years, it never had the technical expertise in house tokeep up with the rapidly evolving ambulance.

Second, there's the increasing number of patients and EMSproviders that are being killed and injured in ambulancecrashes each year.

Those mortality and morbidity numbers prompted theInternational Association of Fire Chiefs to begin working withthe National Fire Protection Association in 2009 to develop atrue standard for a safer ambulance. Their work culminatedwith the approval of NFPA 1917: Standard for Automotive

Ambulance s in August 2 012.

What is NFPA 1917?

Developed with consideration of KKK-A-1822 and NFPA1901: Standard for Automotive Fire Apparatus, NFPA 1917defines the minimum requirements for the design,performance, and testing of new automotive ambulances.

The standard presents general requirements for ambulancedesign and performance, along with standalone chapters for ambulance components including chassis, patientcompartment, low-voltage electrical systems and warningdevices, and line voltage electrical systems. NFPA 1917 alsospecifies provisions for test methods.

Initially, this had to be viewed as a win for all parties involved.GSA would be relieved of its responsibility for maintaining astandard for which it was never fully intended and EMSproviders and patients would get a safer ambulance. Therewere, as one would expect, other entities that did not have thesame positive viewpoint initially.

NFPA was considered a good fit for developing the standard

because of its long history of developing consensus or industrystandards for the fire service. Non-fire EMS organizations,however, expressed fears that the fire service was taking over EMS and that the standard would require all ambulances to bepainted red, have a water tank and be medium-dutyambulances.

Some of those same organizations expressed fears that theywould not have a voice in the standard development, and thatthey could not afford the price of an ambulances meeting anNFPA standard. It is unclear how much more a 1917-compliantambulance would cost.

Fears addressedMany of those fears were assuaged when those non-fire EMSorganizations saw NFPA's technical committee makeup. Itincluded representatives from these groups.

National State Association of EMS Officials (9 p ercent).

VFIS (3 percent).

Emergency Vehicle Technicians Association (3 percent).

International Association of Firefighters (12 percent).

Association of Emergency Vehicle Manufacturers (30

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AMD testing standards.

Speed governed for maximumspeed of 77 mph.

Chevrons on rear doors in red andfluorescent yellow or green.

Underbody lighting thatestablishes lighting zones inwhich all areas of the truck mustdisplay certain warning lights.

Interior cabinets marked withmaximum weight rating.

Items more than 3 pounds mustbe secured in a compartment or by device that withstands a 10-gforce.

Carbon monoxide detector.

Mud flaps.

Additional hand rails at everypoint of ingress.

Certificate of compliance —exceptions to be corrected beforeplacing in service.

"Do not move" light connected todoors, storage racks anddeployed devices.

percent).

Research testing (9 pe rcent).

NIOSH (6 percent).

Users (27 percent).

During 2012, the National Association of State EMS Officialswanted more of a voice in the development and approval of NFPA 1917. NFPA and NASEMSO collaborated to developseveral meetings, hosted by NASEMSO, to inform and educateNASEMSO members about how the NFPA standarddevelopment process worked and on the details of NFPA 1917.IAFC and NFPA were both actively present in these meetings.

NFPA responded to this unprecedented interest by NASEMSOand its membership by establishing a task group to take acloser look at NFPA 1917.

The task group, which included individuals recommended byNASEMSO, met over the course of two days in January 2013and out of those sessions came an extensive list of publiccomments that were sent on to NFPA. Most of those commentswere accepted and will be incorporated into the second editionof NFPA 1917, scheduled for 2016.

The current edition of NFPA 1917 is the 2013 edition; the

revision cycle for the 2016 edition will begin in mid-2015. GSA's

KKK-A-1822 will be sunset — that is, not be revised or renewed

— that same year.

Ultimately, when EMS personnel board an ambulance, theydeserve to arrive to their destination safely. When a patiententers an ambulance, we owe it to them to keep them safe. The

adoption and publication of NFPA 1917 is a significantdevelopment in helping all EMS agencies to obtain ambulancesthat meet both of those objectives.

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