Welcome to the third installment of EMS 2020. Last month we examined risk in EMS. This month’s content looks at efforts to develop standards that can improve the safety of the ambulance environment. POLICY: Exempt from key safety requirements and often poorly laid out, ambulances are...
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The project was spawned by the coming demise of the K specs (now postponed to 2015), which were created for federal purchasing but are utilized by many states to define what can be used as ambulances. Its replacement, NFPA 1917, “includes several departures from and additions to the KKK specs that have raised concerns among NASEMSO members,” the organization says.
The CEN 1789 Standard for European Ambulances
In the early years of the European Union, its leaders wanted to bring greater uniformity to their nations’ ambulance fleets. The standard they developed, CEN 1789, has now become regulation for the EU’s members.
First published in 2000 and revised most recently in 2007, CEN 1789 sets forth requirements for the design, testing, performance and equipping of EU ground ambulances. Its primary goal is safety, but also that ambulances be like enough to be recognized across countries and that personnel can easily work in any of them.
The standard covers both vehicle and engine types, as well as characteristics like size, acceleration and braking power, traction control, heating and cooling, and fire safety. Inside there are ergonomic requirements and specs for patient compartment design. Patient lifting is restricted, and safety measures are featured throughout. European ambulances are typically smaller, and equipment is arranged for seated and restrained reach by attendants. The CEN standard also specifies independent third-party testing by labs certified for the specific tests they perform. Manufacturers can’t do their own testing.
Other interesting aspects:
• Ambulances are classified as A1 or A2 (for nonemergency transports), B (for emergency use, with more treatment space and equipment storage), or C (mobile intensive care unit), with requirements increasing accordingly.
• Yellow—visible to almost all people in almost all conditions—is the primary color for all ambulances, with reflective green Battenburg markings running the length.
We’re still without key crashworthiness and occupant protection requirements, and the standards we do have are stronger in some parts than others. Improving them is a long-term process. The good news is that safety is at the forefront of considerations like never before, and a lot of smart, motivated people—in the public and private spheres, and including manufacturers, consultants and others across the spectrum—are laboring toward the same end.
“The goal is to provide the worker in the back of the ambulance with the same level of safety they’d have in their own vehicle driving to and from work,” says Green. “They have a moving workplace, and we’re trying to bring it up to that same level of safety.”