ASTM F1705-1996(2007) Standard Guide for Training Emergency Medical Services Ambulance Operations《紧急医疗救护服务操作训练用标准指南》.pdf

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1、Designation: F 1705 96 (Reapproved 2007)Standard Guide forTraining Emergency Medical Services AmbulanceOperations1This standard is issued under the fixed designation F 1705; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revision, the year

2、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 provides minimum training standards forEmergency Medical Services (EMS) Ambulance Operatorsincluding le

3、gal 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, passenger

4、s and 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

5、used 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 he

6、alth practices 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 1230 Specification for Minimum Performance Require-ments for Emergency Medical Service (EMS) GroundVehicles3F

7、1258 Practice for Emergency Medical DispatchF 1517 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, seeTerminol

8、ogy 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 times exercising the highest degree of care for the safety

9、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 all three,regarding emergency medical vehicle operations.3.2.3 bona fide occupational qualification (BFOQ)theskills a

10、nd 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 compartmentdoors are secured.3.2.5 egress checkthe visual check of the vehicle

11、 andsurrounding 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

12、 of the inspection, deficiencies, and their correctiveactions.3.2.8 operatora person who operates or assists with theoperation of an ambulance.3.2.9 driverthe individual responsible for operating theambulance in a safe and efficient manner, exercising thehighest degree of care.3.2.10 technicianthe i

13、ndividual responsible for patientcare.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.Current edition approved Feb. 1, 2007. Published February 2007. Originallyapprove

14、d in 1996. Last previous edition approved in 2002 as F 1705 96(2002).2For referenced ASTM standards, visit the ASTM website, www.astm.org, orcontact ASTM Customer Service at serviceastm.org. For Annual Book of ASTMStandards volume information, refer to the standards Document Summary page onthe ASTM

15、website.3Withdrawn.4Available from U.S. Government Printing Office Superintendent of Documents,732 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.3.2.11 post-runthe managed re

16、turn 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 operational functions of thevehicle.3.2.14 reaction timefrom the time the operator identifiesthe h

17、azard 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 medical director.The determinants shall be consistent with Practice F 1258.3.2.16 stopping distanc

18、ethe 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 operations.4.2 Ambulance providers and educators should follow thisguide for the development of educationa

19、l 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 guide is intended to assist those who are respon-sible for the development and implementation of po

20、licies 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 Aspects5.1 The training of the ambulance operator shall include allfederal and state laws and local o

21、rdinances 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.5.1.1 Constitutional LawLaws derived from the U.S.Constitution governing the patients right befor

22、e, 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 RegulationsGuidelines enacted by anagency that have the force of law that are intended to providegreater specific

23、ity 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)/Omnibus Reconciliation Act (OBRA) Laws.5.2 Integration of state laws and local ordinances withcompany p

24、olicies/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)Ageneral principle, frequented in case law, that holds theambulance operator responsible for his actio

25、ns 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 ambulance operation.5.4.2 AbandonmentTerminating care or transportationprior to being relieved by other

26、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 Emergency Medical DispatchAn organized systemof emergency medical dispatching principles intended

27、to pro-vide guidelines for ambulance operations as delineated inPractice F 1258.5.4.4 Multiple Responding Units:5.4.4.1 Vehicle SeparationThe operator shall be trained tomaintain a minimum 300-ft buffer zone between the ambulanceand other emergency vehicles on the same route of travel.(1) Weather, t

28、raffic 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 involved in the use of emergency vehicle escorts andbe trained to avoid such practices.(1) The operat

29、or 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 consis-tent with operational guides delineated in Incident CommandSystem (ICS).5.4.5.2 Communicatio

30、nAmbulance 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 safety agencies in order to providea safe and adequate response.5.4.6 Motor Vehicle Accidents Invol

31、ving 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, localordinances, rules or regulations, and organizational policiesand procedures.5.4.7 Mitigation/Documentatio

32、n Mechanical Failures:5.4.7.1 Scheduled MaintenanceThe ambulance operatorshall be trained in the importance of a scheduled maintenanceprogram.TABLE 1 Emergency Medical Services Ambulance MaintenanceGuidelines for Checklist CompletionRuns per week (pervehicle)Full check Quick check0 to 1 every 96 h e

33、very 24 h2 to 3 every 72 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 hF 1705 96 (2007)25.4.7.2 Vehicle and Equipment InspectionsThe ambu-lance operator shall be trained in the fundamentals andapplication of vehicle and equipment inspections.5.4.7.3 Rep

34、orting of DeficienciesThe ambulance operatorshall understand the importance of inspecting the ambulanceand equipment, and shall be familiar with the reportingprocedures utilized by the provider. The ambulance operatorshall be familiar with provider policies in regard to majordeficiencies which have

35、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 inscreening the operator candidate:6.1.1 Medical Fitness to DriveOperators shall be subjectto periodi

36、c 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 her duty as an operator ofemergency vehicles. (See Guide F 1517.)6.2 Authorization:6.2.1 The auth

37、orization 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 the operator regarding laws, guidelines, and policiesrelating to ambulance operation during emer

38、gency 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 Careless and imprudent driving.6.3.3 Driving under the influence of alcohol or other mind-altering su

39、bstances.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 valid motor vehicle license,and any other certification required by state or local laws orregulatio

40、ns.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 which may be utilized inscreening the operator candidate:7.1.1 Psychological testing.7.1.2 Physica

41、l 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 Evolution of ambulance driving from high-force pur-suit driving to low G-force driving technique

42、s.8.1.2 Changes in vehicle design and dynamics.8.1.3 Evolution of governmental regulation.8.1.3.1 Specification F 1230, Minimum Performance Re-quirements for Emergency Medical Service Ground Vehicles.8.1.3.2 Federal standards KKK 1822C: “A” through currentspecifications.9. Vehicular Types and Equipm

43、ent9.1 The training of the ambulance operator shall include thedifferent ambulance classifications (Type I, II, III, and specialtyresponse vehicles) including maneuverability, handling, weightdistribution, payload allowance, and GVWR.10. Loss Control and Safety Issues in the Operations ofAmbulances1

44、0.1 Preventive MaintenanceThe ambulance operatorshall be trained in basic techniques, documentation, andrationale for preventive maintenance.10.1.1 The operator should follow provider policies ormanufacturers suggested maintenance schedule, or both, forthe ambulance.10.2 Operator FatigueThe ambulanc

45、e 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-tion.10.3 Interactive Crew RolesOperators shall receive in-struction on the importance of intera

46、ctive 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 Thought PatternsThe operator shall be madeaware of the importance of concentration on the dri

47、ving 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 trained tomake determinations regarding the safe operation of theambulance. The operator shall

48、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 proper operation, storage, andhandling of all equipment used in the treatment and transport ofth

49、e 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.11. Vehicular Dynamics11.1 Low Force DrivingThe operator shall be trained toutilize low-force driving techniques in order to minimizefatigue, stress, mechanical degradation, and other risks associ-ate