By Raul A. Angulo

One of the great inventions in the history of mankind was spurred from the question, "How can we make hard work easier?" So someone (probably an ancient truckie) invented the wheel. My favorite vignette about the invention of the wheel is from Gilligan's Island, a popular comedy TV series from the 1960s. In a dream scene, the castaways are prehistoric cavemen. The professor is trying to convince them that the wheel will be his greatest invention and is the most important item to take on a trip. In the next scene, the professor is fervently chiseling a wheel from a large stone. Once it's finished, he demonstrates it to Gilligan. But instead of rolling it, he flips the wheel on its side. Frustrated with failure, he throws the hammer and chisel over his shoulder and says, "Aw! Wheel not work!" Luckily, whoever invented the wheel actually used it the right way, and EMTs nationwide are grateful for that when transporting patients from their point of origin to awaiting rigs.

(1) The Stryker Stair-Pro 6252 is built with thick-wall, square- channeled aluminum for strength, yet it is lightweight. It weighs 31.5 pounds and has a 500-pound weight capacity. The oversized caster wheels maximize mobility in tight spaces. The entire unit is power-washable for easy decon. (Photos by author).

In a previous issue, I reviewed the Stryker Power-Pro™ XT gurney. The Stryker Stair-Pro® Model 6252 stair chair is the companion unit that is a "must have" vital piece of EMS equipment. Firefighters and EMTs perform a wide variety of rescue and extrication techniques that require the use of some sort of equipment. Most take place in potentially dangerous situations or in uncontrolled hazardous environments. But one rescue technique, which contributes to a high number of back injuries, is a common procedure that occurs in a safe, benign environment-manually transporting a patient up or down a flight of stairs.

Scene Size-Up

When my company is dispatched to a medical emergency, we usually know the nature of the call from the run sheet. I have two lead firefighter/EMTs who will head up patient care. As a company officer, part of my job is to size up the nonmedical components of the incident to ensure scene safety. Scene safety is not limited to immediate threats to the patient and the crew like those encountered at a shooting or a motor vehicle accident on a freeway. Scene safety is also accident prevention and predicting actions that may lead to a back injury or a sprained ankle of a crew member during patient packaging and transport to the ambulance.

(2) The patient foot rest has hook-and-loop straps to secure the patient's feet to the chair while descending the stairs. The foot- end extendable handles are molded for better grip and control. The handle's length and location provide the best position for proper ergonomic lifting.

Ground-level incidents or those inside multistory buildings with wheelchair access and elevators pose little risk or difficulty during patient transport. The gurney is the preferred tool of choice. The problems occur when responding to single-family residences. Even a one-story house on a hill with a l

Mike McEvoy

In 2008, the United States General Services Administration (GSA) announced that it would no longer revise and maintain its KKK Star-of-Life ambulance purchasing specification. Since 1974, the KKK specification has been used by federal agencies and organizations purchasing ambulances using federal grant monies. The government looked to the National Fire Protection Association (NFPA)-an organization with a long history of developing industry consensus standards, especially for public safety entities-to pick up the ball and develop a standard to replace the KKK specification. This turned out to be easier said than done.

Varying Standards

The KKK specification, now in its sixth iteration (called KKK-A-1822F, published in August 2008), was originally designed as a purchasing specification (i.e., a template for writing ambulance bid solicitations) yet has been extensively cited and adopted by almost two-thirds of the states as a de facto ambulance safety standard. Although certainly not unsafe, KKK never included specific practices for designing, building, and testing ambulances.

ASTM International (formerly known as the American Society for Testing and Materials) is a safety organization and publishes an industry consensus standard, F2020-02a, which outlines standard ambulance design, manufacturing, and purchasing practices. The Ambulance Manufacturers Division (AMD) of the National Truck Equipment Association (NTEA) publishes manufacturing standards for ambulances (standard 001-025) that specify static load testing of the ambulance body, stretcher mounts, and onboard oxygen cylinder mounts/straps.

The Society of Automotive Engineers (SAE) publishes recommendations for testing passenger restraint systems and equipment mounts to protect against frontal and side-impact collisions. Sadly in the United States, ambulances have always been exempt from the federal motor vehicle safety standards (FMVSS), which serve to protect passenger lives and safety in most other vehicles on the highway.

To varying degrees, the KKK specification has evolved to include many AMD recommendations. Currently 25 AMD test standards appear in KKK. Others, such as ASTM, evolved to reflect the requirements of KKK. The challenge facing the NFPA 1917 committee was to develop a standard that not only incorporated purchasing specifications with design and testing standards but also reflected scientifically sound automotive safe engineering practices. This was further complicated by the proprietary nature of the many existing standards and a virtually nonexistent body of scientific evidence recommending best practices for the design and manufacture of a safer ambulance.

Patient Compartment Study

That's not to say that no one is working to analyze the patient compartment in an effort to make it a safer environment for patients and EMS providers. The National Institute for Occupational Safety and Health (NIOSH) has been working with AMD to study passenger restraints and stretcher mounting devices for more than a decade. More recently, driven by concerns of multiple EMS advocacy groups, NIOSH has partnered with the National Institute of Standards and Technology (NIST) to redesign the layout of the ambulance patient compartment to make it safer while still allowing providers to care for a patient during transport. During NFPA 1917's initial development, none of the NIOSH or NIST research had progressed to the point necessary for inclusion in a published standard.

The NFPA 1917 committee first met in June 2009, using NFPA 1901, Standard for Automotive Apparatus, as a template for its initial design of an ambulance standard. The committee considered creating a completely new standard to include crash restraint and safety technologies, but the dearth of sound crash testing studies virtually forced the committee to work with the existing KKK standard and do its bes

KME 102-foot AerialCat™ platform offers short wheelbase and overall lengths and low travel heights. The platform itself has been redesigned to offer 22.6 square feet of clear work space. The new platform also offers 6.7 square feet of external working space. The parapet ladder access is provided at both sides of the platform, and it offers a movable platform control station, which allows for control of the device from the left, right, and center of the platform for easy operation. The KME AerialCat platform can offer an unrestricted 3,000-gpm waterflow option, achieved with a complete six-inch waterway and 100,000-psi steel ladder. It also offers a 94-foot horizontal reach, a 2.5:1 structural safety ratio, and -12 degree below-grade operation.
-www.kovatch.com, 570-669-9461

Waterous ACCESS™ pump module has a hinged top of the module, allowing access from the top to service or perform maintenance to the module. Also, removable panels on the right and left side and a swing-out foam proportioner enable further access. The ACCESS pump module can be equipped with the ONE STEP™ CAFSystem and the seven-inch SMARTPANEL™ Control System.
-www.waterousco.com, 651-450-5000

Elkhart Brass SafeLink single touchscreen interface integrates pump, valve, and monitor control into a single intuitive touchscreen. Developed in partnership with FRC, SafeLink lets operators manage all components in one central location, allowing firefighters to focus on directing water flow where they need it. SafeLink provides full engine governor controls, multiple valve control and operation, an intuitive 24-inch touchscreen, 1920- by 1080-pixel resolution, durable military spec enclosure, live camera feed video display, and extensive memory technology.
-www.elkhartbrass.com, 574-295-8330

Scott Safety AV-3000 HT Facepiece uses the AV-3000 SureSeal platform to deliver thermal durability and improved voice intelligibility. This allows the product to meet the requirements of National Fire Protection Association (NFPA) 1981, Standard on Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services, (2013 ed.) including those requirements for high heat and flame, radiant heat, and voice intelligibility. The AV-3000 HT features redesigned ducts, voicemitter locations, and dual voicemitters that enhance the facepiece communication to everyone in close proximity of the wearer, not just the individuals directly in front of the user. The AV-3000 HT enables right or left side mounting of Scott's EPIC 3 voice amplifiers to allow users to select the side they prefer. The facepiece flexes with every move and ensures firefighters can use one facepiece with a single fit test for all of their respiratory applications.
-www.scottsafety.com, 800-247-7257

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