ASTM F1517-94(2007)

Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations

SIGNIFICANCE AND USE
This guide provides minimum guidelines for safe and efficient ambulance operation.
All ambulance operations and operators 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.
SCOPE
1.1 This guide covers minimum standards for the performance of emergency medical services (EMS) ambulance operators, including: operator qualifications, pre-run operation, and post-run aspects.
1.2 This guide shall promote 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 other EMS vehicles that do not necessarily provide patient transport.
1.3 This guide shall be used as the basis for training guides of the emergency medical services ambulance operator.
1.4 The values stated in SI units are to be regarded as the standard. The SI units given in parentheses are for information only.
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

• Status: Historical
• Publication Date: 31-Jan-2007
• ICS: 11.160 - First aid
• Technical Committee: F30 - Emergency Medical Services
• Drafting Committee: F30.02 - Personnel, Training and Education

Relations

• Replaces: ASTM F1517-94(2002) - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
• Effective Date: 01-Feb-2007
• Referred By: ASTM F1705-96(2020) - Standard Guide for Training Emergency Medical Services Ambulance Operations
• Effective Date: 01-Feb-2007
• Referred By: ASTM F1220-95(2022) - Standard Guide for Emergency Medical Services System (EMSS) Telecommunications
• Effective Date: 01-Feb-2007

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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.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: F1517 − 94(Reapproved 2007)
Standard Guide for
Scope of Performance of Emergency Medical Services
Ambulance Operations
This standard is issued under the fixed designation F1517; 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 3.1.2 ambulance—See Terminology F1177.
1.1 This guide covers minimum standards for the perfor- 3.2 Definitions of Terms Specific to This Standard:
mance of emergency medical services (EMS) ambulance 3.2.1 ambulance operations—the efficient delivery of the
operators, including: operator qualifications, pre-run operation,
ambulance, equipment, crew, passengers and patients, during
and post-run aspects. all phases of the delivery of EMS involving the ambulance at
all times exercising the highest degree of care for the safety of
1.2 This guide shall promote the safe and efficient delivery
the public.
of the ambulance, equipment, crew, passengers and patients,
during all phases of the delivery of EMS involving the 3.2.2 ambulance service provider—as outlined in this guide,
ambulance; at all times exercising the highest degree of care a person, company, corporation or political entity responsible
for the safety of the public. This guide may be applied to other for operation, maintenance, or policy making, or combination
EMS vehicles that do not necessarily provide patient transport. thereof, regarding emergency medical vehicle operations.
1.3 This guide shall be used as the basis for training guides 3.2.3 bona fide occupational qualification (BFOQ)—the
skills and knowledge relevant to the performance of a specific
of the emergency medical services ambulance operator.
task.
1.4 The values stated in SI units are to be regarded as the
3.2.4 departure check—the visual check of the vehicle and
standard. The SI units given in parentheses are for information
surrounding area ensuring that equipment and supplies have
only.
been retrieved and properly stored and that all compartment
1.5 This standard does not purport to address all of the
doors are secured.
safety concerns, if any, associated with its use. It is the
3.2.5 egress check—the visual check of the vehicle and
responsibility of the user of this standard to establish appro-
priate safety and health practices and determine the applica- surrounding area prior to operating the ambulance.
bility of regulatory limitations prior to use.
3.2.6 emergency mode—as defined by individual state stat-
ues that refer to emergency vehicles, equipment, and opera-
2. Referenced Documents
tions.
2.1 ASTM Standards:
3.2.7 full check—a comprehensive and systematic evalua-
F1177 Terminology Relating to Emergency Medical Ser-
tion of the ambulance at specified intervals, including docu-
vices
mentation of the inspection, any deficiencies found and their
F1258 Practice for Emergency Medical Dispatch
corrective actions.
3. Terminology
3.2.8 operator—a person who operates or assists with the
operation of an ambulance.
3.1 Definitions:
3.1.1 The definitions given in Terminology F1177 are ap-
3.2.9 post-run—the managed return of the ambulance and
plicable to this guide.
operators to optimal pre-run readiness.
3.2.10 pre-run—all aspects of assuring response readiness.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.2.11 quick check—an abbreviated version of the full
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
check, focusing on the major operational functions of the
Current edition approved Feb. 1, 2007. Published February 2007. Originally
vehicle.
approved in 1994. Last previous edition approved in 2002 as F1517 – 94(2002).
DOI: 10.1520/F1517-94R07.
For referenced ASTM standards, visit the ASTM website, www.astm.org, or 4. Significance and Use
contact ASTM Customer Service at [e-mail]. For Annual Book of ASTM
4.1 This guide provides minimum guidelines for safe and
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. efficient ambulance operation.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1517 − 94 (Reapproved 2007)
4.2 All ambulance operations and operators should follow precautions, turning, backing, and parking techniques during
this guide for the development of educational and training emergency and non-emergency modes.
programs.
6.3 A review of the state motor vehicle record for the
4.3 This guide is intended to promote safe and efficient previous three years with specific attention to traffic convic-
ambulance operations and to reduce morbidity, mortality, and tions concerning:
property loss associated with ambulance operations. 6.3.1 Speed,
6.3.2 Careless and imprudent driving,
4.4 This guide is intended to assist those who are respon-
6.3.3 Driving under the influence of alcohol or other mind-
sible for the development and implementation of policies and
altering substances, and
procedures for ambulance operations.
6.3.4 Moving violations.
5. Medical Fitness to Drive
6.4 A review of motor vehicle accidents for the previous
five years.
5.1 Because of the complex relationship of certain medical
and mental impairments, a medical screening program shall be
6.5 The operator shall possess a valid motor vehicle opera-
established by all EMS entities bestowing the privilege of
tors license, and any other certification required by state or
ambulance driving.
local laws or regulations.
5.2 The authorization of ambulance drivers must always be
7. Pre-Run
based on bona fide occupational qualifications (BFOQ) pursu-
7.1 The operator shall have knowledge of and shall comply
ant to the task of ambulance operation. The following consid-
with all applicable federal, state statues, local ordinances, and
erations must be evaluated:
regulations.
5.2.1 Amedical exam of the applicant by a licensed M.D. or
D.O. attesting that the history and physical reveals no evidence
7.2 The operator shall have knowledge of the provider’s
of any medical or physical condition which would prove
policies and procedures.
detrimental to operating an ambulance.
7.3 The operator shall have knowledge of roads, highways,
5.2.2 Eye exam by a licensed ophthalmologist/optometrist
and the locations of and accesses to major public facilities
to include:
within the service area.
5.2.2.1 Visual acuity,
7.4 The provider shall have a process by which the operator
5.2.2.2 Depth perception,
is made aware of conditions that may affect traffic flow within
5.2.2.3 Peripheral vision,
the service area (street closures, construction, special events,
5.2.2.4 Night blindness,
and so forth).
5.2.2.5 Color blindness, and
5.2.2.6 Amblyopia.
7.5 The provider shall have a process by which the operator
5.2.3 An examination of the medical history of the
is made aware of present or forecasted environmental condi-
individual, designed to identify drivers who may be impaired
tions affecting traffic flow within the service area (ice, snow,
by:
rain, and so forth).
5.2.3.1 Loss of consciousness,
7.6 Uponunitavailability,theoperatorshallvisuallyinspect
5.2.3.2 Cardiovascular disease,
the ambulance, and document the inspection in accordance
5.2.3.3 Neurological/neurovascular disorder,
with one of the methods as shown in Table 1. The vehicle shall
5.2.3.4 Mental illness,
be inspected for the following:
5.2.3.5 Substance abuse/dependency,
7.6.1 Apparent body or glass damage,
5.2.3.6 Insulin-dependent diabetes, and
7.6.2 Proper function of emergency lights:
5.2.3.7 Rheumatic, arthritic, orthopedic, muscular,
7.6.2.1 Beacons or strobe,
neuromuscular, or vascular disease that interferes with the
7.6.2.2 Light bar,
ability to control and operate a motor vehicle safely.
7.6.2.3 Tunnel lights/flashers, and
5.2.4 The presence of a medical condition by itself may not
7.6.2.4 Other warning lights.
constitute an impaired operator, but shall identify an area for
7.6.3 Vehicle operating lights:
consideration by the physician in making a determination of
7.6.3.1 Headlights (high/low),
the medical fitness to operating an ambulance.
7.6.3.2 Emergency flashers,
7.6.3.3 Parking/running lights,
6. Qualifications to Drive
6.1 Authorization shall be based upon cognitive evaluation
TABLE 1 Emergency Medical Services Ambulance Maintenance
of the operator regarding laws, guidelines, and policies relating
Guidelines for Checklist Completion
to ambulance operation during emergency and non-emergency
Runs per Week Full Check, h Quick Check, h
modes.
0 to 1 every 96 every 24
6.1.1 The provider shall have a policy that addresses opera-
2 to 3 every 72 every 24
tor fatigue.
4 to 7 every 48 every 24
8 to 50 every 24 every 12
6.2 An ambulance driving evaluation by the provider cov-
50 + every 24 every 8
ering warning device operation, passing, intersection approach
F1517 − 94 (Reapproved 2007)
7.6.3.4 Interior and exterior turn signal, 7.7.3.3 Power steering,
7.6.3.5 Brake lights, 7.7.3.4 Water/coolant level,
7.6.3.6 Back up lights,
7.7.3.5 Brake fluid,
7.6.3.7 Flood or scene lights,
7.7.3.6 Transmission fluid,
7.6.3.8 Dome lights: cab and patient compartment, and 7.7.3.7 Windshield washer fluid, and
7.6.3.9 Spotlights.
7.7.3.8 Battery water level.
7.6.4 Damage, wear, and pressure in tires,
7.7.4 Wear and tension of belts,
7.6.5 Damage, loose, or missing lugs on wheels,
7.7.5 Wear and pressure of tires,
7.6.6 Proper opening, closing, locking, and seals of entry
7.7.6 Emergency lights,
and compartment doors,
7.7.7 Function of lighting systems:
7.6.7 Fluid levels:
7.7.7.1 Emergency lights,
7.6.7.1 Automatic transmission,
7.7.7.2 Running lights,
7.6.7.2 Battery,
7.7.7.3 Vehicle exterior, and
7.6.7.3 Brakes,
7.7.7.4 Vehicle interior.
7.6.7.4 Engine oil,
7.7.8 Proper function of horn and each siren position,
7.6.7.5 Engine coolant,
7.7.9 Vehicle cleanliness, and
7.6.7.6 Power steering, and
7.7.10 Proper function of two-way radio and other commu-
7.6.7.7 Windshield washer.
nications equipment.
7.6.8 Fluid leakage on, around, or under the vehicle,
7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel,
8. Operations
heater, and other hoses,
8.1 Response Mode Management:
7.6.10 Wear, abraded, or cracked engine drive or accessory
8.1.1 The response mode of the ambulance shall be deter-
belts,
mined by dispatch protocol based on dispatch determinants as
7.6.11 Cleanliness of exterior, crew cab, and patient
approved by the medical director. These determinants shall be
compartments,
consistent with Practice F1258.
7.6.12 Wear, abrasion, and proper function of operator,
passenger, and patient restraint,
8.2 The operator shall, on the basis of known information,
7.6.13 Indications and function of gages:
determine the best route to the scene and end destination.
7.6.13.1 Electrical charging system,
8.3 Before beginning the response, the operator shall con-
7.6.13.2 Emergency brake,
duct a brief egress check consisting of the following:
7.6.13.3 Fuel,
8.3.1 Vehicle doors are securely closed and latched,
7.6.13.4 Oil pressure,
8.3.2 Vehicle hood is closed and securely latched,
7.6.13.5 Tachometer, and
8.3.3 Vehicle shore line is disconnected,
7.6.13.6 Temperature.
8.3.4 All equipment is secured,
7.6.14 Wear, abrasion, and proper function of windshield
8.3.5 Egress door is open, and
wipers,
8.3.6 Patient stretcher is in place and secured.
7.6.15 Proper function and aim of windshield washer,
7.6.16 Proper function and clarity of two-way radio and 8.4 Operational Check Sequence:
other communication devices,
8.4.1 Ensure crew is on board and properly restrained,
7.6.17 Damage, stability, and adjustment of outside and
8.4.2 Adjust the operator’s seat,
inside mirrors,
8.4.3 Adjust mirrors,
7.6.18 Proper function and clarity of emergency siren,
8.4.4 Turn on battery(s),
public address, and other warning devices,
8.4.5 Start the engine,
7.6.19 Proper adjustment of all seats,
8.4.6 Review all gages,
7.6.20 Proper adjustment and function of steering wheel,
8.4.7 Adjust environmental controls consistent with appli-
7.6.21 Charged and properly stored fire extinguishers,
cable needs,
7.6.22 Proper function of heating and air conditioning
8.4.8 Turn radio on and contact dispatch,
systems,
8.4.9 Adjust the tilt wheel,
7.6.23 Proper inventory and condition of medical equip-
8.4.10 Turn the headlights on,
ment and supplies, and
8.4.11 Activate the emergency warning lights (if
7.6.24 Level and alignment of chassis.
applicable),
8.4.12 Turn on power to siren/public address control system
7.7 The quick check shall be constituted by:
(if applicable),
7.7.1 Visually checking for any fluid leakage on or around
the ambulance, 8.4.13 Partially open the driver side window,
8.4.14 Evaluate brake pedal resistance,
7.7.2 Conducting vehicle warm-up,
8.4.15 Place the vehicle in gear,
7.7.3 Checking fluid levels:
7.7.3.1 Fuel, 8.4.16 Activate the siren (if applicable), and
7.7.3.2 Engine oil, 8.4.17 Activate the turn signal (if applicable).
F1517 − 94 (Reapproved 2007)
8.5 Crew Roles—The operator/crew member is responsible slow the vehicle enabling the operator to start to apply the
for: brake to bring the ambulance to a complete stop at the
8.5.1 Operating the ambulance in a safe and efficient crosswalk line.
manner, exercising the highest degree of care, 8.6.4 If the ambulance has an air-driven audible airhorn,
8.5.2 Safely passing other vehicles, give two short blasts on the airhorn.
8.5.3 Utilizing eye sweep,
8.6.5 Look to the left, look to the immediate front, look to
8.5.4 Maintaininga3to4-s following distance, and the right, and then again to the left. The operator may then
8.5.5 Maintaining the vehicle at a speed that is safe for proceed through the intersection under ten miles per hour if
conditions. traffic is stopped in all lanes to the left, in front of, and to the
8.5.5.1 Under emergency response conditions the speed rightoftheambulance.Aftertheoperatorhasmadeeyecontact
shall not exceed that which is safe for road or environmental with all stopped vehicle drivers, the ambulance may proceed
conditions; in no case shall the speed exceed ten miles per hour through the intersection exercising the highest degree of care.
over the posted speed limit.
8.6.6 Continue the siren yelp mode activation and proceed
8.5.5.2 Under non-emergency operations the operator shall through the intersection exercising the highest degree of care.
comply with all local and state traffic laws.
8.6.7 When there are vacant lanes to t
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