1、Designation: F1705 96 (Reapproved 2012)Standard Guide forTraining Emergency Medical Services AmbulanceOperations1This standard is issued under the fixed designation F1705; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revision, the year of
2、 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 provides minimum training standards forEmergency Medical Services (EMS) Ambulance Operatorsincluding legal
3、 aspects, operator qualifications and testing,history of EMS vehicle operations, vehicle types/equipment,safety, physical forces, mechanics, pre-run, operations, post-run, and special circumstances.1.2 This guide promotes the safe and efficient delivery ofthe ambulance, equipment, crew, passengers a
4、nd patients,during all phases of the delivery of EMS involving theambulance; at all times exercising the highest degree of carefor the safety of the public. This guide may be applied to thedriving of other EMS vehicles that do not necessarily providepatient transportation.1.3 This guide shall be use
5、d as the basis for all programsrelevant to the training of the emergency medical servicesoperators.1.4 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 healt
6、h practices and determine the applica-bility of regulatory limitations prior to use.2. Referenced Documents2.1 ASTM Standards:2F1177 Terminology Relating to Emergency Medical Ser-vicesF1230 Specification for Minimum Performance Require-ments for Emergency Medical Service (Ems) GroundVehicles3F1258 P
7、ractice for Emergency Medical DispatchF1517 Guide for Scope of Performance of EmergencyMedical Services Ambulance Operations2.2 Federal Specification:4KKK 1822C Federal Specification for the Star-of-Life Am-bulance3. Terminology3.1 For definitions of other emergency medical terms, seeTerminology F11
8、77:3.2 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 times exercising the highest degree of care for the safety ofthe pu
9、blic.3.2.2 ambulance service provideras outlined in this guide,a person, company, corporation, or political entity responsiblefor operation, maintenance, or policy-making, or all three,regarding emergency medical vehicle operations.3.2.3 bona fide occupational qualification (BFOQ)theskills and knowl
10、edge 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 compartmentdoors are secured.3.2.5 egress checkthe visual check of the vehicle andsurr
11、ounding area prior to operating the ambulance.3.2.6 emergency modeas defined by individual state stat-utes that refer to emergency vehicles, equipment, and opera-tions.3.2.7 full checka comprehensive and systematic evalua-tion of the ambulance at specified intervals, including docu-mentation of the
12、inspection, deficiencies, and their correctiveactions.3.2.8 operatora person who operates or assists with theoperation of an ambulance.1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.02 onPersonnel, Trainin
13、g and Education.Current edition approved July 1, 2012. Published August 2012. Originallyapproved in 1996. Last previous edition approved in 2007 as F1705 96 (2007).DOI: 10.1520/F1705-96R12.2For referenced ASTM standards, visit the ASTM website, www.astm.org, orcontact ASTM Customer Service at servic
14、eastm.org. For Annual Book of ASTMStandards volume information, refer to the standards Document Summary page onthe ASTM website.3Withdrawn. The last approved version of this historical standard is referencedon www.astm.org.4Available from U.S. Government Printing Office Superintendent of Documents,7
15、32 N. Capitol St., NW, Mail Stop: SDE, Washington, DC 20401.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.3.2.9 driverthe individual responsible for operating theambulance in a safe and efficient manner, exercising thehighest degre
16、e of care.3.2.10 technicianthe individual responsible for patientcare.3.2.11 post-runthe managed return of the ambulance andoperators to optimal pre-run readiness.3.2.12 pre-runall aspects of assuring response readiness.3.2.13 quick checkan abbreviated version of the fullcheck, focusing on the major
17、 operational functions of thevehicle.3.2.14 reaction timefrom the time the operator identifiesthe hazard until the appropriate action is taken.3.2.15 response mode managementthe response mode ofthe ambulance shall be determined by dispatch protocols basedon (dispatch) determinants as approved by the
18、 medical director.The determinants shall be consistent with Practice F1258.3.2.16 stopping distancethe distance the vehicle travelsuntil it comes to a stop after the brakes are applied.4. Significance and Use4.1 This guide provides minimum training guidelines forsafe and efficient ambulance operatio
19、ns.4.2 Ambulance providers and educators should follow thisguide for the development of educational and training pro-grams.4.3 This guide is intended to promote safe and efficientambulance operations and to reduce morbidity, mortality, andproperty loss associated with ambulance operations.4.4 This g
20、uide is intended to assist those who are respon-sible for the development and implementation of policies andprocedures for ambulance operations.4.5 Topics or concepts listed in this guide are intended toserve as an outline of materials to be covered in the training ofambulance operators.5. Legal Asp
21、ects5.1 The training of the ambulance operator shall include allfederal and state laws and local ordinances including theproviders policies governing emergency medical vehicle op-erations. The operator/driver shall have a clear understandingof the impact of those laws on the operation of the vehicle
22、.5.1.1 Constitutional LawLaws derived from the U.S.Constitution governing the patients right before, during, andafter transport.5.1.2 Statutory LawLaws derived from legislative acts.5.1.3 OrdinancesLaws or guidelines enacted by a govern-ing municipal body or its agent.5.1.4 Rules and RegulationsGuid
23、elines enacted by anagency that have the force of law that are intended to providegreater specificity about statutory laws.5.1.5 Case LawJudicial interpretation of statutory law,rules, or regulations that have been decided in a court of law.5.1.6 Consolidated Omnibus Reconciliation Act (COBRA)/Omnib
24、us Reconciliation Act (OBRA) Laws.5.2 Integration of state laws and local ordinances withcompany policies/procedures. Company policy should incor-porate into guidelines the principles of applicable state laws,local ordinances, rules, and regulations.5.3 Highest Degree of Care (Law of Due Regard)Agen
25、eral principle, frequented in case law, that holds theambulance operator responsible for his actions regardless ofperceived exemptions from traffic laws governing the emer-gency vehicle operator.5.4 Legal Issues:5.4.1 NegligenceAny action that violates a standard ofpractice or care related to ambula
26、nce operation.5.4.2 AbandonmentTerminating care or transportationprior to being relieved by other qualified health care providers.Once a patient provider relationship is established, it mustcontinue until responsibility for the patient is assumed by aprovider of equal or higher qualifications.5.4.3
27、Emergency Medical DispatchAn organized systemof emergency medical dispatching principles intended to pro-vide guidelines for ambulance operations as delineated inPractice F1258.5.4.4 Multiple Responding Units:5.4.4.1 Vehicle SeparationThe operator shall be trained tomaintain a minimum 300-ft buffer
28、zone between the ambulanceand other emergency vehicles on the same route of travel.(1) Weather, traffic conditions, or other factors may causethe operator to increase the length of the buffer zone for thesafe operation of the ambulance.5.4.4.2 EscortsThe operator shall be informed of thehazards invo
29、lved in the use of emergency vehicle escorts andbe trained to avoid such practices.(1) The operator shall be trained to discourage private,non-emergency vehicles from following the ambulance duringtransport.5.4.5 Interacting with Public Safety Agencies:5.4.5.1 CommandAmbulance operations shall be co
30、nsis-tent with operational guides delineated in Incident CommandSystem (ICS).5.4.5.2 CommunicationAmbulance communication sys-tems should allow the ambulance operator to communicatewith other public safety agencies.5.4.5.3 CoordinationCooperative guidelines shall be es-tablished with other public sa
31、fety agencies in order to providea safe and adequate response.5.4.6 Motor Vehicle Accidents Involving the Ambulance:5.4.6.1 ReportingThe ambulance operator shall receiveinstructions regarding reporting guidelines for ambulance re-lated accidents/incidents in accordance with state laws, localordinanc
32、es, rules or regulations, and organizational policiesand procedures.5.4.7 Mitigation/Documentation Mechanical Failures:TABLE 1 Emergency Medical Services Ambulance MaintenanceGuidelines for Checklist CompletionRuns per week (pervehicle)Full check Quick check0 to 1 every 96 h every 24 h2 to 3 every 7
33、2 h every 24 h4 to 7 every 48 h every 24 h8 to 50 every 24 h every 12 h50+ every 24 h every 8 hF1705 96 (2012)25.4.7.1 Scheduled MaintenanceThe ambulance operatorshall be trained in the importance of a scheduled maintenanceprogram.5.4.7.2 Vehicle and Equipment InspectionsThe ambu-lance operator shal
34、l be trained in the fundamentals andapplication of vehicle and equipment inspections.5.4.7.3 Reporting of DeficienciesThe ambulance operatorshall understand the importance of inspecting the ambulanceand equipment, and shall be familiar with the reportingprocedures utilized by the provider. The ambul
35、ance operatorshall be familiar with provider policies in regard to majordeficiencies which have an affect on the serviceability of thevehicle.6. Operator Qualifications to Drive6.1 The training of the ambulance operator shall include thecomponents of evaluation techniques which may be utilized inscr
36、eening the operator candidate:6.1.1 Medical Fitness to DriveOperators shall be subjectto periodic medical evaluations as determined by the ambu-lance service provider. The purpose of the physical examina-tion is to determine whether the operator has the physicalability to adequately perform his or h
37、er duty as an operator ofemergency vehicles. (See Guide F1517.)6.2 Authorization:6.2.1 The authorization of ambulance operators must bebased on Bona Fide Occupational Qualification (BFOQ) pur-suant to the task of ambulance operations.6.2.2 Authorization shall be based upon cognitive evalua-tion of t
38、he operator regarding laws, guidelines, and policiesrelating to ambulance operation during emergency and non-emergency modes.6.3 A periodic review of the operators state motor vehiclerecord for the previous three years with specific attention totraffic convictions concerning:6.3.1 Speed.6.3.2 Carele
39、ss and imprudent driving.6.3.3 Driving under the influence of alcohol or other mind-altering substances.6.3.4 Moving violations/other violations.6.3.5 Suspension of drivers license.6.4 A review of the operators motor vehicle accidents forthe previous three years.6.5 The operator shall possess a vali
40、d motor vehicle license,and any other certification required by state or local laws orregulations.6.6 The operators qualifications and continuing educationshall be reviewed annually.7. Operator Testing7.1 The training of the ambulance operator shall include thecomponents of evaluation techniques whi
41、ch may be utilized inscreening the operator candidate:7.1.1 Psychological testing.7.1.2 Physical agility.7.1.3 Driving evaluation.7.1.4 Cognitive evaluation.8. History of EMS Vehicle Operation8.1 The training of the emergency vehicle operator shallinclude the history of EMS vehicle operation:8.1.1 E
42、volution of ambulance driving from high-force pur-suit driving to low G-force driving techniques.8.1.2 Changes in vehicle design and dynamics.8.1.3 Evolution of governmental regulation.8.1.3.1 Specification F1230, Minimum Performance Re-quirements for Emergency Medical Service Ground Vehicles.8.1.3.
43、2 Federal standards KKK 1822C: “A” through currentspecifications.9. Vehicular Types and Equipment9.1 The training of the ambulance operator shall include thedifferent ambulance classifications (Type I, II, III, and specialtyresponse vehicles) including maneuverability, handling, weightdistribution,
44、payload allowance, and GVWR.10. Loss Control and Safety Issues in the Operations ofAmbulances10.1 Preventive MaintenanceThe ambulance operatorshall be trained in basic techniques, documentation, andrationale for preventive maintenance.10.1.1 The operator should follow provider policies ormanufacture
45、rs suggested maintenance schedule, or both, forthe ambulance.10.2 Operator FatigueThe ambulance operator shall betrained in the recognition of the adverse affects of excessivefatigue. The provider/operator shall be familiar with methodsand policies used to prevent fatigue-related operator dysfunc-ti
46、on.10.3 Interactive Crew RolesOperators shall receive in-struction on the importance of interactive roles utilized tolessen risk exposure, such as the ground guide/driver relation-ship in backing the ambulance or the driver/technician rela-tionship in approaching controlled intersections.10.4 Unsafe
47、 Thought PatternsThe operator shall be madeaware of the importance of concentration on the driving task athand and should be aware of dangerous practices such asallowing the nature of the emergency to affect driving tech-niques or other high-risk behavior.10.5 Resolving ConflictThe driver shall be t
48、rained tomake determinations regarding the safe operation of theambulance. The operator shall be aware that the senior medicalcrew member shall make determinations regarding transporta-tion mode and patient destination.10.6 Patient Handling EquipmentThe ambulance opera-tor shall be trained in the pr
49、oper operation, storage, andhandling of all equipment used in the treatment and transport ofthe patient.10.7 OSHA GuidelinesThe operator/provider shall betrained in the utilization of OSHA guidelines pertaining tofactors affecting the operation of the emergency vehicle.10.8 Hazmat GuidelinesThe operator shall be trained toadhere to the regulations and guidelines regarding ambulanceoperations near a hazardous material environment.F1705 96 (2012)311. Vehicular Dynamics11.1 Low Force DrivingThe operator shall be trained toutilize low
