ASTM F1705-96(2002)

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Designation:F1705–96 (Reapproved2002)
Standard Guide for
Training Emergency Medical Services Ambulance
Operations
This standard is issued under the fixed designation F 1705; 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.
TABLE 1 Emergency Medical Services Ambulance Maintenance
1. Scope
Guidelines for Checklist Completion
1.1 This guide provides minimum training standards for
Runs per week (per
Full check Quick check
Emergency Medical Services (EMS) Ambulance Operators
vehicle)
including legal aspects, operator qualifications and testing,
0 to 1 every 96 h every 24 h
history of EMS vehicle operations, vehicle types/equipment,
2 to 3 every 72 h every 24 h
safety, physical forces, mechanics, pre-run, operations, post- 4 to 7 every 48 h every 24 h
8 to 50 every 24 h every 12 h
run, and special circumstances.
50+ every 24 h every 8 h
1.2 This guide promotes the safe and efficient delivery of
the ambulance, equipment, crew, passengers and patients,
during all phases of the delivery of EMS involving the
ambulance; at all times exercising the highest degree of care
2.2 Federal Specification:
for the safety of the public. This guide may be applied to the
KKK 1822C Federal Specification for the Star-of-Life Am-
driving of other EMS vehicles that do not necessarily provide
bulance
patient transportation.
3. Terminology
1.3 This guide shall be used as the basis for all programs
relevant to the training of the emergency medical services
3.1 For definitions of other emergency medical terms, see
operators.
Terminology F 1177:
1.4 This standard does not purport to address all of the
3.2 Definitions of Terms Specific to This Standard:
safety concerns, if any, associated with its use. It is the
3.2.1 ambulance operations—the efficient delivery of the
responsibility of the user of this standard to establish appro-
ambulance, equipment, crew, passengers, and patients during
priate safety and health practices and determine the applica-
all phases of the delivery of EMS involving the ambulance, at
bility of regulatory limitations prior to use.
all times exercising the highest degree of care for the safety of
the public.
2. Referenced Documents
3.2.2 ambulanceserviceprovider—asoutlinedinthisguide,
2.1 ASTM Standards:
a person, company, corporation, or political entity responsible
F 1177 Terminology Relating to Emergency Medical Ser-
for operation, maintenance, or policy-making, or all three,
vices
regarding emergency medical vehicle operations.
F 1229 Guide for the Qualification and Training of EMS
3.2.3 bona fide occupational qualification (BFOQ)—the
Air-Medical Patient Care Providers
skills and knowledge relevant to the performance of a specific
F 1230 Specification for Minimum Performance Require-
task.
ments for Emergency Medical Service (EMS) Ground
3.2.4 departure check—the visual check of the vehicle and
Vehicles
surrounding area, ensuring that equipment and supplies have
F 1258 Practice for Emergency Medical Dispatch
been retrieved and properly stored and that all compartment
F 1517 Guide for Scope of Performance of Emergency
doors are secured.
Medical Services Ambulance Operations
3.2.5 egress check—the visual check of the vehicle and
F 1651 Practice for Training the Emergency Medical Tech-
surrounding area prior to operating the ambulance.
nician (Paramedic)
3.2.6 emergency mode—as defined by individual state stat-
utes that refer to emergency vehicles, equipment, and opera-
tions.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
Current edition approved June 10, 1996. Published September 1996.
2 4
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Discontinued. See 1996 Annual Book of ASTM Standards, Vol 13.02. 732 N. Capitol St., NW, Mail Stop: SDE, Washington, DC 20401.
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F1705–96 (2002)
3.2.7 full check—a comprehensive and systematic evalua- 5.1.6 Consolidated Omnibus Reconciliation Act (COBRA)/
tion of the ambulance at specified intervals, including docu- Omnibus Reconciliation Act (OBRA) Laws.
mentation of the inspection, deficiencies, and their corrective
5.2 Integration of state laws and local ordinances with
actions.
company policies/procedures. Company policy should incor-
3.2.8 operator—a person who operates or assists with the
porate into guidelines the principles of applicable state laws,
operation of an ambulance.
local ordinances, rules, and regulations.
3.2.9 driver—the individual responsible for operating the
5.3 Highest Degree of Care (Law of Due Regard)—A
ambulance in a safe and efficient manner, exercising the
general principle, frequented in case law, that holds the
highest degree of care.
ambulance operator responsible for his actions regardless of
3.2.10 technician—the individual responsible for patient
perceived exemptions from traffic laws governing the emer-
care.
gency vehicle operator.
3.2.11 post-run—the managed return of the ambulance and
5.4 Legal Issues:
operators to optimal pre-run readiness.
5.4.1 Negligence—Any action that violates a standard of
3.2.12 pre-run—all aspects of assuring response readiness.
practice or care related to ambulance operation.
3.2.13 quick check—an abbreviated version of the full
5.4.2 Abandonment—Terminating care or transportation
check, focusing on the major operational functions of the
prior to being relieved by other qualified health care providers.
vehicle.
Once a patient provider relationship is established, it must
3.2.14 reaction time—from the time the operator identifies
continue until responsibility for the patient is assumed by a
the hazard until the appropriate action is taken.
provider of equal or higher qualifications.
3.2.15 response mode management—the response mode of
5.4.3 Emergency Medical Dispatch—An organized system
the ambulance shall be determined by dispatch protocols based
of emergency medical dispatching principles intended to pro-
on(dispatch)determinantsasapprovedbythemedicaldirector.
vide guidelines for ambulance operations as delineated in
The determinants shall be consistent with Practice F 1258.
Practice F 1258.
3.2.16 stopping distance—the distance the vehicle travels
until it comes to a stop after the brakes are applied. 5.4.4 Multiple Responding Units:
5.4.4.1 Vehicle Separation—The operator shall be trained to
4. Significance and Use
maintainaminimum300-ftbufferzonebetweentheambulance
4.1 This guide provides minimum training guidelines for
and other emergency vehicles on the same route of travel.
safe and efficient ambulance operations.
(1) Weather, traffic conditions, or other factors may cause
4.2 Ambulance providers and educators should follow this
the operator to increase the length of the buffer zone for the
guide for the development of educational and training pro-
safe operation of the ambulance.
grams.
5.4.4.2 Escorts—The operator shall be informed of the
4.3 This guide is intended to promote safe and efficient
hazards involved in the use of emergency vehicle escorts and
ambulance operations and to reduce morbidity, mortality, and
be trained to avoid such practices.
property loss associated with ambulance operations.
(1) The operator shall be trained to discourage private,
4.4 This guide is intended to assist those who are respon-
non-emergency vehicles from following the ambulance during
sible for the development and implementation of policies and
transport.
procedures for ambulance operations.
5.4.5 Interacting with Public Safety Agencies:
4.5 Topics or concepts listed in this guide are intended to
serve as an outline of materials to be covered in the training of 5.4.5.1 Command—Ambulance operations shall be consis-
tent with operational guides delineated in Incident Command
ambulance operators.
System (ICS).
5. Legal Aspects
5.4.5.2 Communication—Ambulance communication sys-
5.1 The training of the ambulance operator shall include all
tems should allow the ambulance operator to communicate
federal and state laws and local ordinances including the
with other public safety agencies.
provider’s policies governing emergency medical vehicle op-
5.4.5.3 Coordination—Cooperative guidelines shall be es-
erations. The operator/driver shall have a clear understanding
tablished with other public safety agencies in order to provide
of the impact of those laws on the operation of the vehicle.
a safe and adequate response.
5.1.1 Constitutional Law—Laws derived from the U.S.
5.4.6 Motor Vehicle Accidents Involving the Ambulance:
Constitution governing the patient’s right before, during, and
5.4.6.1 Reporting—The ambulance operator shall receive
after transport.
instructions regarding reporting guidelines for ambulance re-
5.1.2 Statutory Law—Laws derived from legislative acts.
lated accidents/incidents in accordance with state laws, local
5.1.3 Ordinances—Lawsorguidelinesenactedbyagovern-
ordinances, rules or regulations, and organizational policies
ing municipal body or its agent.
and procedures.
5.1.4 Rules and Regulations—Guidelines enacted by an
5.4.7 Mitigation/Documentation Mechanical Failures:
agency that have the force of law that are intended to provide
greater specificity about statutory laws. 5.4.7.1 Scheduled Maintenance—The ambulance operator
5.1.5 Case Law—Judicial interpretation of statutory law, shall be trained in the importance of a scheduled maintenance
rules, or regulations that have been decided in a court of law. program.
F1705–96 (2002)
5.4.7.2 Vehicle and Equipment Inspections—The ambu- 8.1.1 Evolution of ambulance driving from high-force pur-
lance operator shall be trained in the fundamentals and suit driving to low G-force driving techniques.
application of vehicle and equipment inspections. 8.1.2 Changes in vehicle design and dynamics.
5.4.7.3 Reporting of Deficiencies—The ambulance operator 8.1.3 Evolution of governmental regulation.
shall understand the importance of inspecting the ambulance 8.1.3.1 Specification F 1230, Minimum Performance Re-
and equipment, and shall be familiar with the reporting quirements for Emergency Medical Service Ground Vehicles.
procedures utilized by the provider. The ambulance operator 8.1.3.2 Federal standards KKK 1822: “A” through current
shall be familiar with provider policies in regard to major specifications.
deficiencies which have an affect on the serviceability of the
9. Vehicular Types and Equipment
vehicle.
9.1 The training of the ambulance operator shall include the
differentambulanceclassifications(TypeI,II,III,andspecialty
6. Operator Qualifications to Drive
responsevehicles)includingmaneuverability,handling,weight
6.1 The training of the ambulance operator shall include the
distribution, payload allowance, and GVWR.
components of evaluation techniques which may be utilized in
screening the operator candidate:
10. Loss Control and Safety Issues in the Operations of
6.1.1 Medical Fitness to Drive—Operators shall be subject
Ambulances
to periodic medical evaluations as determined by the ambu-
10.1 Preventive Maintenance—The ambulance operator
lance service provider. The purpose of the physical examina-
shall be trained in basic techniques, documentation, and
tion is to determine whether the operator has the physical
rationale for preventive maintenance.
ability to adequately perform his or her duty as an operator of
10.1.1 The operator should follow provider policies or
emergency vehicles. (See Guide F 1517.)
manufacturer’s suggested maintenance schedule, or both, for
6.2 Authorization:
the ambulance.
6.2.1 The authorization of ambulance operators must be
10.2 Operator Fatigue—The ambulance operator shall be
based on Bona Fide Occupational Qualification (BFOQ) pur-
trained in the recognition of the adverse affects of excessive
suant to the task of ambulance operations.
fatigue. The provider/operator shall be familiar with methods
6.2.2 Authorization shall be based upon cognitive evalua-
and policies used to prevent fatigue-related operator dysfunc-
tion of the operator regarding laws, guidelines, and policies
tion.
relating to ambulance operation during emergency and non-
10.3 Interactive Crew Roles—Operators shall receive in-
emergency modes.
struction on the importance of interactive roles utilized to
6.3 A periodic review of the operator’s state motor vehicle
lessen risk exposure, such as the ground guide/driver relation-
record for the previous three years with specific attention to
ship in backing the ambulance or the driver/technician rela-
traffic convictions concerning:
tionship in approaching controlled intersections.
6.3.1 Speed.
10.4 Unsafe Thought Patterns—The operator shall be made
6.3.2 Careless and imprudent driving.
aware of the importance of concentration on the driving task at
6.3.3 Driving under the influence of alcohol or other mind-
hand and should be aware of dangerous practices such as
altering substances.
allowing the nature of the emergency to affect driving tech-
6.3.4 Moving violations/other violations.
niques or other high-risk behavior.
6.3.5 Suspension of driver’s license.
10.5 Resolving Conflict—The driver shall be trained to
6.4 A review of the operator’s motor vehicle accidents for
make determinations regarding the safe operation of the
the previous three years.
ambulance.The operator shall be aware that the senior medical
6.5 The operator shall possess a valid motor vehicle license,
crew member shall make determinations regarding transporta-
and any other certification required by state or local laws or
tion mode and patient destination.
regulations.
10.6 Patient Handling Equipment—The ambulance opera-
6.6 The operator’s qualifications and continuing education
tor shall be trained in the proper operation, storage, and
shall be reviewed annually.
handlingofallequipmentusedinthetreatmentandtransportof
the patient.
7. Operator Testing
10.7 OSHA Guidelines—The operator/provider shall be
7.1 The training of the ambulance operator shall include the
trained in the utilization of OSHA guidelines pertaining to
components of evaluation techniques which may be utilized in
factors affecting the operation of the emergency vehicle.
screening the operator candidate:
10.8 Hazmat Guidelines—The operator shall be trained to
7.1.1 Psychological testing.
adhere to the regulations and guidelines regarding ambulance
7.1.2 Physical a
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