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1.1 This practice covers certified, tested, commercial type, EMSS ambulances built on chassis that are suitable for the intended application and meet the requirements herein. The ambulances are front or rear wheel driven (4x2) or four wheel driven (4x4) and warranted as specified in Section 9.

1.1.1 Definition of Ambulance—An ambulance is a vehicle for emergency medical care which provides: a driver's compartment; a patient compartment to accommodate an emergency medical technician (EMT)/paramedic and two litter patients (one patient located on the primary cot and a secondary patient on a folding litter located on the squad bench) so positioned that the primary patient can be given intensive life-support during transit; equipment and supplies for emergency care at the scene as well as during transport; two-way radio communication; and, when necessary, equipment for light rescue/extrication procedures. The ambulance shall be designed and constructed to afford safety, comfort, and avoid aggravation of the patient's injury or illness.

1.1.2 This standard may be used to procure an ambulance and the applicable additional systems and equipment.

1.1.3 Purchasers should follow the ordering data in 9.2 to aid them with the preparation of their procurement specification, requisition, and contract. The purpose of this practice is to describe minimum requirements for design, construction, performance, equipment, testing, and appearance of EMSS ambulances which are authorized to display the "Star of Life" symbol so as to provide a practical degree of standardization. The reasons for such standardization are to provide ambulances that are easily detected, nationally recognizable, properly constructed, easily maintained, and, when appropriately equipped, will enable Emergency Medical Technicians (EMTs) to safely and reliably perform their functions as basic and advanced pre-hospital life support providers as set forth in national EMSS standard training guidelines. These functions include:

1.1.3.1 Responding to, providing appropriate basic or advanced life support, on-site, to persons reported experiencing acute injury or illness in a pre-hospital setting, and transporting them, while continuing such life support care, to an appropriate medical facility for definitive care.

1.1.3.2 Providing interhospital critical transport care.

1.1.3.3 Transporting essential personnel and equipment to and from the site of a multiple medical emergency or a triage site and transporting appropriately triaged patients to designated medical facilities.

1.1.3.4 Other functions deemed appropriate by EMSS ambulance service managers and approved by designated EMSS medical directors.

1.2 "Star of Life" Certification—Ambulance manufacturer/contractor shall furnish the purchaser(s) citing this standard an authenticated certification and label (see 6.19) that certifies a "Star of Life" ambulance and equipment complying with this standard and applicable amendments (if any) in effect on the date of manufacture (see 7.3). Ambulance vehicles so certified may display the registered "Star of Life" symbol, as defined by the U.S. Department of Transportation (DOT) and the National Highway Traffic Safety Administration (NHTSA), see Fig 1.

1.3 Classification— "Star of Life" ambulance designs included in this standard may be described in terms of their body type (I, II, or III), class of drive ("1" for two rear wheel drive or "2" for four wheel drive), and floor configuration (A for Advanced Life Support or B for Basic Life Support). Such descriptions may be used to define a variety of ambulance designs which are eligible for certification as "Star of Life" ambulances. (To specify, see 9.2.2 and 9.2.3).

Note 1—For optional advanced life support (ALS) applications, users should consider specifying a modular (Type I or III) ambulance. Modular ambulances provide additional space and compartmentation for cardiac monitors, drug cases, and so forth. The basic life support (BLS) configuration is standard on all types.

1.3.1 Type I—Conventional truck, cab-chassis with modular ambulance body (see Fig. 2).

ClassConfigurationTwo rear wheel driven (4x2)A or BFour wheel driven (4x4)A or B

Configuration A: Elevating cot and squad bench for ALS (See 6.1.5.1 and 6.11.4).
Configuration B: Elevating cot and squad bench for BLS (See 6.1.5.2).

Type I—AD (Additional Duty—with increased GVWR, storage, and payload capacity)—)A or B or Neonatal, Critical Patient Transport, or A or B with Rescue and Fire Suppression Package or a combination thereof. (See 6.1.2.1)

ClassConfigurationTwo rear wheel driven (4x2)A or B or ^*Four wheel driven (4x4)A or B

^* As specified by purchaser. The configuration shall provide for a neonatal, critical patient transport, configuration A or B with fire suppression package and rescue capability when specified.

1.3.2 Type II—Standard van, integral cab-body ambulance (See 6.1.3 and Fig 3.)

Class ConfigurationTwo rear wheel driven (4x2)A^** or BFour wheel driven (4x4)^*A^** or B

^**On a Type II, ALS features are limited, (see 9.2.3)
^*Requires conversion of chassis to four wheel drive (4x4), (see 9.2.3).

1.3.3 Type III—Cutaway van, cab-chassis with integral or containerized modular body ambulance (see 6.1.4 and Fig 4).

Class ConfigurationTwo rear wheel driven (4x2)A or BFour wheel driven (4x4)*A or B*Requires conversion of chassis to four wheel drive (4x4), (see 6.1.6)
.Configuration A: Elevating cot and squad bench for ALS (see 6.1.5.1 and 6.11.4).
Configuration B: Elevating cot and squad bench for BLS (see 6.1.5.2).

1.3.3.1 Type III— AD (Additional Duty-with increased GVWR, storage, and payload capacity) A or B or neonatal, critical patient transport, or A or B with rescue, or fire suppression package, or both (see 6.1.4.1).

Class ConfigurationTwo rear driven (4 x 2)A or B*Four wheel driven (4 x 4)A or B*

*As specified by purchaser. The configuration shall provide for a neonatal, critical patient transport, configuration A or B with fire suppression package and rescue capability when specified.

1.4 Order of Precedence—In the event of a conflict between the text of this practice and the references cited herein, the text of this practice shall take precedence, except where required by law including Federal, State, and local laws and regulations.

1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.