ASTM F1705-96(2020)
(Guide)Standard Guide for Training Emergency Medical Services Ambulance Operations
Standard Guide for Training Emergency Medical Services Ambulance Operations
SIGNIFICANCE AND USE
4.1 This guide provides minimum training guidelines for safe and efficient ambulance operations.
4.2 Ambulance providers and educators should follow this guide for the development of educational and training programs.
4.3 This guide is intended to promote safe and efficient ambulance operations and to reduce morbidity, mortality, and property loss associated with ambulance operations.
4.4 This guide is intended to assist those who are responsible for the development and implementation of policies and procedures for ambulance operations.
4.5 Topics or concepts listed in this guide are intended to serve as an outline of materials to be covered in the training of ambulance operators.
SCOPE
1.1 This guide provides minimum training standards for Emergency Medical Services (EMS) Ambulance Operators including legal aspects, operator qualifications and testing, history of EMS vehicle operations, vehicle types/equipment, safety, physical forces, mechanics, pre-run, operations, post-run, and special circumstances.
1.2 This guide promotes the safe and efficient delivery of the ambulance, equipment, crew, passengers, and patients, during all phases of the delivery of EMS involving the ambulance, at all times exercising the highest degree of care for the safety of the public. This guide may be applied to the driving of other EMS vehicles that do not necessarily provide patient transportation.
1.3 This guide shall be used as the basis for all programs relevant to the training of the emergency medical services operators.
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.
1.5 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
General Information
Relations
Standards Content (Sample)
This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the
Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
Designation: F1705 − 96 (Reapproved 2020)
Standard Guide for
Training Emergency Medical Services Ambulance
Operations
This standard is issued under the fixed designation F1705; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope F1177 Terminology Relating to Emergency Medical Ser-
vices (Withdrawn 2018)
1.1 This guide provides minimum training standards for
F1230 Specification for Minimum Performance Require-
Emergency Medical Services (EMS) Ambulance Operators
ments for Emergency Medical Service (Ems) Ground
including legal aspects, operator qualifications and testing,
Vehicles (Withdrawn 1997)
history of EMS vehicle operations, vehicle types/equipment,
F1258 Practice for Emergency Medical Dispatch
safety, physical forces, mechanics, pre-run, operations, post-
F1517 GuideforScopeofPerformanceofEmergencyMedi-
run, and special circumstances.
cal Services Ambulance Operators
1.2 This guide promotes the safe and efficient delivery of 4
2.2 Federal Specification:
the ambulance, equipment, crew, passengers, and patients,
KKK 1822C Federal Specification for the Star-of-Life Am-
during all phases of the delivery of EMS involving the
bulance
ambulance, at all times exercising the highest degree of care
3. Terminology
for the safety of the public. This guide may be applied to the
driving of other EMS vehicles that do not necessarily provide
3.1 For definitions of other emergency medical terms, see
patient transportation.
Terminology F1177:
1.3 This guide shall be used as the basis for all programs
3.2 Definitions of Terms Specific to This Standard:
relevant to the training of the emergency medical services
3.2.1 ambulance operations—the efficient delivery of the
operators.
ambulance, equipment, crew, passengers, and patients during
all phases of the delivery of EMS involving the ambulance, at
1.4 This standard does not purport to address all of the
all times exercising the highest degree of care for the safety of
safety concerns, if any, associated with its use. It is the
the public.
responsibility of the user of this standard to establish appro-
priate safety, health, and environmental practices and deter-
3.2.2 ambulance service provider—asoutlinedinthisguide,
mine the applicability of regulatory limitations prior to use.
a person, company, corporation, or political entity responsible
1.5 This international standard was developed in accor-
for operation, maintenance, or policy-making, or all three,
dance with internationally recognized principles on standard-
regarding emergency medical vehicle operations.
ization established in the Decision on Principles for the
3.2.3 bona fide occupational qualification (BFOQ)—the
Development of International Standards, Guides and Recom-
skills and knowledge relevant to the performance of a specific
mendations issued by the World Trade Organization Technical
task.
Barriers to Trade (TBT) Committee.
3.2.4 departure check—the visual check of the vehicle and
surrounding area, ensuring that equipment and supplies have
2. Referenced Documents
been retrieved and properly stored and that all compartment
2.1 ASTM Standards:
doors are secured.
3.2.5 egress check—the visual check of the vehicle and
surrounding area prior to operating the ambulance.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.2.6 emergency mode—as defined by individual state stat-
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
utes that refer to emergency vehicles, equipment, and opera-
Current edition approved Nov. 1, 2020. Published November 2020. Originally
tions.
approved in 1996. Last previous edition approved in 2012 as F1705 – 96 (2012).
DOI: 10.1520/F1705-96R20.
2 3
For referenced ASTM standards, visit the ASTM website, www.astm.org, or The last approved version of this historical standard is referenced on
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM www.astm.org.
Standards volume information, refer to the standard’s Document Summary page on AvailablefromU.S.GovernmentPrintingOfficeSuperintendentofDocuments,
the ASTM website. 732 N. Capitol St., NW, Mail Stop: SDE, Washington, DC 20401.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1705 − 96 (2020)
TABLE 1 Emergency Medical Services Ambulance Maintenance
provider’s policies governing emergency medical vehicle op-
Guidelines for Checklist Completion
erations. The operator/driver shall have a clear understanding
Runs per week (per
of the impact of those laws on the operation of the vehicle.
Full check Quick check
vehicle)
5.1.1 Constitutional Law—Laws derived from the U.S.
0 to 1 every 96 h every 24 h
Constitution governing the patient’s right before, during, and
2 to 3 every 72 h every 24 h
4 to 7 every 48 h every 24 h after transport.
8 to 50 every 24 h every 12 h
5.1.2 Statutory Law—Laws derived from legislative acts.
50+ every 24 h every 8 h
5.1.3 Ordinances—Laws or guidelines enacted by a govern-
ing municipal body or its agent.
5.1.4 Rules and Regulations—Guidelines enacted by an
3.2.7 full check—a comprehensive and systematic evalua-
agency that have the force of law that are intended to provide
tion of the ambulance at specified intervals, including docu-
greater specificity about statutory laws.
mentation of the inspection, deficiencies, and their corrective
5.1.5 Case Law—Judicial interpretation of statutory law,
actions.
rules, or regulations that have been decided in a court of law.
3.2.8 operator—a person who operates or assists with the
5.1.6 Consolidated Omnibus Reconciliation Act (COBRA)/
operation of an ambulance.
Omnibus Reconciliation Act (OBRA) Laws.
3.2.9 driver—the individual responsible for operating the
5.2 Integration of state laws and local ordinances with
ambulance in a safe and efficient manner, exercising the
company policies/procedures. Company policy should incor-
highest degree of care.
porate into guidelines the principles of applicable state laws,
3.2.10 technician—the individual responsible for patient local ordinances, rules, and regulations.
care.
5.3 Highest Degree of Care (Law of Due Regard)—A
3.2.11 post-run—the managed return of the ambulance and
general principle, frequented in case law, that holds the
operators to optimal pre-run readiness.
ambulance operator responsible for his actions regardless of
perceived exemptions from traffic laws governing the emer-
3.2.12 pre-run—all aspects of assuring response readiness.
gency vehicle operator.
3.2.13 quick check—an abbreviated version of the full
check, focusing on the major operational functions of the 5.4 Legal Issues:
vehicle.
5.4.1 Negligence—Any action that violates a standard of
practice or care related to ambulance operation.
3.2.14 reaction time—from the time the operator identifies
5.4.2 Abandonment—Terminating care or transportation
the hazard until the appropriate action is taken.
prior to being relieved by other qualified health care providers.
3.2.15 response mode management—the response mode of
Once a patient provider relationship is established, it must
the ambulance shall be determined by dispatch protocols based
continue until responsibility for the patient is assumed by a
on(dispatch)determinantsasapprovedbythemedicaldirector.
provider of equal or higher qualifications.
The determinants shall be consistent with Practice F1258.
5.4.3 Emergency Medical Dispatch—An organized system
3.2.16 stopping distance—the distance the vehicle travels
of emergency medical dispatching principles intended to pro-
until it comes to a stop after the brakes are applied.
vide guidelines for ambulance operations as delineated in
Practice F1258.
4. Significance and Use
5.4.4 Multiple Responding Units:
4.1 This guide provides minimum training guidelines for
5.4.4.1 Vehicle Separation—The operator shall be trained to
safe and efficient ambulance operations.
maintainaminimum300-ftbufferzonebetweentheambulance
and other emergency vehicles on the same route of travel.
4.2 Ambulance providers and educators should follow this
guide for the development of educational and training pro- (1) Weather, traffic conditions, or other factors may cause
the operator to increase the length of the buffer zone for the
grams.
safe operation of the ambulance.
4.3 This guide is intended to promote safe and efficient
5.4.4.2 Escorts—The operator shall be informed of the
ambulance operations and to reduce morbidity, mortality, and
hazards involved in the use of emergency vehicle escorts and
property loss associated with ambulance operations.
be trained to avoid such practices.
4.4 This guide is intended to assist those who are respon-
(1) The operator shall be trained to discourage private,
sible for the development and implementation of policies and
non-emergency vehicles from following the ambulance during
procedures for ambulance operations.
transport.
4.5 Topics or concepts listed in this guide are intended to 5.4.5 Interacting with Public Safety Agencies:
serve as an outline of materials to be covered in the training of
5.4.5.1 Command—Ambulance operations shall be consis-
ambulance operators.
tent with operational guides delineated in Incident Command
System (ICS).
5. Legal Aspects
5.4.5.2 Communication—Ambulance communication sys-
5.1 The training of the ambulance operator shall include all tems should allow the ambulance operator to communicate
federal and state laws and local ordinances including the with other public safety agencies.
F1705 − 96 (2020)
5.4.5.3 Coordination—Cooperative guidelines shall be es- 6.6 The operator’s qualifications and continuing education
tablished with other public safety agencies in order to provide shall be reviewed annually.
a safe and adequate response.
5.4.6 Motor Vehicle Accidents Involving the Ambulance: 7. Operator Testing
5.4.6.1 Reporting—The ambulance operator shall receive
7.1 The training of the ambulance operator shall include the
instructions regarding reporting guidelines for ambulance re-
components of evaluation techniques which may be utilized in
lated accidents/incidents in accordance with state laws, local
screening the operator candidate:
ordinances, rules or regulations, and organizational policies
7.1.1 Psychological testing.
and procedures.
7.1.2 Physical agility.
5.4.7 Mitigation/Documentation Mechanical Failures:
7.1.3 Driving evaluation.
5.4.7.1 Scheduled Maintenance—The ambulance operator
7.1.4 Cognitive evaluation.
shall be trained in the importance of a scheduled maintenance
program.
8. History of EMS Vehicle Operation
5.4.7.2 Vehicle and Equipment Inspections—Theambulance
8.1 The training of the emergency vehicle operator shall
operatorshallbetrainedinthefundamentalsandapplicationof
include the history of EMS vehicle operation:
vehicle and equipment inspections.
8.1.1 Evolution of ambulance driving from high-force pur-
5.4.7.3 Reporting of Deficiencies—The ambulance operator
suit driving to low G-force driving techniques.
shall understand the importance of inspecting the ambulance
8.1.2 Changes in vehicle design and dynamics.
and equipment, and shall be familiar with the reporting
8.1.3 Evolution of governmental regulation.
procedures utilized by the provider. The ambulance operator
8.1.3.1 Specification F1230, Minimum Performance Re-
shall be familiar with provider policies in regard to major
quirements for Emergency Medical Service Ground Vehicles.
deficiencies which have an affect on the serviceability of the
8.1.3.2 Federal standards KKK 1822C: “A” through current
vehicle.
specifications.
6. Operator Qualifications to Drive
9. Vehicular Types and Equipment
6.1 The training of the ambulance operator shall include the
9.1 The training of the ambulance operator shall include the
components of evaluation techniques which may be utilized in
different ambulance classifications (Types I, II, III, and spe-
screening the operator candidate:
cialty response vehicles) including maneuverability, handling,
6.1.1 Medical Fitness to Drive—Operators shall be subject
weight distribution, payload allowance, and GVWR.
to periodic medical evaluations as determined by the ambu-
lance service provider. The purpose of the physical examina-
10. Loss Control and Safety Issues in the Operations of
tion is to determine whether the operator has the physical
Ambulances
ability to adequately perform his or her duty as an operator of
10.1 Preventive Maintenance—The ambulance operator
emergency vehicles. (See Guide F1517.)
shall be trained in basic techniques, documentation, and
6.2 Authorization:
rationale for preventive maintenance.
6.2.1 The authorization of ambulance operators must be
10.1.1 The operator should follow provider policies or
based on Bona Fide Occupational Qualification (BFOQ) pur-
manufacturer’s suggested maintenance schedule, or both, for
suant to the task of ambulance operations.
the ambulance.
6.2.2 Authorization shall be based upon cognitive evalua-
10.2 Operator Fatigue—The ambulance operator shall be
tion of the operator regarding laws, guidelines, and policies
trained in the recognition of the adverse affects of excessive
relating to ambulance operation during emergency and non-
fatigue. The provider/operator shall be familiar with methods
emergency modes.
and policies used to prevent fatigue-related operator dysfunc-
6.3 A periodic review of the operator’s state motor vehicle
tion.
record for the previous three years with specific attention to
10.3 Interactive Crew Roles—Operators shall receive in-
traffic convictions concerning:
struction on the importance of interactive roles utilized to
6.3.1 Speed.
lessen risk exposure, such as the ground guide/driver relation-
6.3.2 Careless and imprudent driving.
ship in backing the ambulance or the driver/technician rela-
6.3.3 Driving under the influence of alcohol or other mind-
tionship in approaching controlled intersections.
altering substances.
10.4 Unsafe Thought Patterns—The operator shall be made
6.3.4 Moving violations/other violations.
aware of the importance of concentration on the driving task at
6.3.5 Suspension of driver’s license.
hand and should be aware of dangerous practices such as
6.4 A review of the operator’s motor vehicle accidents for
allowing the nature of the emergency to affect driving tech-
the previous three years.
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