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The Committee, following the usual NFPA format, will ultimately consist of 30 members divided evenly into 10 representatives from manufacturers, 10 from users, and 10 from regulators. The operant words, "open" and "fair" define the NFPA process (http://www.nfpa.org/). What happened at the first meeting? Well, imagine a couple dozen folks from the previously mentioned groups sitting in a room together - any room, anywhere. You could cut the tension with a knife, err - make that a chainsaw. So there were a few presentations: ambulance crash data (or lack thereof), history of federal government ambulance specifications, development process of the NFPA 1901 standard, resources available from NFPA, and the standards development process. Lunchtime.
First problem: define ambulance. Couldn't do it. Created a subcommittee. Next question: what's out there already? Probably the most popular are the federal KKK-A-1822 standard and the National Truck Equipment Association (NTEA) Ambulance Manufacturers Division (AMD) standard (2007 version). Why reinvent the wheel? Another subcommittee. Merge KKK and AMD with the NFPA 1901 format and let's see where the cards lie.
Not a bad start. In fact, the initial nervousness that some cockamamie standard was sure to be concocted that would blow the socks off the EMS world quite obviously was not on any member's radar. Phew! People actually seemed to leave reassured that consensus is within reach, maybe more within reach than it was for writing fire apparatus design standards. There were common goals amongst the players and now a sense of purpose that will lend itself to a deliberate path. The two subcommittees will report by the end of August, probably on a phone conference. Then the real work will begin. Timeline? Anyone's guess. Don't hold your breath. You'll be cyanotic.
Mike McEvoy
EMS Editor
Fire Engineering magazine
(and NFPA Ambulance Committee member)
Labels: ambulance, EMS, Mike McEvoy, NFPA, standard
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posted by Mike McEvoy
6/17/2009 11:04:00 PM
Investigation of the 2009 influenza A (H1N1) virus, although genetically linked to pigs, has not been found in swine. Pigs do not appear to be involved in the ongoing spread of infections. In an effort to leave the poor pigs alone, the World Health Organization asked that we replace the term “swine flu” with H1N1 influenza A. Hopefully, Egypt got the memo. Joe “shoot from the lips” Biden certainly got a memo from his boss, President Obama, as the White House went into damage control mode. And the Dallas ED doc has no doubt been deluged by calls from his more sensible colleagues. A Harvard School of Public Health study reveals the extent of the panic: full 46% of Americans believe they or someone in their family will get sick from the H1N1 flu within the next 12 months!
Here’s what you need to do to step up to the plate and put the smack down on swine flu idiocy. The public wants answers. Fire/EMS providers want information. Information overload and panicked messages abound. Firstly, you need three sources of information: the Centers for Disease Control (CDC), the World Health Organization (WHO), and your state and local information filtered through your department or service. The CDC set up a nifty minute-to-minute update site at www.cdc.gov/h1n1flu/whatsnew.htm. Scope it out. Everything you need to know is right there; if you want email updates, RSS feeds, or a Twitter follow, that’s there too. The WHO is not so sophisticated, but offers a wealth of information at www.who.int. Local info should be all this and more, but whoa: no need for overload! Your department (pay attention Chiefs) must keep you up to date on your state and local activities and get it to you before the newspaper or CNN. Local info must be filtered – you don’t care how tissue specimens need to be submitted for pathology evaluation nor do you give a hoot about precautions hospitals are taking when caring for suspected flu patients. Your department must give you manageable, filtered, understandable, and timely information needed to do your job and answer questions from your family and the public.
New York State loves paper, memos and advisories. Their Health Department wasn’t too happy with me when I passed their flu advisories on to my Fire/EMS services with commentary that they contained nothing of value to EMS. Guess what? State EMS folks quickly caught on and have themselves started qualifying transmittals with a listing of the salient points specific to EMS. That’s what I need, what you need, and what we all need in a time when our mailboxes are totally overloaded.
Here are some things the public wants to know. Firstly, “how do I know if I have the flu?” Most influenza infections share common characteristics: high fever, chills, myalgias (body aches), headache, non-productive cough, sore throat, and runny nose. The hallmark differentiating flu from other viral illnesses (such as the common cold) is rapid onset. Common cold virus symptoms begin gradually and tend to worsen over time. Influenza symptoms often begin abruptly, causing a perfectly well person to instantly become extremely ill. Fevers typically exceed 101°F; such body temperatures are quite disabling. Influenza A H1N1 infections have included all these typical flu symptoms and, in a small number of patients, vomiting and diarrhea as well.
Secondly, “what is the flu and how do I get it?” All influenza variants are respiratory viruses. They are transmitted through contact with respiratory secretions from an infected person who is coughing or sneezing. The incubation period ranges from 1 to 5 days between exposure and onset of symptoms; most average 2 days. Viral illnesses are communicable for a maximum of 1 to 2 days before symptoms appear and from 4 to 5 days afterwards. The greatest period of communicability correlates with fever. As a public health tool, 7 days is considered the maximum period during which symptoms would appear following an exposure. For reasons not well understood, children can remain communicable for much longer periods of time.
Thirdly, “how close is too close?” Respiratory secretions are large droplets; they don’t travel very far. The “hot zone” around an infected person is considered to be less than 6 feet. Beyond that, even a forceful cough or sneeze would be highly unlikely to land droplets on another person. Placing a simple surgical mask or oxygen mask over an infected person reduces the “hot zone” to inches. When a patient is masked and health care providers also wear N-95 or better respirator masks, human-to-human spread becomes virtually impossible. There is little evidence that wearing surgical masks in the community will reduce spread of infection but, if it makes the public feel safer, the practice should not be discouraged. At the very least, an asymptomatic infected person (who is potentially communicable) wearing a mask in public significantly reduces their likelihood for infecting others. Airplanes, trains, public transportation, and places of mass assembly are no more dangerous right now that they have been during the past six month flu season. Sure, there is a risk of someone coughing or sneezing on you. The greater risk, however, lie with what or who you touch and whether you remember to wash your hands.
Fourth, “how long can flu virus live on surfaces?” Good question. Respiratory droplets can land virtually anywhere. Doorknobs, telephones, computer keyboards, steering wheels, faucets, dishes…the list is endless. Environmental temperature and humidity strongly affect virus survival; in fact, flu season begins and ends when weather conditions change. As a guideline, influenza viruses will survive on hard non-porous surfaces such as steel and plastic for 24 to 48 hours and cloth, paper, or tissue for 8 to 12 hours. Once picked up on your hands, viruses last for 5 to 15 minutes although within this time period, all it takes is touching your face, mouth, eyes, or nose to transfer the virus into your respiratory tract to produce infection. Two rules are obvious: wash your hands often and keep your hands away from your face.
Fifth, “what should I do if I think I have the flu?” It depends on how sick you are. Despite media accounts, the H1N1 influenza has typically produced only mild illness. If illness is severe, or an infected person has other medical problems, antiviral medications may be helpful to reduce the severity and duration of the illness but only if started within 48 hours of when symptoms began. The best advice is to stay at home so you don’t infect others, call your health care provider, rest, drink plenty of liquids, and use the same cold and fever remedies you ordinarily use. The flu season has not yet ended in the United States; many people worried they had contracted the H1N1 flu have either not had influenza at all or had a seasonal variant of the flu. Many of these illnesses could have been prevented by seasonal flu vaccination. Take the opportunity to remind friends, family, and the public of this. Influenza is a serious illness. Over 200,000 Americans are hospitalized and 36,000 die each year from the flu. WHO estimates there are over 500 million cases worldwide, killing over 250,000 people annually. So who are we testing for the H1N1 flu? People who show signs of febrile respiratory illness and have traveled to or had contact in the past 7 days with people who have either traveled to Mexico, been infected with the H1N1 flu, or live in a community where there have been cases of H1N1 infection. And is the treatment any different for H1N1 flu versus seasonal flu? Nope, not at all.
Sixth, “is there a vaccine?” Not yet. The CDC announced that they had identified the 2009 influenza A (H1N1) virus on May 2nd, 2009 and will begin development of a vaccine. With current technology, this will not be ready for several months, hopefully in time for next year’s flu season. Keep in mind that a variant of H1N1 is included every year in the seasonal flu vaccine and this may possibly provide some immunity to the new virus.
Lastly, “is it safe to eat pork?” Yes; pigs do not carry the H1N1 influenza A, people do. Don’t eat people.
Let’s keep this outbreak in perspective. As all hazard responders to the emergency needs of our communities, we must prepare for the worst. We are not certain what direction the H1N1 flu will take. But the facts are being grossly blown out of proportion. The US city with the largest number of H1N1 cases is New York. Despite 8 million New Yorkers living and working in close quarters, the infection has failed to spread beyond the Queens high school students originally infected in Mexico. New Yorkers ride subways, buses, trains, and crowded elevators every day.
The public looks to firefighters and EMS providers in times of crisis. There are plenty of swine flu idiots out there. Panic serves no one. Let’s help calm the hysteria by offering common sense, practical help to each other and our communities. It’s what we do best.
Mike McEvoy
EMS Editor
Fire Engineering Magazine
Labels: CDC, EMS, H1N1, infection, Mike McEvoy, pandemic, swine flu
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posted by Mike McEvoy
5/03/2009 12:19:00 PM
Fire Service Leaders
- Immediately notify all members and staff of the emerging problem.
- Review your plans using the CDC EMS Pandemic Preparedness checklist.
- Set up an email list and web site to provide continual updates and info for your members.
- Monitor news reports and government resources. Communicate with your local public health officials. Use the CDC minute-to-minute swine flu update site.
Communications Center/Dispatch Leaders
- Implement severe respiratory infection (SRI) screening for all callers with chest pain, difficulty breathing, headache, or general illness (sick person). If using the Medical Priority Dispatch System (MPDS), activate the SRI drop down on ProQA or add the following questions to paper card numbers 6, 10, 18, and 26 for further interrogation: (a) has the patient recently been in Mexico (or other outbreak location) or exposed to anyone who has (paying particular attention to those who stayed for 7 days or longer)? (b) are they febrile or have a fever and, if so, is it higher than 101 F (38 C) and (c) do they have a cough or other respiratory illness symptoms?
- Relay responses to these questions to EMS units before they arrive on scene.
Firefighters and EMS Providers
- Request additional information from dispatch when sent to respiratory, sick person and fever related calls if limited initial dispatch information is provided.
- Perform initial interview of all patients from at least 2 meters (6.5 feet) away to determine if personal protective equipment precautions are necessary.
- Place a mask on all patients with suspected influenza symptoms before approach. Use a surgical mask or non-rebreather mask (when oxygen is required).
- Avoid droplet producing procedures whenever possible including nebulizers, bag-valve-mask, suctioning or intubation. If bag-valve-masks are needed, use BVMs with HEPA filters whenever possible.
- Recommended PPE for taking care of ill/potentially infected patients includes: gloves and N95 or better respirators. PPE should be donned and doffed according to published guidelines to prevent cross contamination, including faceshield/eye and gown protection when splash or airborne contamination is possible.
- Alert receiving hospital personnel of the possibility of an infectious patient as soon as possible and hold suspected infectious patients in the ambulance until their destination in the hospital is known, rather than immediately moving them into the emergency department.
- Perform a thorough cleaning of the stretcher and all equipment that has come in contact with or been within 2 meters (6.5 feet) with an approved disinfectant, upon completion of the call following CDC interim guidelines for cleaning EMS transport vehicles.
Remember that this is a continually evolving situation. The most severe flu cases so far have been mostly adults from ages 25 to 45, but patients of all ages have been infected, so the same precautions should be used for all patients. We need to stay on heightened alert until this threat has been controlled. As with all infectious diseases, always remember that hand washing is the number one way to decrease transmission!
Mike McEvoy - EMS Editor - Fire Engineering
Labels: CDC, EMS, Mike McEvoy, pandemic, swine flu
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posted by Mike McEvoy
4/27/2009 09:32:00 AM
3 Comments:
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badge1 said...
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If the swine flu turns into a pandemic there are some other considerations that command staff should consider now. In a pandemic, you can count on 1/3 of the workforce being affected. Man power problems being what they are will be strained even worse. Make some contingencies now.
- Wed Apr 29, 09:20:00 AM EDT
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MusicKat said...
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Just one little, though important addition to prevent cross infection - if you want to be really careful: when washing hands turn on faucet with a paper towel which you throw away before soaping up, wash well, scrubbing cuticles and under nails,between each finger, around wrist - and rinsing well with moderately hot water is equally important.If you are washing hands in a public rest facility,THEN DRY YOUR HANDS WELL WITHOUT TURNING THE FAUCET OFF. WHEN THEY ARE DRY, THEN TURN OFF THE FAUCETS WITH NEW TRIPLE LAYERED PAPER TOWEL AND THE SAME WHEN LEAVING ON THE DOORKNOBS. Otherwise, whatever was on the doorknobs is now back on your hands when leaving and all that washing you did was pointless. This is important regardless of pandemics, epidemics or if you simply don't want to catch a common cold or touch other people's heiny germs (believe it or not, not everyone washes after going to the bathroom). Oh, and if you have to crank to get paper towels out of the dispenser, make sure you crank and leave it hanging BEFORE you wash hands so as not to touch the crank handle after you've washed.
- Wed Apr 29, 10:03:00 AM EDT
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raym54 said...
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If we are to transport patient exhibiting H1N1 or similar pandemic symptoms we better ISOLATE those patients in the ambulance in order to protect ALL our assets ,1st Responders , ambulance and the hospital.95 masks etc are stopgap devices.PPE must be employed for personnel and equipment.
- Wed Jun 24, 11:20:00 AM EDT
The formula for a pandemic requires 3 things: a novel virus to which all or most people are susceptible, transmissability from person to person, and wide geographic spread. So far, we have a novel virus that appears most people are susceptible to. There has been person-to-person transmission. Wide geographic spread has yet to happen. Essentially, we are (overnight, no less) one step closer to a pandemic than the bird flu. Preliminary CDC incubation period estimates are 1 to 7 days. This is expected to be narrowed to 2 to 5 days with further data. That means we will likely see a pandemic or not within a very short time.
What to do? First, don't panic. Second, wash your hands. Often. Third, take an inventory of where you and your department stand. The CDC Pandemic Influenza EMS Planning Checklist has been available for over 3 years. Review the checklist and make sure you have adequate stockpiles of PPE including N-95 masks and hand hygiene gels. You will not be able to purchase or order them during a pandemic. Check availability of antivirals for your members. Review your sick leave and staffing contingency plans. Assure you have current contacts with public health, government, and hospital officials. Be certain your 911 center can handle calls when no EMS services or hospital beds are available. By now, all these matters should be in place. Make certain they are.
Watch the CDC (www.cdc.gov) and the WHO (www.who.int) for updates and notices. Hopefully, this outbreak remains simply an outbreak.
Mike McEvoy
Fire Engineering EMS Editor
Labels: EMS, Mike McEvoy, outbreak, pandemic, swine flu
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posted by Mike McEvoy
4/24/2009 10:17:00 PM
I've heard nurses not want to update family members about a loved one's condition, hospitals refuse to provide patient information to an EMS crew who had treated and transported the patient, firefighters refuse to tell a family member or friend where a patient had been transported - all wrongly in the name of HIPAA.
HIPAA was designed to prevent medical information from falling into the wrong hands. Parking tickets are not medical information. Anyone a patient wants to know about their medical condition is entitled to have that information. Any health care provider who treats a patient is entitled to medical information about that patient. EMS services are required to post HIPAA information on their web sites and provide education on HIPAA to their members and employees. This parking ticket fiasco serves as an outright silly example of how convoluted HIPAA misinterpretations have become. It's probably time to check the HIPAA knowledge in your department.
Mike McEvoy
EMS Editor
Fire Engineering
Labels: EMS, HIPAA, medical, Mike McEvoy
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posted by Mike McEvoy
4/23/2009 11:32:00 AM
1 Comments:
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Peter said...
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We have run into occasional "HIPAA Roadblocks" in transffering care. We have seen HIPPA invoked as crutch to avoid work and as a shield to prevent or inhibit staff gaining useful knowledge about potential patient care issues. It has been addressed HIPAA officer to HIPAA officer with suggestions about retraining. Generally common sense has prevailed and with a little prodding our staff has received the pertinent information. We never miss an opportunity to educate, share, and learn.
- Wed Apr 29, 09:39:00 AM EDT
You can learn more about the foundation at bravefoundation.org.
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posted by Peter Prochilo
3/13/2009 11:09:00 AM
If you're seeing a volume of primary v-fib cardiac arrests enough to ponder over improving your resuscitation rates, maybe you should take a closer look at the quality of primary and cardiovascular care being provided in your community. Cardiac arrests should be on the decline. Cardiac arrest resuscitation rates should be dropping as well. That might be a better measure for bragging rights. Medicine has evolved; EMS needs to evolve with it.
Mike McEvoy
EMS Editor - Fire Engineering
Labels: cardiac arrest, EMS, medical, Mike McEvoy, resuscitation
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posted by Mike McEvoy
3/10/2009 09:43:00 PM
2 Comments:
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Mic said...
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Mike,
I agree that the incidence of sudden cardiac arrest may be falling for all the reasons you mention. There are a few items I think we should all keep in mind to keep your comments in proper context.
First, people will still have cardiac arrests - even with great primary and cardiovascular care. Medicine is helping people live longer - but at some point, fate catches up. So, the incidence of sudden cardiac arrest falls but not the overall incidence of arrests.
But even we go on fewer cardiac arrest calls because more of them are not the of unexpected variety, the survival rates for the ones we do attempt resuscitaiton on should not be going down. There have also been dramatic improvements in our understanding of resuscitation physiology, particularly in how to improve blood flow with better BLS. By reducing the amount to interruptions of chest compressions; by using compression metronomes and other devices to optimize rate; and the using technology built into some monitors to optimize the depth of compressions - BLS is getting much better.
So, we should keep tracking survival rates and with good BLS protocols, training, and QI, survival rates should be improving.
--- Mic
Mic Gunderson
Consultant, IPS
[email protected]
www.onlineips.com/publicsafety - Wed Mar 18, 11:52:00 AM EDT
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mwd101 said...
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Mike,
Interesting and stimulating commentary as always, but I think a bit off the mark. While there seems to be a decrease in the number of survivable primary ventricular fibrillation cardiac arrests among young or otherwise healthy people, no one knows all of the reasons for this decrease. Medicine has made great inroads at the prevention of coronary artery disease; we are a long way from the world you describe. Nowhere is this of greater concern than the fire service. Cardiac arrests frequently occur in patients who have no known cardiac disease, in fact, as many as half of the firefighters that suffer cardiac arrest have no known cardiac history.
We must still work to improve our skills and our systems to treat those patients who suffer cardiac arrest, even while our colleagues in primary care and cardiology work to prevent cardiac arrest. We must not ignore that the differences in our EMS systems and some have rates of return of spontaneous circulation approaching 50%, and others below 10%. If a system moves from having a dismal rate to having a drastically better rate we must trumpet their success.
The chain of survival is real. Across the USA the links are not as strong as they could be. The first link must be prevention, championed by the healthcare community, as you assert. The next link must be community recognition, so no heart attack is missed, and then 911 activation, BLS, and ALS. There must be another link as well, retrospective review. Each case should be a data point that is entered in a National registry, such as the CARES at Emory, and studied the same way in every community. As Mic says, the rates should not be going down--and they won't, if we compare "apples to apples."
Are we ready to declare the war won and cardiac arrest no longer an issue for EMS? No. In fact, as you and I look at systems maturing across New York, not yet. Maybe someday.
Michael
Michael Dailey, MD
Regional EMS Medical Director
REMO
[email protected] - Sun Mar 22, 11:06:00 PM EDT
The second study compared arthroscopic knee surgery to medical and physical therapy in 178 patients with moderate-to-severe osteoarthritis of the knee. These researchers found that arthroscopic surgery was no better than optimized physical and medical therapy for osteoarthritis of the knee (Kirkley A, Birminghan TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. New Eng J Med. 2008;359:1097-1107). Medical therapy provided to 92 of the patients included nonsteroidal anti-inflammatory drugs, acetaminophen, chondroitin sulfate or glucosamine, hyaluronic acid injection, weekly physical therapy for three months, and instruction on twice-daily home exercises. The remaining 86 surgical therapy patients received the same medical treatments plus arthroscopic surgery (including debridement of cartilage and/or meniscus and excision or removal of loose bodies and osteocytes). After 2 years, both groups had similar pain levels, physical function, and overall quality of life scores. Arthroscopic surgery is a widely used treatment for osteoarthritis of the knee with no proven (scientific) benefit. This study provides some proof that it often has no benefit.
Some food for thought if you're having knee problems!
Mike McEvoy
EMS Technical Editor
Fire Engineering
Labels: EMS, knee, medical, surgery
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posted by Mike McEvoy
12/20/2008 11:41:00 PM
2 Comments:
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Jean said...
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I have been told I need total knee replacement I would like to return to work for three more years after the surgery but can find no results of FF returning to work after such type of surgery Any results available?
- Thu Jan 01, 08:45:00 AM EST
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Brian Schaeffer said...
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Jeez Mike... I just read your post as I am sitting on the couch, post knee surgery. ugh. My doc was pretty confident and the photos he took in the arthro are pretty evident that I needed the knife... but the overall #'s and picture you reference really make me wonder. Interesting catch.
- Sat Jan 17, 08:45:00 PM EST
Mike McEvoy
EMS Technical Editor
Fire Engineering
Labels: emergency, EMS, FAA, helicopter, HEMS, medical, NTSB, service
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posted by Mike McEvoy
12/03/2008 09:32:00 PM
4 Comments:
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Kevin said...
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The fire service plays a HUGE part in air medical safety, especially when establishing remote landing zones. All to often this task is taken lightly and time and time again complacency is evident. This is often undertaken by people with little to no training and if they are trained, there is no currency. This could be done by a 25 year veteran who was been trained, accountable and is currrent in his training or by an 18 year old who was 6 months on and just won a popularity contest to become a company officer. There are often no set enforced standards at either the State or County level and are often set forth by individual competing air medical providers. This one wants flares, this one wants cones, this ne wants strobes, this is 75X75, this 100X100, etc. Instead of monitoring the LZ for security and problems every single person on the company is watching the helo land like moths to a fire. When accidents and incidents do occur there is often no follow up, no training or retraining and no repercussions. Let me ask you this, with the "safety culture" we claim to pride ourselves in the fire service, just whay type of message does this convey?
- Wed Dec 10, 12:20:00 PM EST
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Jefe, Global War On Error said...
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Mike
You are spot on with your analysis of becoming "part of the solution" by addressing the issue of "helicopter shopping." We have seen the same thing in helicopter firefighting where the IC will shop until he/she finds someone willing to accept the risk that another has turned down. The use of a "turndown protocol" may be of some use in both environments.
It simply means after one organization (or company) has declined an assignment or request for service based on the risk, all subsequent requests must include the fact that someone else has already turned it down as too risky. At least all facts are on the table then.
Keep up the good work! Tony Kern, CEO, Convergent Performance - Wed Dec 10, 02:03:00 PM EST
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bill shouldis said...
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What is the NIMS recommendation for helicopter operations. It seems that an air Operations is necessary. In the real world a company officer would set up a L/Z .A paramedic that fills the position of a Transportation Group Supervisor would need this information . Operation Section Chief are often not designated when only a few patients need transport to a Burn Center or Trauma Facility. Thanks for any help. Bill Shouldis -Phila. ([email protected])
- Sun Dec 14, 02:11:00 PM EST
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Chris G. said...
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The common denominator in EMS helicopter crashes since the mid eighties has been launching medevac missions when the weather is bad. The NTSB calls it "continued flight into know IFR (lousy weather) conditions." The aeromedical community should learn a lesson from the fire service and apply a more conservative approach to risk assessment, especially when it comes to flying helicopters into bad weather. They should not wait for more government regulation, and adopt a national standard "flight acceptance criteria" that includes a "no go" choice for the pilot.
- Tue Mar 10, 07:11:00 PM EDT
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1 Comments:
Mike
I’m glad to see that the new NFPA project to develop a standard for ambulances is generating enough interest for you to write an article. Like with anything new there is always skepticism about venturing into unchartered territory. I’m also pleased that you are taking the time to participate in the committee process and helping to explain what the new NFPA standard intends to accomplish.
The NFPA Standards Council ensures that all technical committees have a balance of interests, with no interest representing more than one-third. As you point out in your article, committees have a maximum of 30 principle members to ensure the committee is a manageable size. The NFPA recognizes nine different interest groups on our committees. For committees with full rosters of 30 members, no more than 10 of those members can be from any one interest group, manufacturer or otherwise. Usually our committees do not divide out at 10-10-10, and the ambulance committee includes representatives of 8 of the 9 interest groups.
NFPA’s standard development process is an open process. Anyone can submit proposals and comments, and every one of those proposals and comments will be considered by the committee. Public participation is an essential part of what we do. Many of NFPA’s standards have addressed challenging and sometimes very controversial topics such as fire department occupational safety and health (NFPA 1500 in 1987), and organization and deployment of fire service (NFPA 1710/NFPA 1720 in 2001). Despite the challenges and controversies, NFPA’s consensus process has a track record of delivering an indispensible, accepted standard for the fire service.
NFPA’s process works best when everyone affected participates and contributes. NFPA’s standards development process depends upon experts and others with technical knowledge to share their opinion and experience.
I am confident the NFPA Standard for Ambulances will be a important document for all fire and emergency services delivering EMS. For the best end product I encourage everyone in the fire and EMS community to participate and challenge the NFPA Technical Committee for Ambulances with your ideas. NFPA will keep everyone up to date on the process through NFPA’s Fire Service Today blog at http://nfpa.typepad.com/fireservicetoday.
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