ASTM F1517-94(2002)

NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
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Designation:F1517–94 (Reapproved2002)
Standard Guide for
Scope of Performance of Emergency Medical Services
Ambulance Operations
This standard is issued under the fixed designation F 1517; 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 (e) indicates an editorial change since the last revision or reapproval.
1. Scope 3.1.1 The definitions given in Terminology F 1177 are
applicable to this guide.
1.1 This guide covers minimum standards for the perfor-
3.1.2 ambulance—See Terminology F 1177.
mance of emergency medical services (EMS) ambulance
3.2 Definitions of Terms Specific to This Standard:
operators, including: operator qualifications, pre-run operation,
3.2.1 ambulance operations—the efficient delivery of the
and post-run aspects.
ambulance, equipment, crew, passengers and patients, during
1.2 This guide shall promote the safe and efficient delivery
all phases of the delivery of EMS involving the ambulance at
of the ambulance, equipment, crew, passengers and patients,
all times exercising the highest degree of care for the safety of
during all phases of the delivery of EMS involving the
the public.
ambulance; at all times exercising the highest degree of care
3.2.2 ambulance service provider—asoutlinedinthisguide,
for the safety of the public. This guide may be applied to other
a person, company, corporation or political entity responsible
EMS vehicles that do not necessarily provide patient transport.
for operation, maintenance, or policy making, or combination
1.3 This guide shall be used as the basis for training guides
thereof, regarding emergency medical vehicle operations.
of the emergency medical services ambulance operator.
3.2.3 bona fide occupational qualification (BFOQ)—the
1.4 The values stated in SI units are to be regarded as the
skills and knowledge relevant to the performance of a specific
standard. The SI units given in parentheses are for information
task.
only.
3.2.4 departure check—the visual check of the vehicle and
1.5 This standard does not purport to address all of the
surrounding area ensuring that equipment and supplies have
safety concerns, if any, associated with its use. It is the
been retrieved and properly stored and that all compartment
responsibility of the user of this standard to establish appro-
doors are secured.
priate safety and health practices and determine the applica-
3.2.5 egress check—the visual check of the vehicle and
bility of regulatory limitations prior to use.
surrounding area prior to operating the ambulance.
2. Referenced Documents 3.2.6 emergency mode—as defined by individual state stat-
ues that refer to emergency vehicles, equipment, and opera-
2.1 ASTM Standards:
tions.
F 1031 Practice for Training the Emergency Medical Tech-
3.2.7 full check—a comprehensive and systematic evalua-
nician (Basic)
tion of the ambulance at specified intervals, including docu-
F 1177 Terminology Relating to Emergency Medical Ser-
mentation of the inspection, any deficiencies found and their
vices
corrective actions.
F 1230 Specification for Minimum Performance Require-
3.2.8 operator—a person who operates or assists with the
ments for Emergency Medical Service (EMS) Ground
operation of an ambulance.
Vehicles
3.2.9 post-run—the managed return of the ambulance and
F 1258 Practice for Emergency Medical Dispatch
operators to optimal pre-run readiness.
3. Terminology
3.2.10 pre-run—all aspects of assuring response readiness.
3.2.11 quick check—an abbreviated version of the full
3.1 Definitions:
check, focusing on the major operational functions of the
vehicle.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
4. Significance and Use
Personnel, Training, and Education.
4.1 This guide provides minimum guidelines for safe and
Current edition approved May 15, 1994. Published July 1994.
efficient ambulance operation.
Annual Book of ASTM Standards, Vol 13.02.
Discontinued; see 1996 Annual Book of ASTM Standards, Vol 13.01.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
F1517–94 (2002)
4.2 All ambulance operations and operators should follow 6.3 A review of the state motor vehicle record for the
this guide for the development of educational and training previous three years with specific attention to traffic convic-
programs. tions concerning:
4.3 This guide is intended to promote safe and efficient 6.3.1 Speed,
ambulance operations and to reduce morbidity, mortality, and 6.3.2 Careless and imprudent driving,
property loss associated with ambulance operations. 6.3.3 Driving under the influence of alcohol or other mind-
4.4 This guide is intended to assist those who are respon- altering substances, and
sible for the development and implementation of policies and 6.3.4 Moving violations.
procedures for ambulance operations. 6.4 A review of motor vehicle accidents for the previous
five years.
6.5 The operator shall possess a valid motor vehicle opera-
5. Medical Fitness to Drive
tors license, and any other certification required by state or
5.1 Because of the complex relationship of certain medical
local laws or regulations.
and mental impairments, a medical screening program shall be
established by all EMS entities bestowing the privilege of
7. Pre-Run
ambulance driving.
7.1 The operator shall have knowledge of and shall comply
5.2 The authorization of ambulance drivers must always be
with all applicable federal, state statues, local ordinances, and
based on bona fide occupational qualifications (BFOQ) pursu-
regulations.
ant to the task of ambulance operation. The following consid-
7.2 The operator shall have knowledge of the provider’s
erations must be evaluated:
policies and procedures.
5.2.1 Amedical exam of the applicant by a licensed M.D. or
7.3 The operator shall have knowledge of roads, highways,
D.O. attesting that the history and physical reveals no evidence
and the locations of and accesses to major public facilities
of any medical or physical condition which would prove
within the service area.
detrimental to operating an ambulance.
7.4 The provider shall have a process by which the operator
5.2.2 Eye exam by a licensed ophthalmologist/optometrist
is made aware of conditions that may affect traffic flow within
to include:
the service area (street closures, construction, special events,
5.2.2.1 Visual acuity,
and so forth).
5.2.2.2 Depth perception,
7.5 The provider shall have a process by which the operator
5.2.2.3 Peripheral vision,
is made aware of present or forecasted environmental condi-
5.2.2.4 Night blindness,
tions affecting traffic flow within the service area (ice, snow,
5.2.2.5 Color blindness, and
rain, and so forth).
5.2.2.6 Amblyopia.
7.6 Uponunitavailability,theoperatorshallvisuallyinspect
5.2.3 An examination of the medical history of the indi-
the ambulance, and document the inspection in accordance
vidual, designed to identify drivers who may be impaired by:
with one of the methods as shown in Table 1. The vehicle shall
5.2.3.1 Loss of consciousness,
be inspected for the following:
5.2.3.2 Cardiovascular disease,
7.6.1 Apparent body or glass damage,
5.2.3.3 Neurological/neurovascular disorder,
7.6.2 Proper function of emergency lights:
5.2.3.4 Mental illness,
7.6.2.1 Beacons or strobe,
5.2.3.5 Substance abuse/dependency,
7.6.2.2 Light bar,
5.2.3.6 Insulin-dependent diabetes, and
7.6.2.3 Tunnel lights/flashers, and
5.2.3.7 Rheumatic, arthritic, orthopedic, muscular, neuro-
7.6.2.4 Other warning lights.
muscular, or vascular disease that interferes with the ability to
7.6.3 Vehicle operating lights:
control and operate a motor vehicle safely.
7.6.3.1 Headlights (high/low),
5.2.4 The presence of a medical condition by itself may not
7.6.3.2 Emergency flashers,
constitute an impaired operator, but shall identify an area for
7.6.3.3 Parking/running lights,
consideration by the physician in making a determination of
7.6.3.4 Interior and exterior turn signal,
the medical fitness to operating an ambulance.
7.6.3.5 Brake lights,
7.6.3.6 Back up lights,
6. Qualifications to Drive
7.6.3.7 Flood or scene lights,
6.1 Authorization shall be based upon cognitive evaluation
7.6.3.8 Dome lights: cab and patient compartment, and
of the operator regarding laws, guidelines, and policies relating
to ambulance operation during emergency and non-emergency
TABLE 1 Emergency Medical Services Ambulance Maintenance
modes. Guidelines for Checklist Completion
6.1.1 The provider shall have a policy that addresses opera-
Runs per Week Full Check, h Quick Check, h
tor fatigue.
0 to 1 every 96 every 24
6.2 An ambulance driving evaluation by the provider cov- 2 to 3 every 72 every 24
4 to 7 every 48 every 24
ering warning device operation, passing, intersection approach
8 to 50 every 24 every 12
precautions, turning, backing, and parking techniques during
50 + every 24 every 8
emergency and non-emergency modes.
F1517–94 (2002)
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,
7.7.5 Wear and pressure of tires,
7.6.5 Damage, loose, or missing lugs on wheels,
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:
7.7.7.1 Emergency lights,
7.6.7 Fluid levels:
7.6.7.1 Automatic transmission, 7.7.7.2 Running lights,
7.7.7.3 Vehicle exterior, and
7.6.7.2 Battery,
7.7.7.4 Vehicle interior.
7.6.7.3 Brakes,
7.6.7.4 Engine oil, 7.7.8 Proper function of horn and each siren position,
7.7.9 Vehicle cleanliness, and
7.6.7.5 Engine coolant,
7.7.10 Proper function of two-way radio and other commu-
7.6.7.6 Power steering, and
nications equipment.
7.6.7.7 Windshield washer.
7.6.8 Fluid leakage on, around, or under the vehicle,
8. Operations
7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel,
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 com-
approved by the medical director. These determinants shall be
partments,
consistent with Practice F 1258.
7.6.12 Wear, abrasion, and proper function of operator,
8.2 The operator shall, on the basis of known information,
passenger, and patient restraint,
determine the best route to the scene and end destination.
7.6.13 Indications and function of gages:
8.3 Before beginning the response, the operator shall con-
7.6.13.1 Electrical charging system,
duct a brief egress check consisting of the following:
7.6.13.2 Emergency brake,
8.3.1 Vehicle doors are securely closed and latched,
7.6.13.3 Fuel,
8.3.2 Vehicle hood is closed and securely latched,
7.6.13.4 Oil pressure,
8.3.3 Vehicle shore line is disconnected,
7.6.13.5 Tachometer, and
8.3.4 All equipment is secured,
7.6.13.6 Temperature.
8.3.5 Egress door is open, and
7.6.14 Wear, abrasion, and proper function of windshield
8.3.6 Patient stretcher is in place and secured.
wipers,
8.4 Operational Check Sequence:
7.6.15 Proper function and aim of windshield washer,
8.4.1 Ensure crew is on board and properly restrained,
7.6.16 Proper function and clarity of two-way radio and 8.4.2 Adjust the operator’s seat,
other communication devices,
8.4.3 Adjust mirrors,
7.6.17 Damage, stability, and adjustment of outside and
8.4.4 Turn on battery(s),
inside mirrors,
8.4.5 Start the engine,
7.6.18 Proper function and clarity of emergency siren,
8.4.6 Review all gages,
public address, and other warning devices,
8.4.7 Adjust environmental controls consistent with appli-
7.6.19 Proper adjustment of all seats,
cable needs,
7.6.20 Proper adjustment and function of steering wheel,
8.4.8 Turn radio on and contact dispatch,
7.6.21 Charged and properly stored fire extinguishers,
8.4.9 Adjust the tilt wheel,
7.6.22 Proper function of heating and air conditioning
8.4.10 Turn the headlights on,
systems,
8.4.11 Activate the emergency warning lights (if appli-
7.6.23 Proper inventory and condition of medical equip-
cable),
ment and supplies, and
8.4.12 Turn on power to siren/public address control system
7.6.24 Level and alignment of chassis.
(if applicable),
7.7 The quick check shall be constituted by:
8.4.13 Partially open the driver side window,
7.7.1 Visually checking for any fluid leakage on or around
8.4.14 Evaluate brake pedal resistance,
the ambulance,
8.4.15 Place the vehicle in gear,
7.7.2 Conducting vehicle warmup,
8.4.16 Activate the siren (if applicable), and
7.7.3 Checking fluid levels:
8.4.17 Activate the turn signal (if applicable).
7.7.3.1 Fuel,
8.5 Crew Roles—The operator/crew member is responsible
7.7.3.2 Engine oil,
for:
7.7.3.3 Power steering,
8.5.1 Operating the ambulance in a safe and efficient man-
7.7.3.4 Water/coolant level, ner, exercising the highest degree of care,
7.7.3.5 Brake fluid, 8.5.2 Safely passing other vehicles,
7.7.3.6 Transmission fluid, 8.5.3 Utilizing eye sweep,
7.7.3.7 Windshield washer fluid, and 8.5.4 Maintaininga3to4-s following distance, and
F1517–94 (2002)
8.5.5 Maintaining the vehicle at a speed that is safe for 8.6.5 Look to the left, look to the immediate front, look to
conditions. the right, and then again to the left. The operator may then
proceed through the intersection under ten miles per hour if
8.5.5.1 Under emergency response conditions the speed
traffic is stopped in all lanes to the left, in front of, and to the
shall not exceed that which is safe for road or environmental
rightoftheambulance.Aftertheoperatorhasmadeeyecontact
conditions; in no case shall the speed exceed ten miles per hour
with all stopped vehicle drivers, the ambulance may proceed
over the posted speed limit.
through the intersection exercising the highest degree of care.
8.5.5.2 Under non-emergency operations the operator shall
8.6.6 Continue the siren yelp mode activation and proceed
comply with all local and state traffic laws.
through the intersection exercising the highest degree of care.
8.5.6 Controlling the operation of the appropriate audible
8.6.7 When there are vacant lanes to the left or right, the
warning device for the current traffic conditions.
operatormustcompletethepreviousstepsofclearingeachlane
8.5.7 Utilizing the vehicle communication system,
of traffic prior to crossing that lane.
8.5.8 Applying policies and procedures in the d
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