The National Fire Protection Association (NFPA), a nonprofit thathas created and promoted codes and standards related tofire prevention and public safety since 1896, has decidedfor the first time to develop design standards for ambulances. NFPA notified national EMS organizations past August that it was considering this project and invited feedback. Dozens of organizations and individuals submitted comments, and in November NFPA invited those who commented to submit applications and resumes to be considered for membership on the new NFPA Committee on Ambulances.
NFPA expects a 30-member committee (plus 30 alternates) to take three to four years to create the new standards. The federal government would use them instead of the federal KKK standard when purchasing ambulances. Absent other standards, ambulance manufacturers also have relied on the KKK standard when designing ambulances.
"The KKK standard is basically purchase specifications for the federal government," said Carl Peterson, anNFPA fire-division director. "John McDonald[automotive commodity specialist with the federal government], who is keeper of the KKK standard, basically said that if NFPA comes up with a standard, they will use that." He added that he hoped McDonald would participate on the new committee.
Although NFPA spokesperson Linda Fuller said most comments submitted to the NFPA were positive, the American Ambulance Association (AAA) cited three concerns:
First, the AAA wrote, "The NFPA is not the proper forum to develop consensus-based [ambulance] design standards"because fire-department and private-sector ambulance needs are not the same: fire-department-based services primarily use ambulances for scene response and emergency transports, but private services also use them for interfacility transport, including critical-care transports and neonatal transports.
Second, noting "the paucity of EMS safety research," the AAA said, "The NFPA should not commission a new ambulance design project until sufficient baseline safety data exists to compare ambulances built using a new design standard with ambulances built under the current standard."
And finally, the AAA expressed concerns that a new design standard would result in more expensive ambulances, just as services "are lengthening vehicle replacement cycles in response to the current economic downturn."
AAA Professional Standards and Research Committee Chair Ron Thackery, JD, American Medical Response's vice president for safety, risk management and fleet administration, said, "I think one issue that must be addressed concerns the differences in design and configuration of ambulances used primarily for transport as opposed to those used also for rescue or for carrying materials to hazardous materials scenes. I_m not sure one size will fit all. Also, regardless of who is buying the ambulance, fiscal issues will arise as well as environmental and efficiency concerns."
Mark Van Arnum, CEO of American Emergency Vehicles Inc., which builds ambulances for both fire departments and private services, said, "The NFPA is a very effective standards organization, and its 1991 fire truck standard is very good. But ambulances are used by a lot of different folks besides the fire service. Most fire services are using heavy-duty vehicles, which are great for them but not for private users. The fire service is less than half of the ambulance industry, so how do all these other users get this sorted out? This will all play out in the next two to four years and affect this industry significantly."
Kirk Johnson, director of fire and EMS sales for Braun Northwest Inc., another ambulance manufacturer, said, "The problem is, they're developing specifications wholly different from what the majority of the industry uses."
Johnson expressed concerns that the NFPA would create an ambulance standard that will require expensive changes to designs of the 5,500Ï6,000 ambulances built in the U.S. each year. "If they raise the cost too high, no one will be able to buy them," he said. "And when cities or counties go out for bid, they will require bidders to use NFPA standard vehicles, which will be more expensive."
Peterson said, "I hope the private sector will step forward and become part of the committee. There's fear of the unknown until they get involved, see what_s going on and understand the process." He noted that the NFPA requires standards committees to be balanced, with no more than one-third of members from any one interest group (e.g., users, manufacturers or engineers). "Everything the committee does is balloted and requires a two-third vote before it moves forward," he said.
NFPA staff will recommend a roster of committee members plus a chair for approval by the NFPA Standards Council, which meets in March. Peterson predicts the committee would hold its first meeting in May or June and meet two or three times a year after that. Much committeework is conducted online with committeemembers working on an NFPA Web site.
NFPA spokesperson Linda Fuller said NFPA committee meetings are open to observers and are held "all over the United States" out of fairness to committee members who must pay their own expenses to travel to meetings. "We advertise in NFPA news and on our Web site when the committee will meet and where it will be," she said. "The NFPA will also post the new committee's scope once that's been determined," she said.
To comment, go towww.nfpa.org/aboutthecodes/list_of_codes_and_standards.asp, search for each standard by number and then click on "Download the report on Proposals" under "Revision Cycle."
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