Associations, EMS, Fire Department

New Design Standards

Issue 8 and Volume 14.

The National Fire Protection Association (NFPA) Committee on Ambulances has begun work on new design standards for ambulances. Its chairman, retired Suffolk County, N.Y., fire commissioner David Fischler, said the primary goal is safety.

“The idea is not to look at what kind of medical equipment should be on an ambulance,” Fischler said, “but how the vehicle can be made safer for the providers of EMS care and their patients.”

Committee members met in mid-June for the first time to lay down ground rules for civil discussion, select a chairman, and receive their first work assignments. 

Fischler said his involvement with the International Association of Fire Chiefs and his background as an attorney appealed to committee members as they considered who would lead their work. He is a member of the IAFC’s Terrorism/Homeland Security Committee.

NFPA fire service specialist Larry Stewart, who coordinates the committee, said Fischler and company – the committee had 23 members and five alternates at its first meeting – will meet every six months or so until they have a draft in hand. “I have a feeling the committee will have two to three planning development meetings, each spaced six months apart, before a draft is ready,” 
Stewart said. 

But even when a draft is written, Stewart estimated it would be another two to three years before a final product is ready. “I don’t have a crystal ball to know exactly where the committee is going with this,” Steward said. “Ambulances are a new topic for myself, so I’ll be learning a lot as need requires.”

Some ambulance manufacturers have wondered why the NFPA chose to get involved in ambulance standards, when there are already standards set forth by the Federal Specifications for Ambulances KKK-A-822 (KKK). Stewart said the people in charge of the KKK standards got together with the NFPA about a year ago to discuss a proposal that the NFPA take over. 

John McDonald of the U.S. General Services Administration, who represents the federal government and the KKK standards on the new committee, said the government is always looking to get out of the business of setting standards.

“The way it works in the government,” he said, “is if there is a consensus standard available, you are not supposed to use a government produced standard instead. When [the NFPA] expressed interest in the project, we agreed to participate, as we would agree to participate with anyone who is developing a consensus standard that we can conceivably use.”

The Green Light

Stewart said the NFPA standards council looked over the proposal, and gave the green light to begin the project. “After getting the OK, we solicited for committee members, and we had a lot of applications,” he said. “We had to sort them all through and get a balance for having enough manufacturers, enough users, enough enforcers. We have everyone who has a piece of the pie.”

Stewart said the old KKK standards will definitely help the committee come up with ideas in conjunction with NFPA 1901 – the standard for fire apparatus – which will form the basis for the new ambulance standards. 

So what standards will NFPA ambulance committee members consider? “They will definitely want to identify performance requirements and get away from prescriptive things,” Stewart said. “They want to look at crash-worthiness.” 

The NFPA Ambulance Committee will also consider electrical systems, power plants, safety equipment and even seating positions of occupants, Stewart said. “Currently we have this squad-type seating where it’s parallel with the frame of the vehicle,” he said. “Maybe we want to change the position, so that the caregiver is in a forward or rearward facing position to offer some additional safety.” 

Medical Equipment

As for medical equipment on the ambulance, Stewart agreed with Fischler that the NFPA won’t get involved in that since local officials usually decide what ambulances must carry. “We will probably try to get a sense of the minimum of what’s common among everyone else, and maybe provide that as a basis for equipment,” Stewart said. “But even in the apparatus standards, we don’t have a required tool list other than some of the necessary things we have to operate the vehicle, like wheel chocks and so forth.”

The American Ambulance Association, which represents private ambulance services and was founded in 1979, came out earlier this year against NFPA involvement in ambulance standards, stating that fire department and private-sector ambulance needs are not the same and a new design standard would be costly in a time of economic downturn.

McDonald said federal officials initially had similar worries. “Certainly [non-fire department ambulance services] are concerned that a situation would be created that would force them all to use medium-duty ambulances,” he said. “And quite frankly, the government is concerned about that too, because 90 percent of the ambulances we buy are not medium-duty ambulances, but rather the kind that are built on a van or a pick-up-type chassis.”

But McDonald said that the NFPA has promised to produce a standard that covers all kinds of ambulances, large and small, so the government is happy to participate.

He also pointed out that any standards – NFPA, KKK or otherwise – are voluntary, so that setting new standards doesn’t necessarily mean state EMS directors will require them or ambulance manufacturers will use them.

Chairman Fischler said he will try to ease concerns by fostering an atmosphere of communication. “I believe in a fair and open process, allowing input in any and every way,” he said. “I think everyone came away from the first meeting fairly pleased.” 

Interviewed this spring at the Fire Department Instructors Conference, most ambulance manufacturers appeared resigned to the committee process, and some were even applauding it.

“We support the NFPA ambulance standards committee,” said Jim Philips of MedTec, based in Goshen, Ind. “We feel it’s good to create a standard. The triple-K standard is the only default in a vacuum, but it doesn’t address all the stakeholders.” 

Concern About Costs

Dennis Trebus of Marion, S.C.-based Road Rescue agreed. “It won’t affect a lot of areas,” he said. “I don’t think there is anything we won’t be able to overcome.” While Trebus expressed concern about increased costs, he said, “I don’t think there is anything negative about it. People should be belted in and have a switch panel that is within arms reach.”

Some ambulance makers at FDIC even hoped their innovations could be a part of the future NFPA guidelines. Scott Braun, vice president at Van Wert, Ohio-based Braun Industries Inc., said his company’s new Patriot Fire/Rescue/Transport apparatus, unveiled at FDIC this year, could lead the way to the smooth melding of old KKK and new NFPA standards. 

“We were certainly looking at the opportunity to figure out how to mold those together,” Braun said. “I think as the NFPA gets a little closer to wanting to be a part of an ambulance spec, I think we will see that connection come together even better.” 

Limiting Lights

 Meanwhile, Martin Malloy of Grove City, Ohio-based Horton Emergency Vehicles hoped the NFPA would consider his company’s new Horton Occupant Protection System (HOPS), which includes side airbags and three-point harnesses for ambulance attendants. And MedTec’s Philips was already showing a rear-facing bench seat in his company’s ambulances at FDIC this year.

Chad Newsom of Manasquan, N.J.-based PL Custom had more practical concerns. “I hope they put in a rule about limiting some of the lights,” he said, “because the people coming into your scene are blinded by you.” 

Newsom is also concerned about costs. “My customers worry that the standards will hurt the little guy,” Newsom said. “I just hope that everything that is done is in the true nature of helping the end user. 

Scott Barnes, vice president of sales and marketing for Wheeled Coach of Winter Park, Fla., took a balanced view of the proceedings. “I’m sure there will be many late nights and many heated arguments,” he said. “At the end of the day, you have to have faith that the group will come up with a solution that makes sense to everyone. There will always be someone, though, who is disappointed.”

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