ASTM F1705-96(2012)
(Guide)Standard Guide for Training Emergency Medical Services Ambulance Operations
Standard Guide for Training Emergency Medical Services Ambulance Operations
SIGNIFICANCE AND USE
This guide provides minimum training guidelines for safe and efficient ambulance operations.
Ambulance providers and educators should follow this guide for the development of educational and training programs.
This guide is intended to promote safe and efficient ambulance operations and to reduce morbidity, mortality, and property loss associated with ambulance operations.
This guide is intended to assist those who are responsible for the development and implementation of policies and procedures for ambulance operations.
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 and health practices and determine the applicability of regulatory limitations prior to use.
General Information
Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: F1705 − 96 (Reapproved 2012)
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 F1258 Practice for Emergency Medical Dispatch
F1517 GuideforScopeofPerformanceofEmergencyMedi-
1.1 This guide provides minimum training standards for
cal Services Ambulance Operations
Emergency Medical Services (EMS) Ambulance Operators
2.2 Federal Specification:
including legal aspects, operator qualifications and testing,
KKK 1822C Federal Specification for the Star-of-Life Am-
history of EMS vehicle operations, vehicle types/equipment,
bulance
safety, physical forces, mechanics, pre-run, operations, post-
run, and special circumstances.
3. Terminology
1.2 This guide promotes the safe and efficient delivery of
3.1 For definitions of other emergency medical terms, see
the ambulance, equipment, crew, passengers and patients,
Terminology F1177:
during all phases of the delivery of EMS involving the
3.2 Definitions of Terms Specific to This Standard:
ambulance; at all times exercising the highest degree of care
3.2.1 ambulance operations—the efficient delivery of the
for the safety of the public. This guide may be applied to the
ambulance, equipment, crew, passengers, and patients during
driving of other EMS vehicles that do not necessarily provide
all phases of the delivery of EMS involving the ambulance, at
patient transportation.
all times exercising the highest degree of care for the safety of
1.3 This guide shall be used as the basis for all programs
the public.
relevant to the training of the emergency medical services
3.2.2 ambulance service provider—asoutlinedinthisguide,
operators.
a person, company, corporation, or political entity responsible
1.4 This standard does not purport to address all of the
for operation, maintenance, or policy-making, or all three,
safety concerns, if any, associated with its use. It is the
regarding emergency medical vehicle operations.
responsibility of the user of this standard to establish appro-
3.2.3 bona fide occupational qualification (BFOQ)—the
priate safety and health practices and determine the applica-
skills and knowledge relevant to the performance of a specific
bility of regulatory limitations prior to use.
task.
3.2.4 departure check—the visual check of the vehicle and
2. Referenced Documents
surrounding area, ensuring that equipment and supplies have
2.1 ASTM Standards:
been retrieved and properly stored and that all compartment
F1177 Terminology Relating to Emergency Medical Ser-
doors are secured.
vices
3.2.5 egress check—the visual check of the vehicle and
F1230 Specification for Minimum Performance Require-
surrounding area prior to operating the ambulance.
ments for Emergency Medical Service (Ems) Ground
Vehicles (Withdrawn 1997)
3.2.6 emergency mode—as defined by individual state stat-
utes that refer to emergency vehicles, equipment, and opera-
tions.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.2.7 full check—a comprehensive and systematic evalua-
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education. tion of the ambulance at specified intervals, including docu-
Current edition approved July 1, 2012. Published August 2012. Originally
mentation of the inspection, deficiencies, and their corrective
approved in 1996. Last previous edition approved in 2007 as F1705 – 96 (2007).
actions.
DOI: 10.1520/F1705-96R12.
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
3.2.8 operator—a person who operates or assists with the
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
operation of an ambulance.
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website.
The last approved version of this historical standard is referenced on AvailablefromU.S.GovernmentPrintingOfficeSuperintendentofDocuments,
www.astm.org. 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 (2012)
TABLE 1 Emergency Medical Services Ambulance Maintenance
5.1.3 Ordinances—Laws or guidelines enacted by a govern-
Guidelines for Checklist Completion
ing municipal body or its agent.
Runs per week (per
Full check Quick check 5.1.4 Rules and Regulations—Guidelines enacted by an
vehicle)
agency that have the force of law that are intended to provide
0 to 1 every 96 h every 24 h
greater specificity about statutory laws.
2 to 3 every 72 h every 24 h
4 to 7 every 48 h every 24 h
5.1.5 Case Law—Judicial interpretation of statutory law,
8 to 50 every 24 h every 12 h
rules, or regulations that have been decided in a court of law.
50+ every 24 h every 8 h
5.1.6 Consolidated Omnibus Reconciliation Act (COBRA)/
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
3.2.12 pre-run—all aspects of assuring response readiness.
perceived exemptions from traffic laws governing the emer-
3.2.13 quick check—an abbreviated version of the full
gency vehicle operator.
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
3.2.14 reaction time—from the time the operator identifies
practice or care related to ambulance operation.
the hazard until the appropriate action is taken.
5.4.2 Abandonment—Terminating care or transportation
3.2.15 response mode management—the response mode of
prior to being relieved by other qualified health care providers.
the ambulance shall be determined by dispatch protocols based
Once a patient provider relationship is established, it must
on(dispatch)determinantsasapprovedbythemedicaldirector.
continue until responsibility for the patient is assumed by a
The determinants shall be consistent with Practice F1258.
provider of equal or higher qualifications.
3.2.16 stopping distance—the distance the vehicle travels
5.4.3 Emergency Medical Dispatch—An organized system
until it comes to a stop after the brakes are applied.
of emergency medical dispatching principles intended to pro-
vide guidelines for ambulance operations as delineated in
4. Significance and Use
Practice F1258.
4.1 This guide provides minimum training guidelines for
5.4.4 Multiple Responding Units:
safe and efficient ambulance operations.
5.4.4.1 Vehicle Separation—The operator shall be trained to
4.2 Ambulance providers and educators should follow this
maintainaminimum300-ftbufferzonebetweentheambulance
guide for the development of educational and training pro-
and other emergency vehicles on the same route of travel.
grams.
(1) Weather, traffic conditions, or other factors may cause
4.3 This guide is intended to promote safe and efficient
the operator to increase the length of the buffer zone for the
ambulance operations and to reduce morbidity, mortality, and
safe operation of the ambulance.
property loss associated with ambulance operations.
5.4.4.2 Escorts—The operator shall be informed of the
4.4 This guide is intended to assist those who are respon-
hazards involved in the use of emergency vehicle escorts and
sible for the development and implementation of policies and
be trained to avoid such practices.
procedures for ambulance operations.
(1) The operator shall be trained to discourage private,
4.5 Topics or concepts listed in this guide are intended to
non-emergency vehicles from following the ambulance during
serve as an outline of materials to be covered in the training of
transport.
ambulance operators.
5.4.5 Interacting with Public Safety Agencies:
5.4.5.1 Command—Ambulance operations shall be consis-
5. Legal Aspects
tent with operational guides delineated in Incident Command
5.1 The training of the ambulance operator shall include all
System (ICS).
federal and state laws and local ordinances including the
5.4.5.2 Communication—Ambulance communication sys-
provider’s policies governing emergency medical vehicle op-
tems should allow the ambulance operator to communicate
erations. The operator/driver shall have a clear understanding
with other public safety agencies.
of the impact of those laws on the operation of the vehicle.
5.4.5.3 Coordination—Cooperative guidelines shall be es-
5.1.1 Constitutional Law—Laws derived from the U.S.
tablished with other public safety agencies in order to provide
Constitution governing the patient’s right before, during, and
a safe and adequate response.
after transport.
5.1.2 Statutory Law—Laws derived from legislative acts. 5.4.6 Motor Vehicle Accidents Involving the Ambulance:
F1705 − 96 (2012)
5.4.6.1 Reporting—The ambulance operator shall receive 7. Operator Testing
instructions regarding reporting guidelines for ambulance re-
7.1 The training of the ambulance operator shall include the
lated accidents/incidents in accordance with state laws, local
components of evaluation techniques which may be utilized in
ordinances, rules or regulations, and organizational policies
screening the operator candidate:
and procedures.
7.1.1 Psychological testing.
5.4.7 Mitigation/Documentation Mechanical Failures:
7.1.2 Physical agility.
5.4.7.1 Scheduled Maintenance—The ambulance operator
7.1.3 Driving evaluation.
shall be trained in the importance of a scheduled maintenance
7.1.4 Cognitive evaluation.
program.
5.4.7.2 Vehicle and Equipment Inspections—Theambulance
8. History of EMS Vehicle Operation
operatorshallbetrainedinthefundamentalsandapplicationof
8.1 The training of the emergency vehicle operator shall
vehicle and equipment inspections.
include the history of EMS vehicle operation:
5.4.7.3 Reporting of Deficiencies—The ambulance operator
8.1.1 Evolution of ambulance driving from high-force pur-
shall understand the importance of inspecting the ambulance
suit driving to low G-force driving techniques.
and equipment, and shall be familiar with the reporting
8.1.2 Changes in vehicle design and dynamics.
procedures utilized by the provider. The ambulance operator
8.1.3 Evolution of governmental regulation.
shall be familiar with provider policies in regard to major
8.1.3.1 Specification F1230, Minimum Performance Re-
deficiencies which have an affect on the serviceability of the
quirements for Emergency Medical Service Ground Vehicles.
vehicle.
8.1.3.2 Federal standards KKK 1822C: “A” through current
specifications.
6. Operator Qualifications to Drive
6.1 The training of the ambulance operator shall include the
9. Vehicular Types and Equipment
components of evaluation techniques which may be utilized in
9.1 The training of the ambulance operator shall include the
screening the operator candidate:
differentambulanceclassifications(TypeI,II,III,andspecialty
6.1.1 Medical Fitness to Drive—Operators shall be subject
responsevehicles)includingmaneuverability,handling,weight
to periodic medical evaluations as determined by the ambu-
distribution, payload allowance, and GVWR.
lance service provider. The purpose of the physical examina-
tion is to determine whether the operator has the physical
10. Loss Control and Safety Issues in the Operations of
ability to adequately perform his or her duty as an operator of
Ambulances
emergency vehicles. (See Guide F1517.)
10.1 Preventive Maintenance—The ambulance operator
6.2 Authorization:
shall be trained in basic techniques, documentation, and
6.2.1 The authorization of ambulance operators must be
rationale for preventive maintenance.
based on Bona Fide Occupational Qualification (BFOQ) pur-
10.1.1 The operator should follow provider policies or
suant to the task of ambulance operations.
manufacturer’s suggested maintenance schedule, or both, for
6.2.2 Authorization shall be based upon cognitive evalua-
the ambulance.
tion of the operator regarding laws, guidelines, and policies
10.2 Operator Fatigue—The ambulance operator shall be
relating to ambulance operation during emergency and non-
trained in the recognition of the adverse affects of excessive
emergency modes.
fatigue. The provider/operator shall be familiar with methods
6.3 A periodic review of the operator’s state motor vehicle and policies used to prevent fatigue-related operator dysfunc-
record for the previous three years with specific attention to
tion.
traffic convictions concerning:
10.3 Interactive Crew Roles—Operators shall receive in-
6.3.1 Speed.
struction on the importance of interactive roles utilized to
6.3.2 Careless and imprudent driving.
lessen risk exposure, such as the ground guide/driver relation-
6.3.3 Driving under the influence of alcohol or other mind- ship in backing the ambulance or the driver/technician rela-
altering substances. tionship in approaching controlled intersections.
6.3.4 Moving violations/other violations.
10.4 Unsafe Thought Patterns—The operator shall be made
6.3.5 Suspension of driver’s license.
aware of the importance of concentration on the driving task at
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.
niques or other high-risk behavior.
6.5 The operator shall possess a valid motor vehicle license,
10.5 Resolving Conflict—The driver shall be trained to
and any other certification required by state or local laws or
make determinations regarding the safe operation of the
regulations.
ambulance.The operator shall be aware that the senior medical
6.6 The operator’s qualifications and continuing education crew member shall make determinations regarding transporta-
shall be reviewed annually. tion mode and patient destination.
F1705 − 96 (2012)
10.6 PatientHandlingE
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