Understanding NFPA's new ambulance rule
With NFPA taking over the new ambulance standard process, here's a look at what it means and how we got here

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 the 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.
15 ambulance changes
Load capacity will be 171 pounds per seated position.
A seatbelt monitoring system that senses when a seat is occupied and a seatbelt attached. Audible and visible warning devices will trigger for cab and patient compartments if the parking brake is released and the transmission is not in park.
Tire-pressure monitors.
Designate health care provider seating positions that are adjustable to within 6 inches of the cot.
AMD testing standards.
Speed governed for maximum speed of 77 mph.
Chevrons on rear doors in red and fluorescent yellow or green.
Underbody lighting that establishes lighting zones in which all areas of the truck must display certain warning lights.
Interior cabinets marked with maximum weight rating.
Items more than 3 pounds must be secured in a compartment or by device that withstands a 10-g force.
Carbon monoxide detector.
Mud flaps.
Additional hand rails at every point of ingress.
Certificate of compliance — exceptions to be corrected before placing in service.
"Do not move" light connected to doors, storage racks and deployed devices.
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