1、Designation: F1517 94 (Reapproved 2007)F1517 14Standard Guide forScope of Performance of Emergency Medical ServicesAmbulance OperationsOperators1This standard is issued under the fixed designation F1517; the number immediately following the designation indicates the year oforiginal adoption or, in t
2、he case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon () indicates an editorial change since the last revision or reapproval.1. Scope1.1 This guide covers minimum standards for the performance of emergency medical services
3、 (EMS) ambulance operators,including: operator qualifications, pre-run operation, and post-run aspects.1.2 This guide shall promote the safe and efficient delivery of the ambulance, equipment, crew, passengers and patients, duringall phases of the delivery of EMS involving the ambulance; at all time
4、s exercising the highest degree of care for the safety of thepublic. This guide may be applied to other EMS vehicles that do not necessarily provide patient transport.1.3 This guide shall be used as the basis for training guides of the emergency medical services ambulance operator.1.4 The values sta
5、ted in SIinch-pound units are to be regarded as the standard. The SI units values given in parentheses are forinformation only. mathematical conversions to SI units that are provided for information only and are not considered standard.1.5 This standard does not purport to address all of the safety
6、concerns, if any, associated with its use. It is the responsibilityof the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatorylimitations prior to use.2. Referenced Documents2.1 ASTM Standards:2F1177 Terminology Relating to Emergenc
7、y Medical ServicesF1258 Practice for Emergency Medical Dispatch3. Terminology3.1 Definitions:3.1.1 The definitions given in Terminology F1177 are applicable to this guide.3.1.2 ambulanceambulance, nSee Terminology F1177.3.2 Definitions of Terms Specific to This Standard:3.2.1 ambulance operationsope
8、rations, nthe 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 for the safetyof the public.3.2.2 ambulance service providerprovider, nas outlined in this g
9、uide, a person, company, corporation or political entityresponsible for operation, maintenance, or policy making, or combination thereof, regarding emergency medical vehicleoperations.3.2.3 bona fide occupational qualification (BFOQ)(BFOQ), nthe skills and knowledge relevant to the performance of as
10、pecific task.3.2.4 departure checkcheck, nthe visual check of the vehicle and surrounding area ensuring that equipment and supplieshave been retrieved and properly stored and that all compartment doors are secured.3.2.5 egress checkthe visual check of the vehicle and surrounding area prior to operat
11、ing the ambulance.1 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 Feb. 1, 2007June 1, 2014. Published February 2007July 2014. Originally app
12、roved in 1994. Last previous edition approved in 20022007 asF1517 94F1517(2002). DOI: 10.1520/F1517-94R07. 94 (2007). DOI: 10.1520/F1517-14.2 For referencedASTM standards, visit theASTM website, www.astm.org, or contactASTM Customer Service at serviceastm.org. For Annual Book of ASTM Standardsvolume
13、 information, refer to the standards Document Summary page on the ASTM website.This document is not an ASTM standard and is intended only to provide the user of an ASTM standard an indication of what changes have been made to the previous version. Becauseit may not be technically possible to adequat
14、ely depict all changes accurately, ASTM recommends that users consult prior editions as appropriate. In all cases only the current versionof the standard as published by ASTM is to be considered the official document.Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken
15、, PA 19428-2959. United States13.2.5 emergency modemode, nas defined by individual state statuesstatutes that refer to emergency vehicles, equipment, andoperations.3.2.6 full checkcheck, na comprehensive and systematic evaluation of the ambulance at specified intervals, includingdocumentation of the
16、 inspection, any deficiencies found and their corrective actions.3.2.7 operatoroperator, na person who operates or assists with the operation of an ambulance.3.2.8 post-runpost-run, nthe managed return of the ambulance and operators to optimal pre-run readiness.3.2.9 pre-runpre-run, nall aspects of
17、assuring response readiness.3.2.10 quick checkcheck, nan abbreviated version of the full check, focusing on the major operational functions of thevehicle.4. Significance and Use4.1 This guide provides minimum guidelines for safe and efficient ambulance operation.4.2 All ambulance operations and oper
18、ators should follow this guide for the development of educational and training programs.4.3 This guide is intended to promote safe and efficient ambulance operations and to reduce morbidity, mortality, and propertyloss associated with ambulance operations.4.4 This guide is intended to assist those w
19、ho are responsible for the development and implementation of policies andprocedures for ambulance operations.5. Medical Fitness to Drive5.1 Because of the complex relationship of certain medical and mental impairments, a medical screening program shall beestablished by all EMS entities bestowing the
20、 privilege of ambulance driving.5.2 The authorization of ambulance drivers mustshall always be based on bona fide occupational qualifications (BFOQ)pursuant to the task of ambulance operation. The following considerations must shall be evaluated:5.2.1 A medical exam of the applicant by a licensed M.
21、D. or D.O. attesting that the history and physical reveals no evidenceof any medical or physical condition which would prove detrimental to operating an ambulance.ambulance,5.2.2 Eye exam by a licensed ophthalmologist/optometrist to include:5.2.2.1 Visual acuity,acuity;5.2.2.2 Depth perception,perce
22、ption;5.2.2.3 Peripheral vision,vision;5.2.2.4 Night blindness,blindness;5.2.2.5 Color blindness,blindness; and5.2.2.6 Amblyopia.5.2.3 An examination of the medical history of the individual, designed to identify drivers who may be impaired by:5.2.3.1 Loss of consciousness,consciousness;5.2.3.2 Card
23、iovascular disease,disease;5.2.3.3 Neurological/neurovascular disorder,disorder;5.2.3.4 Mental illness,illness;5.2.3.5 Substance abuse/dependency,abuse/dependency;5.2.3.6 Insulin-dependent diabetes,diabetes; and5.2.3.7 Rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease th
24、at interferes with the ability to controland operate a motor vehicle safely.5.2.4 The presence of a medical condition by itself may not constitute an impaired operator, but shall identify an area forconsideration by the physician in making a determination of the medical fitness to operating an ambul
25、ance.6. Qualifications to Drive6.1 Authorization shall be based upon cognitive evaluation of the operator regarding laws, guidelines, and policies relating toambulance operation during emergency and non-emergency modes.6.1.1 The provider shall have a policy that addresses operator fatigue.6.2 An amb
26、ulance driving evaluation by the provider covering warning device operation, passing, intersection approachprecautions, turning, backing, and parking techniques during emergency and non-emergency modes.6.3 A review of the state motor vehicle record for the previous three years with specific attentio
27、n to traffic convictionsconcerning:6.3.1 Speed,Speed;6.3.2 Careless and imprudent driving,driving;6.3.3 Driving under the influence of alcohol or other mind-altering substances,substances; andF1517 1426.3.4 Moving violations.6.4 A review of motor vehicle accidents for the previous five years.6.5 The
28、 operator shall possess a valid motor vehicle operatorsoperators license, and any other certification required by state orlocal laws or regulations.7. Pre-Run7.1 The operator shall have knowledge of and shall comply with all applicable federal, federal and state statues,statutes, localordinances, an
29、d regulations.7.2 The operator shall have knowledge of the providersproviders policies and procedures.7.3 The operator shall have knowledge of roads, highways, and the locations of and accesses to major public facilities withinthe service area.7.4 The provider shall have a process by which the opera
30、tor is made aware of conditions that may affect traffic flow within theservice area (street closures, construction, special events, and so forth). such as ice, snow, and rain.7.5 The provider shall have a process by which the operator is made aware of present or forecasted environmental conditionsaf
31、fecting traffic flow within the service area (ice, snow, rain, and so forth).forth) affecting traffic within the service area.7.6 Upon unit availability, the operator shall visually inspect the ambulance, and document the inspection in accordance withone of the methods as schedules shown in Table 1.
32、 The vehicle shall be inspected for the following:7.6.1 Apparent body or glass damage,damage;7.6.2 Proper function of emergency lights:lights;7.6.2.1 Beacons or strobe,strobe;7.6.2.2 Light bar,bar;7.6.2.3 Tunnel lights/flashers,lights/flashers; and7.6.2.4 Other warning lights.7.6.3 Vehicle operating
33、 lights:7.6.3.1 Headlights (high/low),(high/low);7.6.3.2 Emergency flashers,flashers;7.6.3.3 Parking/running lights,lights;7.6.3.4 Interior and exterior turn signal,signal;7.6.3.5 Brake lights,lights;7.6.3.6 Back up lights,lights;7.6.3.7 Flood or scene lights,lights;7.6.3.8 Dome lights: cab and pati
34、ent compartment,compartment; and7.6.3.9 Spotlights.7.6.4 Damage, wear, and pressure in tires,tires;7.6.5 Damage, loose, or missing lugs on wheels,wheels;7.6.6 Proper opening, closing, locking, and seals of entry and compartment doors,doors;7.6.7 Fluid levels:7.6.7.1 Automatic transmission,transmissi
35、on;7.6.7.2 Battery,Brakes;7.6.7.3 Brakes,7.6.7.3 Engine oil,oil;7.6.7.4 Engine coolant,coolant;7.6.7.5 Power steering,steering; and7.6.7.6 Windshield washer.7.6.8 Fluid leakage on, around, or under the vehicle, vehicle;7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel, heater, and other
36、 hoses,hoses;7.6.10 Wear, abraded, or cracked engine drive or accessory belts,belts;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 3 every 72 every 244 to 7 every 48 every 248 to 50 eve
37、ry 24 every 1250 + every 24 every 8F1517 1437.6.11 Cleanliness of exterior, crew cab, and patient compartments,compartments;7.6.12 Wear, abrasion, and proper function of operator, passenger, and patient restraint,restraint;7.6.13 Indications and function Function of gages:7.6.13.1 Electrical chargin
38、g system,system;7.6.13.2 Emergency brake,Indicator light;7.6.13.3 Fuel,Fuel;7.6.13.4 Oil pressure,pressure;7.6.13.5 Tachometer,Tachometer; and7.6.13.6 Temperature.7.6.14 Wear, abrasion, and proper function of windshield wipers,wipers;7.6.15 Proper function and aim of windshield washer,washer;7.6.16
39、Proper function and clarity of two-way radio and other communication devices,devices;7.6.17 Damage, stability, and adjustment of outside and inside mirrors,mirrors;7.6.18 Proper function and clarity of emergency siren, public address, and other warning devices,devices;7.6.19 Proper adjustment of all
40、 seats,seats;7.6.20 Proper adjustment and function of the steering wheel, wheel;7.6.21 Charged and properly stored fire extinguishers, extinguishers;7.6.22 Proper function of heating and air conditioning systems,systems;7.6.23 Proper inventory and condition of medical equipment and supplies,supplies
41、; 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 around the ambulance,ambulance;7.7.2 Conducting vehicle warm-up,warm-up;7.7.3 Checking fluid levels:7.7.3.1 Fuel,Fuel;7.7.3.2 Engine oil,oil;7.7.3.3 Power steeri
42、ng,steering;7.7.3.4 Water/coolant level,level;7.7.3.5 Brake fluid,fluid;7.7.3.6 Transmission fluid,fluid; and7.7.3.7 Windshield washer fluid, andfluid;7.7.3.8 Battery water level.7.7.4 Wear and tension of belts,belts;7.7.5 Wear and pressure of tires,tires;7.7.6 Emergency lights,lights;7.7.7 Function
43、 of lighting systems:7.7.7.1 Emergency lights,lights;7.7.7.2 Running lights,lights;7.7.7.3 Vehicle exterior,exterior; and7.7.7.4 Vehicle interior.7.7.8 Proper function of horn and each siren position, horn;7.7.9 Vehicle cleanliness,cleanliness; and7.7.10 Proper function of two-way radio and other co
44、mmunications equipment.8. Operations8.1 Response Mode Management:8.1.1 The response mode of the ambulance shall be determined by dispatch protocol based on dispatch determinants as approvedby the medical director. These determinants shall be consistent with Practice F1258.8.2 The operator shall, on
45、the basis of known information, determine the best route to the scene and end destination.8.2 Before beginning the response, the operator shall conduct a brief egress check consisting of the following:8.2.1 Vehicle doors are securely closed and latched, latched;8.2.2 Vehicle hood is closed and secur
46、ely latched,latched;8.2.3 Vehicle shore line is disconnected,disconnected;8.2.4 All equipment is secured,secured;8.2.5 Egress door is open,open; and8.2.6 Patient stretcher is in place and secured.8.3 Operational Check Sequence:F1517 1448.3.1 Ensure crew is on board and properly restrained, restraine
47、d;8.4.2 Adjust the operators seat,8.4.3 Adjust mirrors,8.3.2 Turn on battery(s),battery(s);8.3.3 Start the engine,engine;8.3.4 Review all gages,gages;8.3.5 Adjust environmental controls consistent with applicable needs,needs;8.3.6 Turn radio on and contact dispatch,dispatch;8.4.9 Adjust the tilt whe
48、el,8.3.7 Turn the headlights on,on;8.3.8 Activate the emergency warning lights (if applicable), applicable);8.3.9 Turn on power to siren/public address control system (if applicable),applicable);8.3.10 Partially open the driver side window,window;8.3.11 Evaluate brake pedal resistance,resistance;8.3
49、.12 Place the vehicle in gear,gear;8.3.13 Activate the siren (if applicable),applicable); and8.3.14 Activate the turn signal (if applicable).8.4 Crew RolesThe operator/crew member is responsible for:8.4.1 Operating the ambulance in a safe and efficient manner, exercising the highest degree of care,8.4.2 Safely passing other vehicles,vehicles;8.4.3 Utilizing eye sweep,sweep;8.4.4 Maintaining a 33- to 4-s following distance,distance; and8.4.5 Maintaining the vehicle at a speed that is safe for conditions.8.4.5.1 Under emergency response conditions t
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