For about as long as there has been EMS in the United States, there has been the “Triple K” specifications for ambulances. The KKK-A-1822 specifications were first developed and published by the U.S. General Services Administration in the 1970s as the purchasing specifications for federal ambulances.
At that same time, block grants were in vogue as a means for distributing federal money to communities, and those block grants required that vehicle purchases must comply with federally approved specifications.
Very quickly, as things tended to happen in the early days of EMS, EMS agencies and local, state, and federal officials used the KKK-A-1822 for ambulance purchases under block grants as it was the only document available. And thus, KKK-A-1822 became the de facto ambulance standard in the United States.
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In recent years, two developments have prompted the search for a more applicable ambulance standard.
First was GSA’s decision that it would no longer continue to maintain the specifications that were originally focused solely on a vehicle purchasing decision. Although GSA has revised and routinely extended the KKK specifications over the past 40-plus years, it never had the technical expertise in house to keep up with the rapidly evolving ambulance.
Second, there’s the increasing number of patients and EMS providers that are being killed and injured in ambulance crashes each year.
Those mortality and morbidity numbers prompted the International Association of Fire Chiefs to begin working with the National Fire Protection Association in 2009 to develop a true standard for a safer ambulance. Their work culminated with the approval of NFPA 1917: Standard for Automotive Ambulances in August 2012.
What is NFPA 1917?
Developed with consideration of KKK-A-1822 and NFPA 1901: Standard for Automotive Fire Apparatus, NFPA 1917 defines the minimum requirements for the design, performance, and testing of new automotive ambulances.
The standard presents general requirements for ambulance design and performance, along with standalone chapters for ambulance components including chassis, patient compartment, low-voltage electrical systems and warning devices, and line voltage electrical systems. NFPA 1917 also specifies provisions for test methods.
Initially, this had to be viewed as a win for all parties involved. GSA would be relieved of its responsibility for maintaining a standard for which it was never fully intended and EMS providers and patients would get a safer ambulance. There were, as one would expect, other entities that did not have the same positive viewpoint initially.
NFPA was considered a good fit for developing the standard because of its long history of developing consensus or industry standards for the fire service. Non-fire EMS organizations, however, expressed fears that the fire service was taking over EMS and that the standard would require all ambulances to be painted red, have a water tank and be medium-duty ambulances.
Some of those same organizations expressed fears that they would not have a voice in the standard development, and that they could not afford the price of an ambulances meeting an NFPA standard. It is unclear how much more a 1917-compliant ambulance would cost.
Fears addressed
Many of those fears were assuaged when those non-fire EMS organizations saw NFPA’s technical committee makeup. It included representatives from these groups.
- National State Association of EMS Officials (9 percent).
- VFIS (3 percent).
- Emergency Vehicle Technicians Association (3 percent).
- International Association of Firefighters (12 percent).
- Association of Emergency Vehicle Manufacturers (30 percent).
- Research testing (9 percent).
- NIOSH (6 percent).
- Users (27 percent).
During 2012, the National Association of State EMS Officials wanted more of a voice in the development and approval of NFPA 1917. NFPA and NASEMSO collaborated to develop several meetings, hosted by NASEMSO, to inform and educate NASEMSO members about how the NFPA standard development process worked and on the details of NFPA 1917. IAFC and NFPA were both actively present in these meetings.
NFPA responded to this unprecedented interest by NASEMSO and its membership by establishing a task group to take a closer look at NFPA 1917.
The task group, which included individuals recommended by NASEMSO, met over the course of two days in January 2013 and out of those sessions came an extensive list of public comments that were sent on to NFPA. Most of those comments were accepted and will be incorporated into the second edition of NFPA 1917, scheduled for 2016.
The current edition of NFPA 1917 is the 2013 edition; the revision cycle for the 2016 edition will begin in mid-2015. GSA’s KKK-A-1822 will be sunset — that is, not be revised or renewed — that same year.
Ultimately, when EMS personnel board an ambulance, they deserve to arrive to their destination safely. When a patient enters an ambulance, we owe it to them to keep them safe. The adoption and publication of NFPA 1917 is a significant development in helping all EMS agencies to obtain ambulances that meet both of those objectives.
