Ambulance manufacturers are committed to making their ambulances as safe as possible. The question is, are ambulances as safe as they should be for our patients, for our EMS providers and for the public at large?
Search the internet for ambulance accidents; you'll find that throughout the United States, ambulance accidents occur on a daily basis. Many of these have injured or killed EMS providers, the patient or the general public.
Approximately four years ago, a trend was identified that showed an increase in ambulance accidents and a resulting increase in EMS-provider deaths and injuries. Two issues arose:
- Did the operation of the ambulance result in the accident?
- Is there a way to improve the construction of ambulances to make them safer?
Fire service and EMS leaders petitioned the National Fire Protection Association (NFPA) to create a committee to address the second issue. That committee was formed the following year to develop a new NFPA standard (NFPA 1917) for the construction and mechanical operation of an ambulance.
For years, most ambulances were built using a specific U.S. General Services Administration document. In the absence of any other ambulance construction document, many states adopted it as their state's standard. The GSA document is a purchase specification developed to purchase ambulances for the federal government; it serves as a design specification and not a performance standard.
NFPA 1917 was formed with representatives from EMS, the fire service, manufacturers, enforcement agencies and users. Not wanting to reinvent the wheel, the committee focused on using the above document as the foundation to build the 1917 standard on.
That's why 1917 is similar in certain components to the GSA document. The committee added new material and with the superb cooperation of the National Truck Equipment Association – Ambulance Manufacturers Division, the committee incorporated testing procedures, including crash tests, to ensure ambulances would meet the 1917 performance safety and mechanical criteria.
The new NFPA 1917 standard was published on January 1; it isn't retroactive and only applies to ambulances purchased after this date. The GSA document is expected to sunset within the next two years. Safety criteria that will affect EMS agencies include:
- Responsibility of the purchaser is to specify useable payload to include equipment and personnel; vehicles handle differently when the gross vehicle weight is exceeded.
- Responsibility of the manufacturer is to provide a detailed noncompliance document with a statement of exceptions if the ambulance doesn't meet the 1917 standard.
- The purchaser will identify a primary patient-care position that would allow the EMS provider to have all controls and medical equipment within reach without removing seating restraints. All equipment is to be secured to prevent them from becoming projectiles in a collision.
- Roof and structural components will be load tested.
- Seatbelt warning systems will have visual and audible alerts in both the patient and driver compartments to indicate someone is unbelted.
What's next? NFPA 1917 has entered its revision cycle for the next edition; the public-input period is now open through July 8.
Now's the time for EMS providers to offer input to the additions and revisions of the next version of this standard and to help improve ambulance safety. Read the document and provide your comments.
We all share a common goal to ensure the safety of EMS providers, our patients and the general public. NFPA 1917 is one way to help meet this safety goal.