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Which safety standards should your ambulance remount meet?

With more safety data available, ambulance remounts may be the next to receive significant upgrades to minimum quality standards


How can services be assured that their crews and their patients are safe?

Photo/Greg Friese

Remounting an existing patient care compartment on a new vehicle chassis is less expensive and often faster than building a new ambulance from scratch, making it an attractive upgrade path for many agencies. The remount process has been used more frequently in the past 10 years, and one in every five ambulances is soon expected to be a remount. But since remounts typically are not required to meet the same strict safety standards as new ambulances, how can services be assured that their crews and their patients are safe?

Ambulance remount standards

Here are the current and forthcoming standards governing ambulance remounts:

  • The Vehicle Safety Act: The National Highway Traffic Safety Administration (NHTSA) considers ambulance body remount companies as “final stage manufacturers,” subject to basic Federal Motor Vehicle Safety Standards (FMVSS), the same as any car, van, truck or other vehicle manufacturer. As such, they assume legal responsibility for all certification related duties and liabilities under the Vehicle Safety Act.
  • KKK-A-1822: Developed as a purchasing specification for federal ambulances in the 1970s, the primary standard that applies to new ambulance manufacture today is the Federal General Services Administration KKK-A-1822 specification. KKK-A-1822 identifies a variety of minimum safety requirements, including electrical system specifications, warning indicators, weight capacity, general construction and more.
  • NFPA 1917: With development beginning in 2009, NFPA 1917: Standard for Automotive Ambulances was initially intended to replace the KKK specifications. NFPA 1917 addresses safety issues beyond the KKK specifications, including CO detectors, seat-belt monitoring systems and speed governors. While NFPA 1917 is seen by many as an important step forward for ambulance safety and reliability, it does not yet apply to ambulance remounts, although this will be included in an annex of the revision due to be published in 2019.
  • GVS: Addressing many of the same issues as KKK and NFPA 1917, version 1 of the Ground Vehicle Standard (GVS) developed by the Commission on Accreditation of Ambulance Services does not specifically address ambulance remounts, but version 2 of the GVS standard, also due in 2019, will.

While it remains to be seen whether the traditional KKK ambulance specifications will be replaced by NFPA 1917, GVS or both, future standards will apply to both construction and testing of remounted ambulances.

Virginia leads the way in ambulance remount requirements

Although adherence to standards can vary from state to state, the Virginia Office of Emergency Medical Services is an example of a state EMS administration that is taking ambulance remount safety very seriously. Virginia is the first state to have a remount standard that requires ambulances successfully demonstrate the integrity of both cot retention and restraint systems in front and side-impact collisions.

While there can be additional costs to compliance, in Virginia, they are not making a distinction between the importance of safety in new ambulances versus remounts.

Steps you can take today to increase ambulance safety

Any ambulance service seeking the often faster and less expensive remount ambulance upgrade option should ask their manufacturer about compliance with current and future safety standards, including NFPA 1917 and CAAS GVS. This will help any ambulance service looking for a remount to ensure that they are getting a safe and quality product.

While it may add some cost to use a service that considers these specifications in the remount process, the value it adds can be invaluable to your providers, your patients and everyone else on the road.

Rom Duckworth is a dedicated emergency responder, author and educator with more than 30 years of experience working in career and volunteer fire departments, hospital healthcare systems, and private EMS. He is a career fire captain and paramedic EMS coordinator for the Ridgefield (Connecticut) Fire Department and the founder of the New England Center for Rescue and Emergency Medicine. Duckworth is recipient of the American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award in addition to numerous awards and citations for excellence in education and dedication to service. Duckworth is a member of numerous national education, advisory and editorial boards, as well as a contributing author to more than a dozen EMS, fire and rescue books, including the IFSTA Pumping Apparatus Driver/Operator textbook as well as over 100 published articles in fire and EMS journals, magazines and websites. Duckworth has a bachelor’s degree in public safety administration from Charter Oak State College in Connecticut. Connect with Duckworth via or or on LinkedIn.