In last month’s column, I reviewed the history behind the decision for the National Fire Protection Association (NFPA) to develop a new standard on ambulances. In short, the GSA’s “Triple K” purchasing document had defaulted to a specification document. It was past time for an update to “Triple K,” and the stakeholders in that process saw benefits to the document becoming a performance document—with an emphasis on safety.
Moreover, stakeholders acknowledged that the fire service has emerged as the primary emergency medical services (EMS) provider (in varying degrees) in most jurisdictions. Patient transport is handled by the fire department in all of the largest metropolitan areas of the United States.
NFPA 1917, Standard for Automotive Ambulances, is on schedule for final approval next year. Barring an unforeseen problem, the standard will be effective for all new ambulances purchased or contracted for on or after January 1, 2013.
Skepticism and resentment from some individuals and agencies about a new standard for ambulances was (and will be) an issue. For example, the committee received 1,785 public proposals! Unfortunately, many of the proposals had to be rejected because the submitters simply expressed opinions. As a reminder, public proposals and comments for an NFPA standard must provide the following: document number, section, and paragraph; exact wording to be added, changed, and/or deleted; and a substantiation statement for the proposal and comment. Nonetheless, the high number of proposals indicates that the EMS community is involved in the process rather than “sitting on the sidelines.”
For future revisions to this standard and all other standards, the NFPA will start a new standards development process in 2012. The online format should be a lot more user-friendly for submitters and followers. A key component of the new process will be the opportunity to see the existing text as well as the proposed text online.
David Fischler is the chair of the standard committee. His resume in fire, EMS, and emergency management is remarkable. He is also an attorney. With this skill set, he has brought a very diverse and often conflicting group together to work within an unfamiliar process. He and the committee members, along with NFPA staff liaison Larry Stewart, have traveled an uncharted course and are to be commended.
It is premature to discuss the requirements of the new standard, since it is still a work in progress. However, the emphasis of the proposed standard is safety—for the driver, attendants, patients, and other motorists. In fact, Fischler told me the primary reason for the standard is safety.
Clearly, there are safety issues to be addressed as we see and read about too many horrific ambulance crashes. One key focus area is attendant safety (occupant restraint) in the patient compartment. The National Institute for Occupational Safety and Health (NIOSH) is currently conducting a detailed study of this area, and the preliminary findings are encouraging.
Unfortunately the study will not be completed in time to benefit the first edition of this standard. Hopefully the ambulance manufacturers that are in tune with the process will go ahead and incorporate some of the information into their designs. If the final study is released well ahead of the next revision of the standard, then a “tentative interim amendment” could possibly be voted on. Or, the standard could be revised in three or four years, rather than the typical five years. NFPA 1917 will have a similar template as NFPA 1901, Standard for Automotive Fire Apparatus.
End users will not like some of the requirements and will identify areas they wish there were additional requirements. That is common with consensus standards and the reason why NFPA standards have revision cycles. The new standard is a big step for firefighter/EMS safety, but there are more steps to be taken. The evolution of this standard in the coming years is worthy of attention.
You can follow the standard through the NFPA Web site at www.nfpa.org. Click on the “Codes and Standards” tab, then click on the “List of NFPA Codes and Standards (Document Information Pages).” Use the search engine on the right side of the page, enter document number 1917, and click on the “Next Edition” tab.
ROBERT TUTTEROW is safety coordinator for the Charlotte (NC) Fire Department and a member of the Fire Apparatus & Emergency Equipment editorial advisory board. His 34-year career includes 10 as a volunteer. He has been very active in the National Fire Protection Association through service on the Fire Service Section Executive Board and technical committees involved with safety, apparatus, and personal protective equipment. He is a founding member and president of the Fire Industry Equipment Research Organization (F.I.E.R.O.).