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What the new ambulance safety standard could mean

Eighty-three page proposed draft of NFPA 1917: Standard for Automotive Ambulances was released this week


By Jim Love
EMSafety.net

Decades ago, the General Services Administration (GSA) created the first document for the construction of ambulances. As a result the "triple K" (KKK-A-1822) specification was born.

For almost as long, this document has come under criticism. To be fair, the K spec was written to be a buying specification for federal government ambulances — it was not intended to be a build specification or design or safety standard for the ambulance industry.

It is said that nature abhors a vacuum and as there was no other standard in place, many states began to adopt the current K spec as the state requirement for ambulance conversion.

More than 30 states have adopted this as rule. Even in those states where this is not the referenced standard, there is a very close resemblance.

For most of us, we have operated under the KKK-A-1822 (now at version F) for years. Compliance with and building to the standard is what allows manufacturers to display the "Star of Life" insignia.

Industry experts and stakeholders
Several years ago, the National Fire Protection Association (NFPA) took on the task of rewriting the ambulance (EMS ground ambulance) standard.

Many feel that the NFPA is the right organization to lead this task as they have written dozens of adopted standards for the fire service including various build standards used for a variety of fire apparatus. As part of the process, the NFPA brought together industry experts and stakeholders to discuss the many various aspects of building a proper vehicle.

This week, it released its 83-page proposed draft of NFPA 1917: Standard for Automotive Ambulances. All interested parties are invited to review this proposal, which can be viewed on the NFPA's website. More important is that the NFPA is required to offer a public comment period. This is the time that concerns be voiced in order to be considered for change in this version of the standard.

Many of the changes required under this new standard will be invisible to the end user — the EMT or medic. The standard sets specific requirements and is very technical in nature.

One requirement under this standard is the requirement for a Vehicle Data Recorder (VDR). The VDR will be required to record, second by second, certain vehicle data including speed, rate of acceleration and deceleration.

Seats and seat belts
There are also new requirements for seats and seat belts in this draft. All seats must be sensed and the VDR must record which seats are occupied and whether or not seat belts are in use. The vehicle operator must also be advised by use of an enunciator where occupants are seated and that they are belted.

The end user must supply an estimate of equipment and crew weight to the manufacturer to help assure that the weight capacity (GVW) is not exceeded. There is also a requirement that all switches, etc., be within reach of the primary patient care position so the caregiver may remain seated and secured.

These changes along with the head clearance requirements to prevent or reduce the chance of head strikes are all to improve occupant safety.

Some believe this is a good start to improving occupant safety — others feel the standard does not go far enough. All seem to agree that the new standards will make ambulances more expensive.

But if the result is a safer, more stable, better built vehicle then it is well worth the additional cost. The public comment period closes on December 15, with the new standard set to go into effect in 2013. Once final it will undoubtedly take time for the different states to evaluate and adopt it. 

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