A COMPREHENSIVE GUIDE TO AMBULANCE SPECIFICATIONS ACCORDING TO THE EN1789 EUROPEAN AMBULANCE STANDARD

A COMPREHENSIVE GUIDE TO AMBULANCE SPECIFICATIONS ACCORDING TO THE EN1789 EUROPEAN AMBULANCE STANDARD

1. Introduction to Ambulance Specifications

En1789 European Ambulance Standard ; The main factors responsible for different patient safety and care conditions in an ambulance show that all ambulances are not equivalent to the transfer of a patient between health care facilities: vehicular architecture shapes different access, rescue, diagnosis, and reversal medical care opportunities at an early phase in hospital facilities. These opportunities (real, extended, or just potential) differentially benefit not only the patient or the safety of the patient but, as well, the paramedics, nurses, and doctors that assist patients in the vehicle. The range of different equipment needs of different ambulances translates into a range of vehicle body configuration and ergonomic requirements (complex, especially for some items). In practice, it reflects a logistic challenge for the vehicle body constructor, a challenge that emphasizes the costs of ambulance manufacture and operating and maintenance. In a general manner, manufacturers attending the specific needs of major customers design ambulance vehicles. Nevertheless, the high number of ambulances sold in Europe by different companies makes it more and more impracticable the present strategy of customer-oriented vehicle design, selling successively limited numbers of vehicles with identical architecture. The same thinking applies to the amount of maintenance and repair of a fleet of an extensive number of unique vehicles. By mutual agreement of all these stakeholders, the activity related to the construction of lobby and national purchase-of-ambulances guidelines is the most immediate and identified task of the future European project.

With the purpose of standardizing the different requirements in bodywork manufacture, based on ambulance functionality, a European Standard is written with several improvement objectives of equipment and vehicle equipment transportation. This generic guide to ambulance specifications can be useful for vehicle and medical equipment purchasers and all agents involved in patient care and medical transportation. One selling point of an ambulance is a combination of equipment and packaging. The improvement of equipment in universal standards like the one proposed in the present is a complementary abusive construction requirement focusing mainly on the logistics and packaging of the equipment in embedded and standardized spaces so the vehicle fits best in pre-existing information flows between hospital services (stock and management of individual patient kits, just-in-time services), medical personnel (logistics of hospital/ambulance equipment, patient safety, accessibility), and vehicle manufacturers (improve manufacturing economy, cost, and time of vehicle assembly).

2. Key Components and Features of Ambulances According to En1789 European Ambulance Standard

This standard describes what the ambulance is and what general characteristics it should have. Safety, comfort, and accessibility of the vehicle are important. These are the main problems for ambulance producers. The content of this report answers the question “what kind of vehicle is an ambulance?” to guarantee these three important factors. The medical equipment of an ambulance is also important. The same meaning as the medical equipment of the vehicle is general material aspects according to 1789. Also, at the beginning of the section, the patient compartment according to the patient room and cabinet space for the ambulance has been explained in general. In short, all standards required for ensuring that a vehicle is able to provide health services have been included according to domestic or interstation transportation.

The full name of EN 1789 is “Medical vehicles and their equipment—Road ambulances,” included in the European Standard. This standard specifies the requirements and test methods for medical road ambulances. It is applicable to road ambulances capable of transporting patients. This standard applies to road ambulances capable of transporting at least one person on a stretcher, including those that require adaptation to the patient. This standard can be adapted to road ambulances used in the harshest conditions, for example, due to climatic and topographical conditions. These special ambulances can include alternative or innovative energy sources.

Ambulances are very special vehicles due to providing an emergency medical service in extreme conditions. Therefore, it is important to standardize the vehicles. There is a standard, referred to by the code name EN 1789, which determines general requirements regarding the medical and technical capacities of ambulances. The relevant standard was updated in 2007 and is currently being revised.

We have included the following categorized topics about ambulances according to the EN1789 standard: – Ambulance standardization in general – General and medical requirements of road ambulance vehicles – Requirements Compliance verification – Risk analysis – Basic configurations – Patient compartment – Preventing patient access – Emergency cab location – Access and evacuation – Traffic safety requirements – Electromagnetic compatibility (EMC) – Ergonomics

3. Compliance and Certification Process According to En1789 European Ambulance Standard

The ambulances prepared individually to transport the patient must obtain type approval according to the En1789 European Ambulance Standard. For this, the preparator must first apply to a notified body designated by the certification institution. After the necessary submitted documents are reviewed, and a general technical audit is performed, a type approval certificate is issued by the notified body. After the ambulances are confirmed to have completed the categorization and that they were prepared in accordance with all necessary components and emergency equipment, the ambulances are notified to the certification institution. Then, if the institution is prepared to apply to the certification institution, a certified medical transport ambulance certificate will be obtained for the ambulance and the ambulance designation process will be terminated. An ambulance objected to the technical compatibility at any stage must be reconfigured according to the EN 1789 standard and must re-obtain the certificate requirements.

The institution is required to comply with the management system of the executive body responsible for ambulances and patient transportation institutions in order to evaluate compliance with the standard. After determining the management system, the system applies for a certificate to the legal organization responsible for the national certification institution. After the certification institution has completed the necessary audits, the organization issues a certificate of conformity to the relevant management systems. At the end of this process, the executive body responsible for patient transportation starts its activities with the license that it has obtained. It should be noted that the institution does not have certified ambulance status as long as this certification is valid. After completing this process, the ambulances prepared individually to transport the patients must also be prepared according to the 1789 standard.

4. Innovations and Future Trends in Ambulance Design and Specifications

There are seven parts that the En1789 European Ambulance Standard has, and the new standard editions are intended to provide information on the current and evolving state-of-the-art standards of the European Union. The extensive standard information that is now available for all ambulances can be applied to all existing and future types of emergency vehicles in a more beneficial manner than in the past. New vehicle builders should refer to the actual documents for detailed information, as critical areas such as interior dimensions remain virtually identical. However, their values have been determined at different development times with similar design considerations and projected technological advancements.

Most of the new vehicles built comply with the motor standards, but the EN1789 specifies the structural characteristics of an ambulance that make it capable of operating as a therapeutic area. On one hand, the European standard describes the vehicle’s dimensions and inside volume based on the need to carry related equipment and to ensure standing restriction and mobility within the patient treatment area. On the other hand, some specific requirements about inside facilities guarantee patient and medical staff security and the vehicle’s dynamic features. An ambulance has to ensure the good state of a patient until he or she reaches the hospital. Then, the EN1789 specifies the requirements for an ambulance to be used as equipment for patient transport. That means that medical staff perform a patient’s management and necessary treatment during his or her transport.

5. Case Studies and Best Practices in Implementing En1789 European Ambulance Standard

For the diagnosis of stroke, we developed a dedicated transport solution of continuous monitoring and associated safety arrangements for extra care in transport to prevent fatal complications. This has brought major business advantages through correlation, since valuing a vehicle also means recognizing how much specific long-felt needs are fulfilled. Also, in many call cases, the standard minimum requirements mask important safety and transport economy points. Going beyond these standards may therefore provide added features, which are our responsibility to make known to potential customers – like new thoughts on seat selection. In fact, as we drive the market of stretchers (collaborating also with stretcher/projection companies), we can and must institute their better configuration.

The recent recognition of unique needs for ambulance vehicles helped build a real comprehensive understanding of those unique needs of clients, thus drawing an important bonanza of specific knowledge and competing advantages for the company. The new information and training European Strategic – and Very Specific Project allowed concentrating new know-how and recognition for the better of client needs: our knowledge led, for example, to upgraded vehicles such as an emergency drive module designed for economical and functional high-performance; ambulance ceiling and central rail for ergonomic medical gas units. Our enhanced specificity for customer vehicles customization, like neonatology (light and oxygen probes ready to use).

The standard places only minimum requirements and does not cover every situation or need. This means that emergency medical professionals – the prime users of these vehicles – must often rely on experience and guesswork to define specific requirements, making the purchasing of specialist vehicles often more or less a matter of guesswork.