Thread: Nfpa 1917?

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    Default Nfpa 1917?

    I just got done reading the Draft, and have to ask.... Why is NFPA getting involved with Ambulances, when we already have the KKK Standards? If a FD want's a NFPA ambulance, why don't they just order a KKK ambulance that meets relevant 1901 standards? For instance, the section dictating the reflective chevrons on the back of the truck, would contradict Mississippi laws on ambulance markings. It just seems to me NFPA is reaching outside their realm, and into ventures that aren't fire service related. I welcome constructive dialog on the subject.

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    I can't substantiate it by any means, but I heard a rumor recently that they're doing away with the KKK requirements and going with NFPA as its replacement.

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    With fire-based EMS becoming more popular across the US, NFPA's attempting to have a positive impact on all of the vehicles that firefighters routinely ride on. Basically, ambulances were the only thing that we routinely staff and didn't have an NFPA standard for.

    The KKK standard isn't bad, but it's surely a "bare bones" standard.
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    I see where your going, I guess I am slightly disappointed with all of the "cut and paste" work from 1901 & KKK. Heck, there is even a picture of a fire truck in the lighting standards. Not very much original material. If this was an English class, someone would get in trouble for handing in a report like that.

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    I feel confident you'll see that the final edition has a lot of these things fixed. Remember that the ROP doesn't necessarily reflect the final edition, which is still several months away.

    In related news, we're hearing that a lot of the volunteer rescue squads in Virginia have a lot of beef with the NFPA 1917 standard, which bears the question about non-fire-service agencies being pressured into purchasing an ambulance that meets a FD standard.
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    Quote Originally Posted by ADC120 View Post
    If this was an English class, someone would get in trouble for handing in a report like that.
    It's not plagiarism if you copy your own work.

    As a matter of practice/style, NFPA standards often reuse the same language by reference to other standards for consistency.
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    The Code is more what you'd call "guidelines" than actual rules.

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    Having been involved in ambulance purchases, I can tell you that KKK is NOT a standard. It is simply the federal government's identifier for their specification for an ambulance. It's what the U. S. government agencies have to use when they buy an ambulance. No one else is required to adhere to the KKK specification--most people do, though.

    NFPA, for a variety of reasons, decided to establish a standard for ambulances, thus the draft of NFPA 1917.

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    Quote Originally Posted by ADC120 View Post
    I just got done reading the Draft, and have to ask.... Why is NFPA getting involved with Ambulances, when we already have the KKK Standards? If a FD want's a NFPA ambulance, why don't they just order a KKK ambulance that meets relevant 1901 standards? For instance, the section dictating the reflective chevrons on the back of the truck, would contradict Mississippi laws on ambulance markings. It just seems to me NFPA is reaching outside their realm, and into ventures that aren't fire service related. I welcome constructive dialog on the subject.
    The fire service, in general, has been a provider of emergency medical care for at least the past 4 decades. During that time period many FDs have spent a substantial amount of time providing transport services in addition to non-transport care. So, EMS and ambulances ARE very much "fire service related".

    As was mentioned, NFPA has a standard for most of the other apparatus a FD uses, so an ambulance standard wouldn't be "reaching outside their realm" in my opinion.

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    Quote Originally Posted by pgoldsmith View Post
    Having been involved in ambulance purchases, I can tell you that KKK is NOT a standard. It is simply the federal government's identifier for their specification for an ambulance. It's what the U. S. government agencies have to use when they buy an ambulance. No one else is required to adhere to the KKK specification--most people do, though.

    NFPA, for a variety of reasons, decided to establish a standard for ambulances, thus the draft of NFPA 1917.

    Phil Goldsmith
    Pikesville VFC, Baltimore, MD
    Pleasant Hill VFC, Hanover, PA
    I think you are both correct and incorrect. Although the Federal KKK standards themselves may not have been intended to be used as a national "standard", many states (at least in the south) in the absence of such and being to lazy to delevop there own simply enact laws that adopt federal kkk regulations and it becomes law.
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    This is also where the comments on proposed standards and changes to standards are so important - to find out if there are conflicts to state laws etc.....

    If anyone is interested in submitting comments/proposed changes during the open period and needs assistance please feel free to contact me....I have a little experience in this - more so in reviewing the comments as a TC member.....

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    Quote Originally Posted by Catch22 View Post
    I can't substantiate it by any means, but I heard a rumor recently that they're doing away with the KKK requirements and going with NFPA as its replacement.
    I have also heard the KKK standards are going away, and that NFPA was approached to take over setting up standards for these apparatus.

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    Default Comments were closed on Dec. 15, 2010

    I read over the 1917 Draft in detail and returned about 30 comments. You can tell that some of the people involved in putting this together has no experience in the back of an ambulance or maybe what an Ambulance is for.
    Examples:
    3.3.37.2 - Discusses Primers and Booster Reel rewind motors using 12 Volt electrical current.
    When was the last time you saw these on an ambulance.
    6.1.1 - At least 10" of space between the rear door and cot.
    6.26 - Seat belt warning lights and audible alarm to be heard in front & back for all seats.
    Attendant can't move in back of ambulance. How do you do patient care with out moving.
    6.29 - This says about 25% of the front width to have reflective striping and 50 % of the side of the unit to have reflective striping. OK but how wide - And ambulance is 96" wide, I can have a strip 1/4" wide by 24" long and meet the front requirement. The same for the side.
    6.32.11.3 - Nothing to be stored with the onboard O2 Bottle. Why?

    There are a whole lot more that don't make any sense. As far as I'm concerned NFPA needs to keep well enough along.
    This I know will stir things up - But those that want to do EMS and know what it is about, should be the ones controlling EMS keep the firefighters out of it.
    No disrespect to my Firefighting friends but most don't want anything to do with EMS but have to do it because its their job requirement. Then you follow this up the chain of command ladder and you see what you get. Just look at the fire apparatus around and it looks great and well cared for. Look at the ambulances and they look cheap and uncared for. You can tell what is the most important just be looking at the fleet.

    I could ramble on and on but I will shut-up for now.

    nc

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    Quote Originally Posted by nc1130 View Post
    I read over the 1917 Draft in detail and returned about 30 comments. You can tell that some of the people involved in putting this together has no experience in the back of an ambulance or maybe what an Ambulance is for.
    Examples:
    3.3.37.2 - Discusses Primers and Booster Reel rewind motors using 12 Volt electrical current.
    When was the last time you saw these on an ambulance.3.3.37.2 Total Continuous Electrical Load. The total current required to operate all of the devices permanently
    connected to the ambulance that can be simultaneously energized excluding intermittent-type loads such as primers
    and booster reel rewind motors.

    6.1.1 - At least 10" of space between the rear door and cot.
    6.26 - Seat belt warning lights and audible alarm to be heard in front & back for all seats.
    Attendant can't move in back of ambulance. How do you do patient care with out moving.
    6.29 - This says about 25% of the front width to have reflective striping and 50 % of the side of the unit to have reflective striping. OK but how wide - And ambulance is 96" wide, I can have a strip 1/4" wide by 24" long and meet the front requirement. The same for the side.6.29.2 The stripe or combination of stripes shall be a minimum of 4 in. (100 mm) in total vertical width.
    6.32.11.3 - Nothing to be stored with the onboard O2 Bottle. Why? Sparks from metal to metal banging isn't a good thing in a compartment full of O2. Think "Big Flame Flash".

    There are a whole lot more that don't make any sense. As far as I'm concerned NFPA needs to keep well enough along.
    This I know will stir things up - But those that want to do EMS and know what it is about, should be the ones controlling EMS keep the firefighters out of it.
    No disrespect to my Firefighting friends but most don't want anything to do with EMS but have to do it because its their job requirement. Then you follow this up the chain of command ladder and you see what you get. Just look at the fire apparatus around and it looks great and well cared for. Look at the ambulances and they look cheap and uncared for. You can tell what is the most important just be looking at the fleet.

    I could ramble on and on but I will shut-up for now.

    nc
    I like the idea that the NFPA is getting involved with the specifications/guidelines with ambulances/med units. To a degree.

    As for the care of our med units, they all look as good as the fire trucks sitting beside them. Our FF's know they are needed, and are there if it is needed for them. So to slam a fire based EMS system is way out of line. Any FD running EMS should be happy that the NFPA is getting involved. Remember, an ambulance is still an emergency vehicle, and should be given the respect as a fire truck for standards and guidelines.

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    I have read thru 1917 . For those that dont like the seatbelt alarm, I would get used to it. It is the biggest thing that is killing people in ambulances is the lack of restraint. If you cant move with a seatbelt on look for other options that will allow you to do your job while belted, forward facing seats, 4-5 belt systems (they offer more movment than the lap belts) I for one dont think 1917 goes far enough, but you cant expect NFPA to take KKK adn throw it out overnight. 1917 had to use the KKK spec as a starting point. I would think further editions will place more stress on pt and crew safty, with the elimination in many cases of the bench and CPR seats that tend to kill many EMT's by there poor design.

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    Quote Originally Posted by nc1130 View Post
    This I know will stir things up - But those that want to do EMS and know what it is about, should be the ones controlling EMS keep the firefighters out of it.
    I'm very proud to be good at delivering both EMS and firematic services. I work with a whole department full of guys that don't mind it, under an OMD who's striving to make us one of the premier fire-based EMS agencies in the US. Be careful stereotyping us! (And we're still pretty good at putting fires out too )

    Just look at the fire apparatus around and it looks great and well cared for. Look at the ambulances and they look cheap and uncared for.
    Sounds like management needs to talk with those folks then. When we wash and clean our suppression rigs, the ambulance is right there with it, getting the same attention to detail.

    However, I digress. I've also heard from reliable sources that the KKK standards will be eliminated, so someone needed to step in with a national standard.
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    Default Ambulance Std's

    My understanding is the NFPA Committee is combining the KKK, and the Ambulance Manufactuers Association std's and some of the Safety Initiatives from NFPA 1901 to come up with a universal North American Standard. I'm sure some kinks will have to be worked out on the first pass.

    And there are some Ambulances built with small water tanks, water pumps and hose reels.

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    Quote Originally Posted by donethat View Post
    And there are some Ambulances built with small water tanks, water pumps and hose reels.
    I was getting ready to address that when I saw your post. There are several out there that have just like what you describe, and some that have chemical suppression systems, most with fire-based EMS. I've also seen some that will do the chemical-bases systems for EMS services that still provide extrication.

    That particular section could potentially also apply to cord reels and other electrical systems that you can end up with when you cross EMS with fire.

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    Quote Originally Posted by eagle5473 View Post
    I would think further editions will place more stress on pt and crew safety, with the elimination in many cases of the bench and CPR seats that tend to kill many EMT's by there poor design.
    Well I hope they don't ditch the bench anytime soon, I routinely haul 2 pt's. I do wish they would eliminate type II ambulances. They are too top heavy, and the supplies always seem to pop out like a can of worms. Also roof strength is much less than a box. I've run out of all three types, and can't think of a time where I would have preferred a type II.

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    I thought this might start something.

    FIREMEDIC1 - I never said ALL fire companys don't take care of there ambulances as they do fire apparatus only some. If you look around you well see a difference. With putting stuff in an O2 compartment - If you follow NFPA guidelines all tools and equipment are suppose to be "secured" in brackets and crash worthy. Us putting PPE in that compartment should not cause any harm. (Helmet Coat and Pants)

    BoxAlarm 187 - Our department, while it may be a Ambulance & Rescue Company. We are controlled via a Fire & Rescue Association which is mostly fire side heavy. We have personnel that fight fire along side our brothers on the fire side. It is just a different mindset, if you will, between the two as to what is most important.

    eagle 5473 - While I can agree there needs to be a way to have a restraint system for attendants in the back of an ambulance. Having an alarm go off in the back of the ambulance while a patient is in the back is not wise. Can you imagine what that patient would think if all of a sudden an alarm goes off while transporting. It will scare the sh** out of him. Then I got to clean that up. If you are doing any type of definitive patient care, you are moving around. Checking airway, Vital signs. Re-evaluating the patient from head to toe. Adjusting O2, gotta grab a puke pan, or Kleenex, what about other getting other bandages. Talk on the EMS Radio to the "Doc in the box" etc etc. Can't do these things sitting in one spot when the items you need are located in different areas of the unit and you cant put everything you need at you finger tips.

    Just some thoughts.

    nc

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    Quote Originally Posted by nc1130 View Post
    eagle 5473 - While I can agree there needs to be a way to have a restraint system for attendants in the back of an ambulance. Having an alarm go off in the back of the ambulance while a patient is in the back is not wise. Can you imagine what that patient would think if all of a sudden an alarm goes off while transporting. It will scare the sh** out of him. Then I got to clean that up. If you are doing any type of definitive patient care, you are moving around. Checking airway, Vital signs. Re-evaluating the patient from head to toe. Adjusting O2, gotta grab a puke pan, or Kleenex, what about other getting other bandages. Talk on the EMS Radio to the "Doc in the box" etc etc. Can't do these things sitting in one spot when the items you need are located in different areas of the unit and you cant put everything you need at you finger tips.
    I haven't a clue how busy your agency, or if you're BLS or ALS, but I can transport 90% of my patients to the hospital seated (and belted) in the CPR chair on the driver's side of the box. Doing about 8-12 transports a day on my medic unit, very few of these patients (even if they're candidates for ALS care) require the attendant to be bouncing all over the back of the box.

    Perhaps your agency can look at re-designing some of the cabinetry in the back to put some of the more critical items closer together to prevent you from having to go from cabinet to cabinet and seat to seat?

    I don't think you're going to find a patient freaking out if an alarm goes off, seriously. I'm not a fan of the audible alarms in the ambulances (though I think the visual alarms are a good idea, and like to see both in the fire apparatus), but I don't believe they're creating a patient care issue.
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    NC,

    just because you need to jump from seat to seat to get things using the current design of yours and 99% of ALL ambulances in the US does not make it the the right way to provide care in a moving vehicle.

    Take the time to look to Austrailia and Europe to see how they are working and how those ambulances are set up. Most have the equipment you need in arms reach with forward facing seats. Some of these designs do have folding seats to allow for carrying of a second pt.

    There was a comment above as well that the type 2 should be done away with . I have to disagree in that there have been studies that show they are safer than a type I or III. This is due to the face that the entire Chassis and side structures of the type II's are subject to dynamic crash tests. There are few type III's or I's bodies that have ben dynamicly (destroyed) crash tested to NHTSA standards .

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    O.K. folks, lets try to keep a civil dialog going here. Personal shots at each other do not make anyone sound more intelligent on a subject. If anyone has a different point of view on the topic then post it, but do not step on others views in order to make your point.

    I posted the comment about removing Type II's from service. I unfortunately have had experience with both vans and boxes in accidents, and can attest the boxes always held up better. The NFPA standard lists that boxes must be able to hold 2.5 times the weight of the vehicle, vs. vans only having the normal 1.5.

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    Quote Originally Posted by BoxAlarm187 View Post
    I haven't a clue how busy your agency, or if you're BLS or ALS, but I can transport 90% of my patients to the hospital seated (and belted) in the CPR chair on the driver's side of the box. Doing about 8-12 transports a day on my medic unit, very few of these patients (even if they're candidates for ALS care) require the attendant to be bouncing all over the back of the box.

    Perhaps your agency can look at re-designing some of the cabinetry in the back to put some of the more critical items closer together to prevent you from having to go from cabinet to cabinet and seat to seat?

    I don't think you're going to find a patient freaking out if an alarm goes off, seriously. I'm not a fan of the audible alarms in the ambulances (though I think the visual alarms are a good idea, and like to see both in the fire apparatus), but I don't believe they're creating a patient care issue.
    Even so, I can't imagine NFPA designing a standard that doesn't allow the attendant in the box to get up and move around. That's the ONLY riding position allowed to be without a seatbelt when you look at NFPA 1500. I'm wonder if the seat alarm is intended for the front-seat occupants and sounds in the front and rear to notify everyone that someone's out of the seat or unrestrained or whatever.

    Realistically, you're right in that 90% of transports can be done belted and secured. With NiBP, pulse oximetry, cardiac monitoring, etc. there's no need to get up for vitals, and the AutoPulse/LUCAS and other devices coupled with a ventilator reduce the need to be out of the seat even on a code. Just put the drug bag on the floor beside you and grab what you need.

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    Didn't mean to set everyone off. Just trying to show how some of the new requirements in NFPA 1917 don't make much sense. With having an alarm on the seating positions - I have no real problem with lights in the cab of the vehicle just don't need it in the patient compartment.
    We have AutoPulse's on all units, the Medic is on the squad bench seat, a BLS provider is in the Captains Chair doing ventilations. Still have to move around even if you have to change the batteries of the unit.
    To visit my company go to: www.bvar19.com

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    Quote Originally Posted by nc1130 View Post
    Didn't mean to set everyone off. Just trying to show how some of the new requirements in NFPA 1917 don't make much sense. With having an alarm on the seating positions - I have no real problem with lights in the cab of the vehicle just don't need it in the patient compartment.
    We have AutoPulse's on all units, the Medic is on the squad bench seat, a BLS provider is in the Captains Chair doing ventilations. Still have to move around even if you have to change the batteries of the unit.
    To visit my company go to: www.bvar19.com

    nc
    I wouldn't worry too much about setting people off, it happens. The internet world is wonderful in the fact that you can't express emotion or anything with your posts and it's easy to take someone as being confrontational when they're not.

    I worked rural EMS for a number of years and the greatest thing we ever got was the AutoPulse. We could get the AutoPulse on, get them on the cot, hook up the oxylator to the tube and all I had to do as the medic was watch the monitor and push a drug every now and then. It's virtually hands-off.

    I for one took advantage of that fact and buckled up until the point I had to get up to do something. I'd usuall take my position on the bench, put the drug bag beside me, and go to town. I could reassess whatever I needed and never leave my seat unless it was something important I needed to do. I preferred that much more than the days I used to have to have someone bagging, someone compressing, and me jumping over them to push drugs or work the monitor. All it took was one wreck and one time nearly wrecking (my fine partner drove the right side off into a ditch) to convince me it's not worth riding in the back without a belt.

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