Medical vehicles and their equipment - Road ambulances

This European Standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients. It contains requirements for the patient’s compartment.
This European Standard does not cover the requirements for approval and registration of the vehicle and the training of the staff which is the responsibility of the authority/authorities in the country where the ambulance is to be registered.
This European Standard is applicable to road ambulances capable of transporting at least one person on a stretcher.
Requirements are specified for categories of road ambulances based in increasing order of the level of treatment that can be carried out. These are the patient transport ambulance (types A1 A2), the emergency ambulance (type B) and the mobile intensive care unit (type C).
This European Standard gives general requirements for medical devices carried in road ambulances and used therein and outside hospitals and clinics in situations where the ambient conditions can differ from normal indoor conditions.

Rettungsdienstfahrzeuge und deren Ausrüstung - Krankenkraftwagen

Diese Europäische Norm legt Anforderungen, Prüfung und Ausrüstung für den Transport und die Sicherheit von Patienten in Krankenkraftwagen fest. Sie enthält Anforderungen an den Krankenraum.
Diese Europäische Norm enthält keine Anforderungen für die Zulassung und Registrierung von Fahrzeugen und die Ausbildung des Personals. Dafür ist die Behörde des Landes zuständig, in der der Krankenkraftwagen registriert ist.
Die Europäische Norm gilt für Krankenkraftwagen, in denen mindestens eine Person liegend auf einer Krankentrage transportiert werden kann.
Die Anforderungen werden für drei Kategorien von Krankenkraftwagen festgelegt, die sich in aufsteigender Ordnung auf den Umfang der Behandlung im Fahrzeug beziehen. Es sind dies Krankentransportwagen (Typ A1, A2), Notfallkrankenwagen (Typ B) und Rettungswagen (Typ C).
Diese Europäische Norm enthält allgemeine Anforderungen an Medizinprodukte (Geräte), die in Krankenkraftwagen befördert und in ihnen sowie außerhalb von Krankenhäusern und Kliniken verwendet werden, wo die Umweltbedingungen sich von üblichen Innenraumbedingungen abweichen können.

Véhicules de transport sanitaire et leurs équipements - Ambulances routieres

La présente Norme européenne définit les exigences concernant la conception, les méthodes d'essai, les performances et l'armement des ambulances routieres utilisées pour le transport et le traitement des patients. Elle comporte des exigences relatives a la cellule sanitaire.
La présente Norme européenne ne couvre pas les exigences pour l’approbation et l’immatriculation du véhicule ni la formation du personnel dont la responsabilité incombe a l’autorité/aux autorités du pays dans lequel l’ambulance doit etre immatriculée.
La présente Norme européenne s'applique aux ambulances routieres capables de transporter au moins un patient sur un brancard.
Des exigences sont définies pour des catégories d'ambulances routieres basées sur l'ordre croissant du niveau de soins pouvant etre prodigués a bord. Ce sont l'ambulance pour le transport des patients (types A1 et A2), l'ambulance de soins d'urgence (type B) et l'unité mobile de soins intensifs (type C).
La présente Norme européenne énonce des exigences générales pour les dispositifs médicaux transportés et utilisés dans les ambulances routieres et en dehors des hôpitaux et des cliniques dans des situations ou les conditions ambiantes peuvent différer de celles normales en intérieur.

Medicinska vozila in pripadajoča oprema - Reševalna vozila

General Information

Status
Withdrawn
Publication Date
15-Aug-2007
Withdrawal Date
02-May-2010
Technical Committee
Current Stage
9900 - Withdrawal (Adopted Project)
Start Date
03-May-2010
Due Date
26-May-2010
Completion Date
03-May-2010

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2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.Medical vehicles and their equipment - Road ambulancesVéhicules de transport sanitaire et leurs équipements - Ambulances routieresRettungsdienstfahrzeuge und deren Ausrüstung - KrankenkraftwagenTa slovenski standard je istoveten z:EN 1789:2007SIST EN 1789:2007en,fr,de43.160Vozila za posebne nameneSpecial purpose vehicles11.160First aidICS:SIST EN 1789:2000/A1:2003SIST EN 1789:20001DGRPHãþDSLOVENSKI
STANDARDSIST EN 1789:200701-september-2007







EUROPEAN STANDARDNORME EUROPÉENNEEUROPÄISCHE NORMEN 1789May 2007ICS 11.160; 43.160Supersedes EN 1789:1999
English VersionMedical vehicles and their equipment - Road ambulancesVéhicules de transport sanitaire et leurs équipements -Véhicule d'ambulancesRettungsdienstfahrzeuge und deren Ausrüstung -KrankenkraftwagenThis European Standard was approved by CEN on 24 February 2007.CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this EuropeanStandard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such nationalstandards may be obtained on application to the CEN Management Centre or to any CEN member.This European Standard exists in three official versions (English, French, German). A version in any other language made by translationunder the responsibility of a CEN member into its own language and notified to the CEN Management Centre has the same status as theofficial versions.CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland,France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal,Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.EUROPEAN COMMITTEE FOR STANDARDIZATIONCOMITÉ EUROPÉEN DE NORMALISATIONEUROPÄISCHES KOMITEE FÜR NORMUNGManagement Centre: rue de Stassart, 36
B-1050 Brussels© 2007 CENAll rights of exploitation in any form and by any means reservedworldwide for CEN national Members.Ref. No. EN 1789:2007: E



EN 1789:2007 (E) 2 Contents Page Foreword.4 1 Scope.5 2 Normative references.5 3 Terms and definitions.7 4 Requirements.8 4.1 General requirements.8 4.1.1 General.8 4.1.2 Maximum overall dimensions.8 4.1.3 Wheel arch clearance.9 4.2 Performance.9 4.2.1 Acceleration.9 4.2.2 Braking.9 4.2.3 Safety system.9 4.3 Electrical requirements.9 4.3.1 General.9 4.3.2 Electromagnetic compatibility (EMC).9 4.3.3 Battery and alternator.10 4.3.4 Electrical installation.11 4.4 Vehicle body.12 4.4.1 Fire safety.12 4.4.2 Driver's seat configuration.12 4.4.3 Minimum loading capacity.12 4.4.4 Bulkhead.12 4.4.5 Openings (doors, windows, emergency exits).12 4.4.6 Loading area.13 4.5 Patient’s compartment.14 4.5.1 General.14 4.5.2 Patient’s compartment dimensions.15 4.5.3 Patient and attendant seating.21 4.5.4 Ventilation and anaesthetic gas scavenging systems.21 4.5.5 Temperature system.22 4.5.6 Interior lighting.22 4.5.7 Interior noise level.23 4.5.8 Holding system for infusion.23 4.5.9 Mounting systems.23 5 Testing.24 5.1 Testing of the interior noise level.24 5.2 Testing of the acceleration.24 5.3 Testing of maintain systems and fixations of the equipment in the patient’s compartment.24 5.4 Testing of rounded edges.26 6 Medical devices.27 6.1 Provision of medical devices.27 6.2 Medical devices storage.27 6.3 Requirements for medical devices.28 6.3.1 General.28 6.3.2 Temperature.28 6.3.3 Humidity and ingress of liquids.28 6.3.4 Mechanical strength.28 6.3.5 Fixation of devices.29



EN 1789:2007 (E) 3 6.3.6 Electrical safety.29 6.3.7 User interface.29 6.3.8 Gas installation.29 6.3.9 Marking and instructions.31 6.3.10 Maintenance.31 6.4 Mechanical strength – Test methods for medical devices for use in road ambulances.31 6.4.1 Vibration and bump test.31 6.4.2 Free fall.32 6.5 List of equipment.32 Annex A (informative)
Recognition.39 A.1 Recognition and visibility of ambulances.39 A.2 Recognition of personnel.39 Annex B (informative)
Test summary.40 Annex C (informative)
Certificate of compliance.41 Annex ZA (informative)
Relationship between this European Standard and the Essential Requirements of EU Directive 93/42/EEC concerning medical devices.42 Bibliography.43



EN 1789:2007 (E) 4 Foreword This document (EN 1789:2007) has been prepared by Technical Committee CEN/TC 239 “Rescue systems”, the secretariat of which is held by DIN. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by November 2007, and conflicting national standards shall be withdrawn at the latest by November 2007. This document supersedes EN 1789:1999. This document has been prepared under a mandate given to CEN by the European Commission and the European Free Trade Association, and supports essential requirements of EU Directive(s). For relationship with EU Directive(s), see informative Annex ZA, which is an integral part of this document. According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.



EN 1789:2007 (E) 5 1 Scope This European Standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients. It contains requirements for the patient’s compartment. This European Standard does not cover the requirements for approval and registration of the vehicle and the training of the staff which is the responsibility of the authority/authorities in the country where the ambulance is to be registered. This European Standard is applicable to road ambulances capable of transporting at least one person on a stretcher. Requirements are specified for categories of road ambulances based in increasing order of the level of treatment that can be carried out. These are the patient transport ambulance (types A1 A2), the emergency ambulance (type B) and the mobile intensive care unit (type C). This European Standard gives general requirements for medical devices carried in road ambulances and used therein and outside hospitals and clinics in situations where the ambient conditions can differ from normal indoor conditions. 2 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies. EN 3-7, Portable fire extinguishers — Part 7: Characteristics, performance requirements and test methods EN 420, Protective gloves — General requirements and test methods EN 455-1, Medical gloves for single use — Part 1: Requirements and testing for freedom from holes EN 455-2, Medical gloves for single use — Part 2: Requirements and testing for physical properties EN 471:2003, High-visibility warning clothing for professional use — Test methods and requirements EN 737-1:1998, Medical gas pipeline systems — Part 1: Terminal units for compressed medical gases and vacuum EN 737-3:1998, Medical gas pipeline systems — Part 3: Pipelines for compressed medical gases and vacuum EN 739, Low-pressure hose assemblies for use with medical gases EN 794-3, Lung ventilators — Part 3: Particular requirements for emergency and transport ventilators EN 980, Graphical symbols for use in the labelling of medical devices EN 1041, Information supplied by the manufacturer with medial devices EN 1865, Specifications for stretchers and other patient handling equipment used in road ambulances EN 12470-1, Clinical thermometers — Part 1: Metallic liquid-in-glass thermometers with maximum device EN 13544-1, Respiratory therapy equipment — Part 1: Nebulizing systems and their components EN 14052, High performance industrial helmets



EN 1789:2007 (E) 6 EN 60068-2-6, Environmental testing — Part 2: Tests — Tests Fc: Vibration (sinusoidal) (IEC 60068-2-6:1995 + Corrigendum 1995) EN 60068-2-29, Basic environmental testing procedures — Part 2: Tests; test Eb and guidance: bump
(IEC 60068-2-29:1987) EN 60068-2-32, Basic environmental testing procedures — Part 2: Tests; test Ed: free fall (IEC 60068-2-32:1975 + A1:1982 + A2:1990) EN 60068-2-64, Environmental testing — Part 2: Test methods — Test Fh: Vibration, broad-band random (digital control) and guidance (IEC 60068-2-64:1993 + Corrigendum 1993) EN 60601-1 (all parts), Medical electrical equipment EN 60601-2 (all parts), Medical electrical equipment EN 60601-2-4, Medical electrical equipment — Part 2-4: Particular requirements for the safety of cardiac
defibrillators (IEC 60601-2-4:2002) EN ISO 407, Small medical gas cylinders — Pin-index yoke- type valve connections (ISO 407:2004) EN ISO 9919, Medical electrical equipment — Particular requirements for the basic safety and essential
performance of pulse oximeter equipment for medical use (ISO 9919:2005) EN ISO 10079-1:1999, Medical suction equipment — Part 1: Electrically powered suction equipment — Safety requirements (ISO 10079-1:1999) EN ISO 10079-2:1999, Medical suction equipment — Part 2: Manually powered suction equipment
(ISO 10079-2:1999) EN ISO 10079-3:1999, Medical suction equipment — Part 3: Suction equipment powered from a vacuum or pressure source (ISO 10079-3:1999) EN ISO 10524-1, Pressure regulators for use with medical gases — Part 1: Pressure regulators and pressure regulators with flow-metering devices (ISO 10524-1:2006) EN ISO 10524-3, Pressure regulators for use with medical gases — Part 3: Pressure regulators integrated with cylinder valves (ISO 10524-3:2005) EN ISO 11197:2004, Medical supply units (ISO 11197:2004) EN ISO 14971, Medical devices — Application of risk management to medical devices
(ISO 14971:2007) prEN ISO 15002, Flow-metering devices for connection to terminal units of medical gas pipeline systems (ISO/DIS 15002:2006) EN ISO 19054, Rail systems for supporting medical equipment (ISO 19054:2005) EN ISO 20345, Personal protective equipment — Safety footwear (ISO 20345:2004) EN ISO 21647, Medical electrical equipment – Particular requirements for the basic safety and essential performance of respiratory gas monitors (ISO 21647:2004)



EN 1789:2007 (E) 7 IEC 60364-7-708, Electrical installations of buildings — Part 7: Requirements for special installations or locations. Section 708 — Electrical installations in caravan parks and caravans1)
ISO 3795, Road vehicles, and tractors and machinery for agriculture and forestry — Determination of burning behaviour of interior materials ISO 5128:1980, Acoustics— Measurement of noise inside motor vehicles 3 Terms and definitions For the purposes of this document, the following terms and definitions apply. 3.1 patient and emergency patient
3.1.1 patient person whose condition requires appropriately trained personnel to provide medical care and/or suitable transport 3.1.2 emergency patient patient who through sickness, injury or other circumstances is in immediate or imminent danger to life unless emergency treatment and/or monitoring and suitable transport to diagnostic facilities or medical treatment is provided 3.2 ambulance vehicle or craft intended to be crewed by a minimum of two appropriately trained staff for the provision of care and transport of at least one stretchered patient 3.3 types of road ambulances2)
3.3.1 type A: patient transport ambulance road ambulance designed and equipped for the transport of patients who are not expected to become emergency patients. Two types of patient transport ambulance exist: type A1: suitable for transport of a single patient; type A2: suitable for transport of one or more patient(s) (on stretcher(s) and/or chair(s)) 3.3.2 type B: emergency ambulance road ambulance designed and equipped for the transport, basic treatment and monitoring of patients
1) IEC/TC 64 “Electrical installations and protection against electric shock” is developing the revision of IEC 60364-7-708. The draft is presently at the DIS stage. The standard, when ready, will be published as the first edition of the new section 7-721 “Electrical installations in caravans and motor caravans”. 2) Road ambulances are road vehicles which comply with type approval for special use vehicles according to Directive 70/156/EEC in the last applicable amended version.



EN 1789:2007 (E) 8 3.3.3 type C: mobile intensive care unit road ambulance designed and equipped for the transport, advanced treatment and monitoring of patients 3.4 net vehicle mass unloaded mass vehicle mass according to 92/21/EEC modified of the road ambulance including the driver taken as 75 kg and all fixed installations NOTE Loose portable patient handling, sanitary, medical and technical equipment are not included in net vehicle mass. 3.5 permissible gross vehicle mass permissible total mass vehicle mass comprising the net vehicle mass, the mass of sanitary, medical and technical equipment, the mass of passengers, taken as 75 kg per person, and any reserve mass NOTE The permissible gross vehicle mass should be specified by the chassis manufacturer in accordance with Directive 70/156/EEC. 3.6 loading capacity difference between the gross vehicle mass and the net vehicle mass NOTE This represents the mass that may be distributed on the road ambulance such that the permissible axle loads are not exceeded. 3.7 fixation system system or device to ensure the permanent fixation of medical devices or other equipment into the ambulance 3.8 maintain system bracket or other interface device used to secure a mobile or transportable item of equipment or medical device of the vehicle without the use of tools 4 Requirements 4.1 General requirements 4.1.1 General The road ambulance shall comply with the requirements of Directive 70/156/EEC, and separate Directives, for ambulances or corresponding national requirements for approval of vehicles. Road ambulances equipment shall, when operated in normal use and maintained according to the instructions of the manufacturer, cause no safety hazard which could reasonably be foreseen using risk management procedures in accordance with EN ISO 14971 and which is connected with their intended application, in normal condition and in single fault condition. Annex B and C give an example of "test summery" and "certificate of compliance". 4.1.2 Maximum overall dimensions The maximum overall dimensions shall be in accordance with the following:



EN 1789:2007 (E) 9  length in accordance with Directive 92/21/EEC modified;  height 3 000 mm (measured at net vehicle mass excluding flexible antenna);  width in accordance with Directive 92/21/EEC modified. 4.1.3 Wheel arch clearance Vehicle converters shall maintain the minimum wheel arch clearance specified by the chassis manufacturer. 4.2 Performance 4.2.1 Acceleration A road ambulance loaded to permissible gross vehicle mass shall be able to accelerate from 0 km/h to 80 km/h within 35 s. 4.2.2 Braking An original equipment manufacturer’s anti-lock braking system shall be fitted. 4.2.3 Safety system The vehicle should be fitted with a control system for stabilisation and a passive safety system. NOTE Examples of a control system for stabilisation are an electronic brake distribution system and traction control. Examples of a passive safety system could be an air bag, a collapsible steering column and an energy absorbing body structure.’ 4.3 Electrical requirements 4.3.1 General Electrical installations shall comply with those clauses of IEC 60364-7-708 which are applicable to ambulances. NOTE 1 The reference to IEC 60364-7-708 does not apply to the original electrical equipment, which is already covered by the type approval of the base vehicle. The vehicle shall be fitted with a visual and audible warning system to assist emergency passage. NOTE 2 The visual and audible warning system is optional for type A ambulances according to national regulations. 4.3.2 Electromagnetic compatibility (EMC) 4.3.2.1 General To minimise any risk to the safe operation of the complete ambulance and any of the equipment operated on or in the vehicle from the effects of electromagnetic influences created by the vehicle or its equipment, each item shall comply with the appropriate EMC regulation(s). The complete operational vehicle shall consist of components, equipment or sub systems that are certified as conforming to the respective industry EMC regulations. Additionally for the supply system of the medical equipment the EN 60601-1 and EN 60601-2 series shall apply.



EN 1789:2007 (E) 10 4.3.2.2 Communication equipment Communication equipment (e.g. radio installation) shall comply with national regulations. 4.3.2.3 Electric/electronic system and components The vehicle’s electric/electronic system, components, sub systems and all permanently fixed equipments shall be e-marked in accordance with Directive 72/245/EEC modified. NOTE It is recommended that the electrical medical equipment can withstand the exposure of radiated RF field strength of 20 V/m, measured according to IEC 60601-1-2, be considered as the minimum acceptable limit. 4.3.3 Battery and alternator Batteries shall be positioned to allow maintenance without removing the battery from its securing device. The construction of the battery and all connections to it shall be such as to prevent any possibility of an inadvertent short circuit. For types A2, B and C road ambulances the electrical system shall be capable of holding a reserve of electrical power for restarting the engine. The characteristics of starter batteries shall comply with Table 1. The characteristics of additional batteries, if fitted, shall comply with Table 1. NOTE 1 Additional batteries may be required to power the medical devices carried on board and the intended use of the ambulance. The characteristics of the alternator shall comply with Table 1.
Table 1 — Minimum capacity/power Type of road ambulance
A1 A2 B C Nominal voltage 12 V 54 Ah 54 Ah up to
4 seats and 80 Ah more than 4 seats in the compartment 80 Ah 80 Ah Starter
battery(ies) Nominal voltage 24 V – – 63 Ah (2 × 12 V) 63 Ah (2 × 12 V) Nominal voltage 12 V – – 80 Ah a 80 Ah Additional b battery(ies) Nominal voltage 24 V – – 63 Ah a (2 × 12 V) 63 Ah (2 × 12 V) Alternator power 700 W 700 W 1 200 W 1 200 W a Recommended for special operational conditions. b Additional batteries shall have high cyclic stability (e.g. gel batteries) and of a sealed type.
NOTE 2 When the engine is idling electrical stability should be maintained between electrical load and alternator output. In order to achieve this it may be necessary to fit an electrical load prioritisation device to the vehicle.



EN 1789:2007 (E) 11 4.3.4 Electrical installation 4.3.4.1 In type B and C road ambulances there shall be a recessed externally mounted power connector to enable external power to be provided for operations such as the following:  charging battery(ies);  operating medical devices, when installed;  operating a patient compartment heater, when installed;  operating an engine preheater, when installed. The connector for 110 V or 220/240 V, shall be a male connector and not interfere with the electrical and mechanical safety. It shall be not possible to start the engine whilst it is connected to an external 220/240 V power supply unless an automatic mechanical disconnection is fitted. If no automatic mechanical disconnection is fitted, the connector shall be on the driver’s side. The 110 V or 220/240 V circuit shall be protected either by an "earth leakage device" with a maximum setting of 30 mA or by a separate transformer. If the protection is given only by an "earth leakage device" there shall be a label near the plug that reads as follows: "CAUTION! CONNECT ONLY TO AN AUTHORISED SOCKET." 4.3.4.2 The patient’s compartment shall be fitted with the minimum number of connections as given in Table 2. For these connections a permanent power supply shall exist.
Table 2 — 12 V connections for medical devices in patient’s compartment Type of road ambulance
A1 A2 B C Minimum number of connections 2 2 4 4
4.3.4.3 Any additional electrical systems fitted to the base vehicle shall be separate from the base vehicle electrical system and the body or chassis shall not be used as an earth return for additional circuits. All circuits in the additional system(s) shall have separate overload protection3). All circuits shall be well defined and cables clearly marked at the connection points and at a maximum of 1m intervals along its length. The system shall have enough circuits and be so constructed that when/if a circuit fails all illumination and medical technical equipment can be switched to an alternative power source. 4.3.4.4 The wiring and, where applicable conduits, shall withstand vibrations. No wiring shall be located in or pass through conduit intended for medical gas installation. The wiring shall not be loaded higher than that stated by the wire manufacture. 4.3.4.5 Where there are different voltage systems, the connections shall be non-interchangeable.
3) Overload protection may consist of either fuses or so called Electronic Management Control systems.



EN 1789:2007 (E) 12 4.4 Vehicle body 4.4.1 Fire safety All interior materials shall have a burning rate of less than 100 mm/min when tested in accordance with ISO 3795. 4.4.2 Driver's seat configuration For all types of road ambulances the ergonomic space of the driver’s compartment and of the seat adjustment as approved by the base vehicles manufacturer shall not be reduced. 4.4.3 Minimum loading capacity The minimum loading capacity shall be in accordance with Table 3. Table 3 — Minimum loading capacity (persons) Type of road ambulance
A1 A2 B C Number of seats and/or stretcher facilities (in addition to the drivers seat) 3 4 3 4 5 a a With two stretchers.
4.4.4 B
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