ASTM F1705-96(2007)
(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.
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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.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 (Reapproved2007)
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 Guide for Scope of Performance of Emergency
1.1 This guide provides minimum training standards for
Medical 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-LifeAm-
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 ambulanceserviceprovider—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.
2. Referenced Documents 3.2.4 departure check—the visual check of the vehicle and
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
3 3.2.6 emergency mode—as defined by individual state stat-
Vehicles
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
tion of the ambulance at specified intervals, including docu-
Personnel, Training and Education.
mentation of the inspection, deficiencies, and their corrective
Current edition approved Feb. 1, 2007. Published February 2007. Originally
approved in 1996. Last previous edition approved in 2002 as F1705 – 96(2002).
actions.
DOI: 10.1520/F1705-96R07.
3.2.8 operator—a person who operates or assists with the
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
operation of an ambulance.
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website.
3 4
Withdrawn. The last approved version of this historical standard is referenced AvailablefromU.S.GovernmentPrintingOfficeSuperintendentofDocuments,
on 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 (2007)
TABLE 1 Emergency Medical Services Ambulance Maintenance
5.1.4 Rules and Regulations—Guidelines enacted by an
Guidelines for Checklist Completion
agency that have the force of law that are intended to provide
Runs per week (per
greater specificity about statutory laws.
Full check Quick check
vehicle)
5.1.5 Case Law—Judicial interpretation of statutory law,
0 to 1 every 96 h every 24 h
rules, or regulations that have been decided in a court of law.
2 to 3 every 72 h every 24 h
5.1.6 Consolidated Omnibus Reconciliation Act (COBRA)/
4 to 7 every 48 h every 24 h
8 to 50 every 24 h every 12 h
Omnibus Reconciliation Act (OBRA) Laws.
50+ every 24 h every 8 h
5.2 Integration of state laws and local ordinances with
company policies/procedures. Company policy should incor-
porate into guidelines the principles of applicable state laws,
local ordinances, rules, and regulations.
3.2.9 driver—the individual responsible for operating the
5.3 Highest Degree of Care (Law of Due Regard)—A
ambulance in a safe and efficient manner, exercising the
general principle, frequented in case law, that holds the
highest degree of care.
ambulance operator responsible for his actions regardless of
3.2.10 technician—the individual responsible for patient
perceived exemptions from traffic laws governing the emer-
care.
gency vehicle operator.
3.2.11 post-run—the managed return of the ambulance and
5.4 Legal Issues:
operators to optimal pre-run readiness.
5.4.1 Negligence—Any action that violates a standard of
3.2.12 pre-run—all aspects of assuring response readiness.
practice or care related to ambulance operation.
3.2.13 quick check—an abbreviated version of the full
5.4.2 Abandonment—Terminating care or transportation
check, focusing on the major operational functions of the
prior to being relieved by other qualified health care providers.
vehicle.
Once a patient provider relationship is established, it must
3.2.14 reaction time—from the time the operator identifies
continue until responsibility for the patient is assumed by a
the hazard until the appropriate action is taken.
provider of equal or higher qualifications.
3.2.15 response mode management—the response mode of
5.4.3 Emergency Medical Dispatch—An organized system
the ambulance shall be determined by dispatch protocols based
of emergency medical dispatching principles intended to pro-
on(dispatch)determinantsasapprovedbythemedicaldirector.
vide guidelines for ambulance operations as delineated in
The determinants shall be consistent with Practice F1258.
Practice F1258.
3.2.16 stopping distance—the distance the vehicle travels
until it comes to a stop after the brakes are applied. 5.4.4 Multiple Responding Units:
5.4.4.1 Vehicle Separation—Theoperatorshallbetrainedto
4. Significance and Use maintainaminimum300-ftbufferzonebetweentheambulance
and other emergency vehicles on the same route of travel.
4.1 This guide provides minimum training guidelines for
(1) Weather, traffic conditions, or other factors may cause
safe and efficient ambulance operations.
the operator to increase the length of the buffer zone for the
4.2 Ambulance providers and educators should follow this
safe operation of the ambulance.
guide for the development of educational and training pro-
5.4.4.2 Escorts—The operator shall be informed of the
grams.
hazards involved in the use of emergency vehicle escorts and
4.3 This guide is intended to promote safe and efficient
be trained to avoid such practices.
ambulance operations and to reduce morbidity, mortality, and
property loss associated with ambulance operations. (1) The operator shall be trained to discourage private,
non-emergency vehicles from following the ambulance during
4.4 This guide is intended to assist those who are respon-
sible for the development and implementation of policies and transport.
procedures for ambulance operations. 5.4.5 Interacting with Public Safety Agencies:
4.5 Topics or concepts listed in this guide are intended to
5.4.5.1 Command—Ambulance operations shall be consis-
serve as an outline of materials to be covered in the training of tent with operational guides delineated in Incident Command
ambulance operators. System (ICS).
5.4.5.2 Communication—Ambulance communication sys-
5. Legal Aspects
tems should allow the ambulance operator to communicate
with other public safety agencies.
5.1 The training of the ambulance operator shall include all
5.4.5.3 Coordination—Cooperative guidelines shall be es-
federal and state laws and local ordinances including the
tablished with other public safety agencies in order to provide
provider’s policies governing emergency medical vehicle op-
a safe and adequate response.
erations. The operator/driver shall have a clear understanding
5.4.6 Motor Vehicle Accidents Involving the Ambulance:
of the impact of those laws on the operation of the vehicle.
5.4.6.1 Reporting—The ambulance operator shall receive
5.1.1 Constitutional Law—Laws derived from the U.S.
Constitution governing the patient’s right before, during, and instructions regarding reporting guidelines for ambulance re-
lated accidents/incidents in accordance with state laws, local
after transport.
5.1.2 Statutory Law—Laws derived from legislative acts. ordinances, rules or regulations, and organizational policies
and procedures.
5.1.3 Ordinances—Lawsorguidelinesenactedbyagovern-
ing municipal body or its agent. 5.4.7 Mitigation/Documentation Mechanical Failures:
F1705–96 (2007)
5.4.7.1 Scheduled Maintenance—The ambulance operator 8. History of EMS Vehicle Operation
shall be trained in the importance of a scheduled maintenance
8.1 The training of the emergency vehicle operator shall
program.
include the history of EMS vehicle operation:
5.4.7.2 Vehicle and Equipment Inspections—The ambu-
8.1.1 Evolution of ambulance driving from high-force pur-
lance operator shall be trained in the fundamentals and
suit driving to low G-force driving techniques.
application of vehicle and equipment inspections.
8.1.2 Changes in vehicle design and dynamics.
5.4.7.3 Reporting of Deficiencies—The ambulance operator
8.1.3 Evolution of governmental regulation.
shall understand the importance of inspecting the ambulance
8.1.3.1 Specification F1230, Minimum Performance Re-
and equipment, and shall be familiar with the reporting
quirements for Emergency Medical Service Ground Vehicles.
procedures utilized by the provider. The ambulance operator
8.1.3.2 Federal standards KKK 1822C: “A” through current
shall be familiar with provider policies in regard to major
specifications.
deficiencies which have an affect on the serviceability of the
vehicle.
9. Vehicular Types and Equipment
6. Operator Qualifications to Drive
9.1 The training of the ambulance operator shall include the
differentambulanceclassifications(TypeI,II,III,andspecialty
6.1 The training of the ambulance operator shall include the
components of evaluation techniques which may be utilized in responsevehicles)includingmaneuverability,handling,weight
distribution, payload allowance, and GVWR.
screening the operator candidate:
6.1.1 Medical Fitness to Drive—Operators shall be subject
to periodic medical evaluations as determined by the ambu- 10. Loss Control and Safety Issues in the Operations of
Ambulances
lance service provider. The purpose of the physical examina-
tion is to determine whether the operator has the physical
10.1 Preventive Maintenance—The ambulance operator
ability to adequately perform his or her duty as an operator of
shall be trained in basic techniques, documentation, and
emergency vehicles. (See Guide F1517.)
rationale for preventive maintenance.
6.2 Authorization:
10.1.1 The operator should follow provider policies or
6.2.1 The authorization of ambulance operators must be
manufacturer’s suggested maintenance schedule, or both, for
based on Bona Fide Occupational Qualification (BFOQ) pur-
the ambulance.
suant to the task of ambulance operations.
10.2 Operator Fatigue—The ambulance operator shall be
6.2.2 Authorization shall be based upon cognitive evalua-
trained in the recognition of the adverse affects of excessive
tion of the operator regarding laws, guidelines, and policies
fatigue. The provider/operator shall be familiar with methods
relating to ambulance operation during emergency and non-
and policies used to prevent fatigue-related operator dysfunc-
emergency modes.
tion.
6.3 A periodic review of the operator’s state motor vehicle
10.3 Interactive Crew Roles—Operators shall receive in-
record for the previous three years with specific attention to
struction on the importance of interactive roles utilized to
traffic convictions concerning:
lessen risk exposure, such as the ground guide/driver relation-
6.3.1 Speed.
ship in backing the ambulance or the driver/technician rela-
6.3.2 Careless and imprudent driving.
tionship in approaching controlled intersections.
6.3.3 Driving under the influence of alcohol or other mind-
10.4 Unsafe Thought Patterns—The operator shall be made
altering substances.
aware of the importance of concentration on the driving task at
6.3.4 Moving violations/other violations.
hand and should be aware of dangerous practices such as
6.3.5 Suspension of driver’s license.
allowing the nature of the emergency to affect driving tech-
6.4 A review of the operator’s motor vehicle accidents for
niques or other high-risk behavior.
the previous three years.
10.5 Resolving Conflict—The driver shall be trained to
6.5 The operator shall possess a valid motor vehicle license,
make determinations regarding the safe operation of the
and any other certification required by state or local laws or
ambulance.The operator shall be aware that the senior medical
regulations.
crew member shall make determinations regarding transporta-
6.6 The operator’s qualifications and continuing education
tion mode and patient destination.
shall be reviewed annually.
10.6 Patient Handling Equipment—The ambulance opera-
tor shall be trained in the proper operation, storage, and
7. Operator Testing
handlingofallequipmentusedinthetreatmentandtransportof
7.1 The training of the ambulance operator shall include the the patient.
components of evaluation techniques which may be utilized in
10.7 OSHA Guidelines—The operator/provider shall be
screening the ope
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