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