2015 was a busy year for the Fire Apparatus Manufacturers’ Association (FAMA) Ambulance Technical Committee. FAMA committee members work hard to advance the interests of both the emergency care provider and the patient as they relate to ambulance specifications, and there are several recent noteworthy changes. Whether and when each state will adopt these changes will likely be determined in the coming months.

Triple K Changes

July 1, 2015, saw the publication of Change Notice 8 to the Federal Government’s KKK-A1822-F Star-of-Life Ambulance Specification (the Triple-K). Developed in the 1970s, this specification is provided by federal government to agencies wishing to purchase ambulances. This document is followed by roughly 30 U.S. states, in whole or in part, as the minimum guideline under which a vehicle may be called an ambulance. It was written with the intent that an ambulance manufacturer could read and follow it to determine specific design elements and options, resulting in a finished ambulance that will meet the federal government’s criteria.

There are several additions to the Triple-K required in Change Notice 8. The two most significant changes are the addition of recommended practices from the Society of Automotive Engineers International (SAE), namely SAE J3026 Ambulance Patient Compartment Seating Integrity and Occupant Restraint and SAE J3027 Ambulance Litter Integrity, Retention, and Patient Restraint. Both guidelines from SAE describe the test forces that manufacturers of attendant seating and patient cots (regionally referred to as stretchers, litters, or gurneys) must design and certify to. Those G-forces are 22.5 Gs in a frontal impact and 26.0 Gs in a side impact over a very short time segment. This is roughly equal to the initial forces seen in a head-on crash between a 10,000-pound ambulance and a 3,000-pound car, both traveling at 55 miles per hour.

The take-away from these SAE-related changes is that the rear compartment seats and cot fasteners used in the past will likely not be compliant with the new guidelines. EMS providers already using “Captain’s Chairs” with four- or five-point harnesses will see only a minimal increase to become compliant. Providers using ambulances with squad benches and simple lap belts, however, will likely have to make a greater investment in safer seating alternatives for their medics and other rear-compartment passengers.

NFPA 1917 Changes

Also changing this year is National Fire Protection Association (NFPA) 1917, Standard for Automotive Ambulances. In August at the NFPA Standards Council meeting in Chicago, NFPA 1917 (2016 ed.) was issued for publication, and the new edition is now available at www.nfpa.org. This document is nearly 70 pages long, describing the requirements to both construct and test an ambulance. As such, the consensus-developed aspects and requirements of the NFPA “standard” ambulance may exceed existing state minimum requirements. Throughout the revision process from the initial 2013 edition, a greater effort to involve the nonfire-based EMS community was solicited, with the majority of that community’s concerns addressed in the 2016 edition. Note that this standard references the two SAE recommended practices as well.

New CAAS Standard

The Committee on Accreditation of Ambulance Services (CAAS) began crafting an alternate ambulance standard in its Ground Vehicle Standard v 1.0 (GVS v.1.0) document. From its Web site, “The CAAS Ground Vehicle Standard (GVS v.1.0) establishes minimum requirements, performance parameters, and essential criteria for the design of ground ambulances to provide a practical degree of standardization.” Largely developed through a consensus effort to combine the widely fami

By Bill Adams

Decades ago when responding as a white coat, I noticed that the headlights on many apparatus washed out the rigs’ lower warning and directional lights (turn signals)-especially at night and more so when the headlights were flashing. It still happens today. This is my personal take on forward-facing lower-level warning lights.

The January 17, 1912, edition of the San Francisco Call reported that city’s first motorized apparatus was placed in service that day. Describing its features, the paper noted, “The equipment also includes electric side lights and a large searchlight for night service.” Side lights, mounted on each side of the engine cowl, replaced Dietz-style kerosene lanterns. In 1924, American LaFrance rebuilt an accident-damaged 1920 chemical and hose car delivered to Ferndale, Michigan. Factory paperwork indicates steady burning side lights were added and wired into the taillight circuit (photos 1 and 2). Side lights were common well into the 1930s. Ask apparatus historians or light manufacturers who coined the terminology warning lights, who started using flashing lights, and who invented the first mechanically moving light.

Red side lights on a 1924 rebuild by American LaFrance. Equipped with dull red lenses, they probably were to identify the vehicle as a fire truck. It is unknown when manufacturers started to make them flash and call them warning lights. (Photos by author unless otherwise noted.)

Some purchasers consider warning lights a necessary evil required by National Fire Protection Association (NFPA) 1901, Standard for Automotive Fire Apparatus. Others believe only the brightest lights in the western hemisphere capable of causing severe optical damage are worthy of being mounted on their apparatus. I find it humorous and sad that firefighters at trade shows will stand three feet from an exhibitor’s illuminated light display and make a multi-thousand-dollar purchasing decision based on the degree of temporary blindness suffered. Ask those same firefighters what they expect each light to accomplish in the field, and you might receive blank stares.

Beacon-ray, rotoray, figure 8, crossfire, and oscilaser are used generically to describe lights similar to trademarked products by Federal Signal, Whelen, Tripp-Lite, Code 3, and Mars. Strobe lights and lens colors are volatile topics left for another discussion.

Cab Fascia Light Configurations

Most custom cab manufacturers (OEMs) advertise a standard configuration of a side-by-side turn signal and warning light mounted immediately above dual headlights. Notable exceptions are the Pierce Quantum and the Sutphen Monarch. A half-dozen rigs delivered from 1991 to 2014 have only seven to 10 inches center-to-center between the rows of lights. That’s not much. Little has changed in cab fascia light configurations in more than 20 years. This isn’t a criticism of OEMs. The arrangement is probably inexpensive to supply. For a price,

Tom Bowman

The Similarities Between Turnout Gear and Bulletproof Vests

It’s a common staple of film and TV that firefighters and police officers are enemies. Watch any sitcom, and you will eventually see representatives of the two battling it out for supremacy, usually through pranks and childish one-upmanship.

In reality, nothing could be further from the truth. The two may perhaps share a friendly rivalry, but you only have to see news reports of disasters anywhere to see the bravest members of society working together to save lives and restore order. The parallels between firefighters and law enforcement officers are numerous: Both are undoubtedly brave and heroic, putting themselves in danger to protect communities, and both require very specialized equipment to do so. For the police, it is bulletproof vests. For the fire service, it’s turnout gear. But how similar is their gear, and how can one improve the other?

What to Protect Against

The threats a law enforcement officer faces may be vastly different from those a firefighter faces. Police officers are given and encouraged to wear bulletproof vests, in recognition of the main threat they will face: guns. The main cause of homicides among police officers is firearms, specifically handguns. This is the reason officers are given vests specifically designed to protect against smaller-caliber bullets. The Kevlar® usually used in these vests is an incredibly strong fiber, woven together in many layers to create a “web,” which displaces the energy of a bullet across the vest, slowing it down to a stop before it can penetrate the armor. This is the same principle as the vests designed to prevent attacks with edged or stabbing weapons. While law enforcement faces numerous threats on a day-to-day basis, a bulletproof vest has shown to be crucial in preventing deaths. For firefighters, however, there are also sadly a great many causes of death, as the U.S. Fire Administration shows us, and this is the reason turnout gear for firefighters must protect against nearly any threat imaginable.

The Biggest Danger

Of course, the biggest danger for firefighters comes from fire-more specifically, heat. Turnout gear has to be designed to withstand extremely high temperatures first and foremost, as well as the many problems they cause. Both turnout gear and body armor are largely made from the same materials: aramids. Aramids are aromatic polyamides-strong, heat-resistant synthetic fibers. Their heat-resistant properties make them very well suited to be woven into fabric for turnout gear. These aramids retain their integrity at high temperatures; have very low flammability; and, most importantly, don’t melt or degrade, even at temperatures of more than 840°F. DuPont, the manufacturer of Kevlar, produces a material called Nomex®, which is most commonly found in turnout gear and is an example of an aramid. This is where turnout gear starts to differentiate itself from body armor, which uses para-aramids with a much higher strength-to-weight ratio, at the expense of some heat/flame resistance. The most common example of this is Kevlar, a name synonymous with bulletproof vests. Some manufacturers use Dyneema, which is a plastic-based substance with an equally high strength-to-weight ratio but with significantly lower upper t

By Gary Morris

This past June, the National Fire Protection Association (NFPA) approved the release of its second edition of a ground ambulance vehicle standard known as NFPA 1917, Standard for Automotive Ambulances.

The standard is expected to substantially increase safety and survival of emergency medical services (EMS) personnel as well as the patients involved in ambulance crashes. Additionally, as a result of the standards-setting work by the NFPA, the National Institute for Occupational Safety and Health (NIOSH) and the National Institute of Standards and Technology (NIST) were able to secure funding to conduct crash testing and other safety-related research regarding ambulance vehicle safety and survivability that was inserted into the second edition.

Origin

Over the decade leading to the NFPA’s entry into an ambulance standard development, there had been considerable discussion about the safety of ambulance vehicles used by both private EMS transport companies and fire departments. Studies of crashes involving ambulances showed that the rate of injuries and fatalities was greater than what was experienced in crashes involving police vehicles. More disturbing, if an EMS professional was riding in the patient compartment at the time of a crash, he would be 2.7 times more likely to be killed than the occupants of the ambulance vehicle cab. Over a 10-year study period, 350 fatalities were reported along with 23,000 injuries (involving EMS personnel and patients).1 Media coverage often showed an ambulance with a patient compartment sheared off the vehicle frame or simply “exploded” during the collision. Little crash testing had occurred that would have led to improved vehicle safety.

In late 2008, with no other organization actively pursuing improvements in ambulance vehicle safety, the Safety, Health, and Survival Section of the International Association of Fire Chiefs (IAFC) stepped up to the plate, seeking a better safety standard for ambulance vehicle designs. The IAFC agreed and called on the NFPA to develop a performance standard for ambulance vehicles. The NFPA was selected for its international reputation and decades-long history at producing high-quality standards while strictly adhering to the American National Standards Institute (ANSI) standard development criteria. The NFPA also had decades of experience developing standards for fire apparatus as well as other EMS-related standards, which brought an elevated level of expertise to developing an ambulance standard.

Note that ANSI’s “essential requirements” document is internationally recognized as the premium guideline for developing standards. The key element in the document is due process, which ensures standards are developed in an environment that is equitable, accessible, and responsive to the requirements of various stakeholders. This ensures there is an equitable balance in stakeholder groups so that no one group can unfairly dominate an outcome.

For more than four decades, the EMS transport industry and fire departments have used the federal Government Services Administration (GSA) purchase specification, known as “KKK-A-1822 F,” as an ambulance design document. This specification became the “de facto” unofficial vehicle design “standard” for many EMS transport organizations. The problem was, little scientific research had been conducted to justify the specifications, and there was no crash-worthiness testing of the cab or patient compartment.

Early Meetings

The NFPA 1917 technical committee first met at NFPA headquarters in June 2009 to begin work on the first edition of the standard. In accordance with ANSI requirements, the 33 members of the committee represented a broad spectrum of EMS organizations in America.