ASTM F1517-1994(2007) Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations《医用急救车工作性能范围标准导则》.pdf

1、Designation: F 1517 94 (Reapproved 2007)Standard Guide forScope of Performance of Emergency Medical ServicesAmbulance Operations1This standard is issued under the fixed designation F 1517; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revi

2、sion, the year of last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon (e) indicates an editorial change since the last revision or reapproval.1. Scope1.1 This guide covers minimum standards for the perfor-mance of emergency medical services (EMS) ambula

3、nceoperators, including: operator qualifications, pre-run operation,and post-run aspects.1.2 This guide shall promote the safe and efficient deliveryof the ambulance, equipment, crew, passengers and patients,during all phases of the delivery of EMS involving theambulance; at all times exercising the

4、 highest degree of carefor the safety of the public. This guide may be applied to otherEMS vehicles that do not necessarily provide patient transport.1.3 This guide shall be used as the basis for training guidesof the emergency medical services ambulance operator.1.4 The values stated in SI units ar

5、e to be regarded as thestandard. The SI units given in parentheses are for informationonly.1.5 This standard does not purport to address all of thesafety concerns, if any, associated with its use. It is theresponsibility of the user of this standard to establish appro-priate safety and health practi

6、ces and determine the applica-bility of regulatory limitations prior to use.2. Referenced Documents2.1 ASTM Standards:2F 1177 Terminology Relating to Emergency Medical Ser-vicesF 1258 Practice for Emergency Medical Dispatch3. Terminology3.1 Definitions:3.1.1 The definitions given in Terminology F 11

7、77 areapplicable to this guide.3.1.2 ambulanceSee Terminology F 1177.3.2 Definitions of Terms Specific to This Standard:3.2.1 ambulance operationsthe efficient delivery of theambulance, equipment, crew, passengers and patients, duringall phases of the delivery of EMS involving the ambulance atall ti

8、mes exercising the highest degree of care for the safety ofthe public.3.2.2 ambulance service provideras outlined in this guide,a person, company, corporation or political entity responsiblefor operation, maintenance, or policy making, or combinationthereof, regarding emergency medical vehicle opera

9、tions.3.2.3 bona fide occupational qualification (BFOQ)theskills and knowledge relevant to the performance of a specifictask.3.2.4 departure checkthe visual check of the vehicle andsurrounding area ensuring that equipment and supplies havebeen retrieved and properly stored and that all compartmentdo

10、ors are secured.3.2.5 egress checkthe visual check of the vehicle andsurrounding area prior to operating the ambulance.3.2.6 emergency modeas defined by individual state stat-ues that refer to emergency vehicles, equipment, and opera-tions.3.2.7 full checka comprehensive and systematic evalua-tion o

11、f the ambulance at specified intervals, including docu-mentation of the inspection, any deficiencies found and theircorrective actions.3.2.8 operatora person who operates or assists with theoperation of an ambulance.3.2.9 post-runthe managed return of the ambulance andoperators to optimal pre-run re

12、adiness.3.2.10 pre-runall aspects of assuring response readiness.3.2.11 quick checkan abbreviated version of the fullcheck, focusing on the major operational functions of thevehicle.4. Significance and Use4.1 This guide provides minimum guidelines for safe andefficient ambulance operation.4.2 All am

13、bulance operations and operators should followthis guide for the development of educational and trainingprograms.1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.02 onPersonnel, Training and Education.Curren

14、t edition approved Feb. 1, 2007. Published February 2007. Originallyapproved in 1994. Last previous edition approved in 2002 as F 1517 94(2002).2For referenced ASTM standards, visit the ASTM website, www.astm.org, orcontact ASTM Customer Service at serviceastm.org. For Annual Book of ASTMStandards v

15、olume information, refer to the standards Document Summary page onthe ASTM website.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.4.3 This guide is intended to promote safe and efficientambulance operations and to reduce morbidity,

16、mortality, andproperty loss associated with ambulance operations.4.4 This guide is intended to assist those who are respon-sible for the development and implementation of policies andprocedures for ambulance operations.5. Medical Fitness to Drive5.1 Because of the complex relationship of certain med

17、icaland mental impairments, a medical screening program shall beestablished by all EMS entities bestowing the privilege ofambulance driving.5.2 The authorization of ambulance drivers must always bebased on bona fide occupational qualifications (BFOQ) pursu-ant to the task of ambulance operation. The

18、 following consid-erations must be evaluated:5.2.1 Amedical exam of the applicant by a licensed M.D. orD.O. attesting that the history and physical reveals no evidenceof any medical or physical condition which would provedetrimental to operating an ambulance.5.2.2 Eye exam by a licensed ophthalmolog

19、ist/optometristto include:5.2.2.1 Visual acuity,5.2.2.2 Depth perception,5.2.2.3 Peripheral vision,5.2.2.4 Night blindness,5.2.2.5 Color blindness, and5.2.2.6 Amblyopia.5.2.3 An examination of the medical history of the indi-vidual, designed to identify drivers who may be impaired by:5.2.3.1 Loss of

20、 consciousness,5.2.3.2 Cardiovascular disease,5.2.3.3 Neurological/neurovascular disorder,5.2.3.4 Mental illness,5.2.3.5 Substance abuse/dependency,5.2.3.6 Insulin-dependent diabetes, and5.2.3.7 Rheumatic, arthritic, orthopedic, muscular, neuro-muscular, or vascular disease that interferes with the

21、ability tocontrol and operate a motor vehicle safely.5.2.4 The presence of a medical condition by itself may notconstitute an impaired operator, but shall identify an area forconsideration by the physician in making a determination ofthe medical fitness to operating an ambulance.6. Qualifications to

22、 Drive6.1 Authorization shall be based upon cognitive evaluationof the operator regarding laws, guidelines, and policies relatingto ambulance operation during emergency and non-emergencymodes.6.1.1 The provider shall have a policy that addresses opera-tor fatigue.6.2 An ambulance driving evaluation

23、by the provider cov-ering warning device operation, passing, intersection approachprecautions, turning, backing, and parking techniques duringemergency and non-emergency modes.6.3 A review of the state motor vehicle record for theprevious three years with specific attention to traffic convic-tions c

24、oncerning:6.3.1 Speed,6.3.2 Careless and imprudent driving,6.3.3 Driving under the influence of alcohol or other mind-altering substances, and6.3.4 Moving violations.6.4 A review of motor vehicle accidents for the previousfive years.6.5 The operator shall possess a valid motor vehicle opera-tors lic

25、ense, and any other certification required by state orlocal laws or regulations.7. Pre-Run7.1 The operator shall have knowledge of and shall complywith all applicable federal, state statues, local ordinances, andregulations.7.2 The operator shall have knowledge of the providerspolicies and procedure

26、s.7.3 The operator shall have knowledge of roads, highways,and the locations of and accesses to major public facilitieswithin the service area.7.4 The provider shall have a process by which the operatoris made aware of conditions that may affect traffic flow withinthe service area (street closures,

27、construction, special events,and so forth).7.5 The provider shall have a process by which the operatoris made aware of present or forecasted environmental condi-tions affecting traffic flow within the service area (ice, snow,rain, and so forth).7.6 Upon unit availability, the operator shall visually

28、 inspectthe ambulance, and document the inspection in accordancewith one of the methods as shown in Table 1. The vehicle shallbe inspected for the following:7.6.1 Apparent body or glass damage,7.6.2 Proper function of emergency lights:7.6.2.1 Beacons or strobe,7.6.2.2 Light bar,7.6.2.3 Tunnel lights

29、/flashers, and7.6.2.4 Other warning lights.7.6.3 Vehicle operating lights:7.6.3.1 Headlights (high/low),7.6.3.2 Emergency flashers,7.6.3.3 Parking/running lights,7.6.3.4 Interior and exterior turn signal,7.6.3.5 Brake lights,7.6.3.6 Back up lights,7.6.3.7 Flood or scene lights,7.6.3.8 Dome lights: c

30、ab and patient compartment, and7.6.3.9 Spotlights.7.6.4 Damage, wear, and pressure in tires,7.6.5 Damage, loose, or missing lugs on wheels,TABLE 1 Emergency Medical Services Ambulance MaintenanceGuidelines for Checklist CompletionRuns per Week Full Check, h Quick Check, h0 to 1 every 96 every 242 to

31、 3 every 72 every 244 to 7 every 48 every 248 to 50 every 24 every 1250 + every 24 every 8F 1517 94 (2007)27.6.6 Proper opening, closing, locking, and seals of entryand compartment doors,7.6.7 Fluid levels:7.6.7.1 Automatic transmission,7.6.7.2 Battery,7.6.7.3 Brakes,7.6.7.4 Engine oil,7.6.7.5 Engin

32、e coolant,7.6.7.6 Power steering, and7.6.7.7 Windshield washer.7.6.8 Fluid leakage on, around, or under the vehicle,7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel,heater, and other hoses,7.6.10 Wear, abraded, or cracked engine drive or accessorybelts,7.6.11 Cleanliness of exterior, c

33、rew cab, and patient com-partments,7.6.12 Wear, abrasion, and proper function of operator,passenger, and patient restraint,7.6.13 Indications and function of gages:7.6.13.1 Electrical charging system,7.6.13.2 Emergency brake,7.6.13.3 Fuel,7.6.13.4 Oil pressure,7.6.13.5 Tachometer, and7.6.13.6 Temper

34、ature.7.6.14 Wear, abrasion, and proper function of windshieldwipers,7.6.15 Proper function and aim of windshield washer,7.6.16 Proper function and clarity of two-way radio andother communication devices,7.6.17 Damage, stability, and adjustment of outside andinside mirrors,7.6.18 Proper function and

35、 clarity of emergency siren,public address, and other warning devices,7.6.19 Proper adjustment of all seats,7.6.20 Proper adjustment and function of steering wheel,7.6.21 Charged and properly stored fire extinguishers,7.6.22 Proper function of heating and air conditioningsystems,7.6.23 Proper invent

36、ory and condition of medical equip-ment and supplies, and7.6.24 Level and alignment of chassis.7.7 The quick check shall be constituted by:7.7.1 Visually checking for any fluid leakage on or aroundthe ambulance,7.7.2 Conducting vehicle warm-up,7.7.3 Checking fluid levels:7.7.3.1 Fuel,7.7.3.2 Engine

37、oil,7.7.3.3 Power steering,7.7.3.4 Water/coolant level,7.7.3.5 Brake fluid,7.7.3.6 Transmission fluid,7.7.3.7 Windshield washer fluid, and7.7.3.8 Battery water level.7.7.4 Wear and tension of belts,7.7.5 Wear and pressure of tires,7.7.6 Emergency lights,7.7.7 Function of lighting systems:7.7.7.1 Eme

38、rgency lights,7.7.7.2 Running lights,7.7.7.3 Vehicle exterior, and7.7.7.4 Vehicle interior.7.7.8 Proper function of horn and each siren position,7.7.9 Vehicle cleanliness, and7.7.10 Proper function of two-way radio and other commu-nications equipment.8. Operations8.1 Response Mode Management:8.1.1 T

39、he response mode of the ambulance shall be deter-mined by dispatch protocol based on dispatch determinants asapproved by the medical director. These determinants shall beconsistent with Practice F 1258.8.2 The operator shall, on the basis of known information,determine the best route to the scene an

40、d end destination.8.3 Before beginning the response, the operator shall con-duct a brief egress check consisting of the following:8.3.1 Vehicle doors are securely closed and latched,8.3.2 Vehicle hood is closed and securely latched,8.3.3 Vehicle shore line is disconnected,8.3.4 All equipment is secu

41、red,8.3.5 Egress door is open, and8.3.6 Patient stretcher is in place and secured.8.4 Operational Check Sequence:8.4.1 Ensure crew is on board and properly restrained,8.4.2 Adjust the operators seat,8.4.3 Adjust mirrors,8.4.4 Turn on battery(s),8.4.5 Start the engine,8.4.6 Review all gages,8.4.7 Adj

42、ust environmental controls consistent with appli-cable needs,8.4.8 Turn radio on and contact dispatch,8.4.9 Adjust the tilt wheel,8.4.10 Turn the headlights on,8.4.11 Activate the emergency warning lights (if appli-cable),8.4.12 Turn on power to siren/public address control system(if applicable),8.4

43、.13 Partially open the driver side window,8.4.14 Evaluate brake pedal resistance,8.4.15 Place the vehicle in gear,8.4.16 Activate the siren (if applicable), and8.4.17 Activate the turn signal (if applicable).8.5 Crew RolesThe operator/crew member is responsiblefor:8.5.1 Operating the ambulance in a

44、safe and efficient man-ner, exercising the highest degree of care,8.5.2 Safely passing other vehicles,8.5.3 Utilizing eye sweep,8.5.4 Maintaininga3to4-sfollowing distance, and8.5.5 Maintaining the vehicle at a speed that is safe forconditions.8.5.5.1 Under emergency response conditions the speedshal

45、l not exceed that which is safe for road or environmentalF 1517 94 (2007)3conditions; in no case shall the speed exceed ten miles per hourover the posted speed limit.8.5.5.2 Under non-emergency operations the operator shallcomply with all local and state traffic laws.8.5.6 Controlling the operation

46、of the appropriate audiblewarning device for the current traffic conditions.8.5.7 Utilizing the vehicle communication system,8.5.8 Applying policies and procedures in the driving of theambulance,8.5.9 Initiating a constant rate of acceleration,8.5.10 Using engine compression in stopping of the ambu-

47、lance,8.5.11 Maintaining smooth braking and cornering of theambulance,8.5.12 Assuring adequate stopping distance in traffic,8.5.12.1 The operator shall stop the ambulance in traffic sothe operator can see the bumper, both rear tires of the vehiclein front of the ambulance, and a minimum of five feet

48、 of theroad surface in front of the ambulance.8.5.13 Utilizing the 10-s lane change procedure,8.5.14 Maintaining a rear and side space cushion,8.5.15 Backing with a ground guide,8.5.15.1 The operator is responsible for the safe backing ofthe ambulance. The operator shall never begin to back theambul

49、ance before it has come to a complete stop. A personserving as a ground guide should be in place, eight to ten feetdirectly behind the left rear of the ambulance.Audio and visualcommunications should be established between the operatorand the ground guide.8.5.16 Understanding special transport procedures,8.5.17 Undertaking special safety precautions with multiplepersonnel in the patient compartment,8.5.18 Safely using and loading patient handling equipment,8.5.19 Utilizing other crew members in the operation of theambulance,8.5.20 Accepting constructive criticism fro