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and mounting system compatible with all models and vendors; and design shouldn't allow items greater than 31 lbs. to be stored higher than 5 feet off the foor, or items greater than 44 lbs. to be higher than 3 feet Not all of NIST's suggestions will make it through the NFPA's revision process; "NFPA is a consensus organization, and there's always a give-and-take on certain things," notes Marshall. Some may be refned and resubmitted. To stay current with the NFPA's work, go to www.nfpa.org, search for 1917 and click the "Next Edition" tab. Delethalize It While DHS and NIST are relative newcomers to the realm of ambulance safety, NIOSH has worked for a decade-plus on related issues. Its current focus includes developing 10 standards (technically recommended practices) for testing various aspects of the ambulance, for publication by the Society of Automotive Engineers. Two of those are complete: SAE J2917 describes procedures for front-impact occupant restraint and equipment mounting integrity tests, and SAE J2956 does the same for side impacts. In February a third, for rear impacts, advanced toward publi- cation with approval by the SAE Crashworthiness Committee. Two more have been presented to SAE, for patient-compartment seating and restraints and occupant excursion, and returned with comments for further tinkering. NIOSH is still working on three more. One of those covers cabinets and drawers. "We want those to stay shut in a crash, instead of expelling all of their contents," says Jim Green, who's leading the work. Another deals with the integrity of the patient compartment itself; the third deals with what's called "interior delethalization." "What we want to do is look at how we can make the wall surfaces less likely to injure an occupant," says Green. "If we can't prevent every occupant from hitting every wall or cabinet, how can we make them less likely to be injured? If you think about your own car, the framing around your driver's door—the pillar next to your left shoulder and the pillar that runs forward of your door—all has padding to help reduce the likelihood of injury to your head." That testing should be done by the end of the fscal year. NIOSH is also conducting anthropometric measurement of EMS workers at various sites around the country. Says Green: "Our goal is to measure EMS workers and try to determine the size of that work population for males and females, as well as, as best we can, characterize any unique properties that may be in different minority groups." For more on that, see www.emsworld. com/11291509. Paradigm Shift It's possible to fnd ways to perform virtually all patient care seated and restrained, with secured equipment and interior contents mounted to withstand crashes. Lots of people in the federal government and beyond want to help us do it. Change is incremental, but the 1917 revisions, forthcoming guidebook and demo ambulance should help it along. "It's really about a paradigm shift as much as it is about the standards and safety work," says Jim Grove, program manager for the DHS' Science and Technology Directorate. "We can do so much providing recommendations and guidebooks, but it's really going to take a shift within the EMS provider community to embrace that they can still perform their jobs in a seated manner, being able to reach the patient. In the end they'll see they can do that; it's just something that, because folks have done it a certain way for so many years, has to be overcome." EMS still has a chance to sound off; NFPA is taking online comments through May 16 for its latest draft. DHS will seek feedback from sources like those in its First Responder Resource Group and NASEMSO's Agency & Vehicle Licensure Committee. It also plans to develop a training program to accompany the guidebook and is working through FICEMS to determine how efforts can continue once its interagency agreement with NIST ends later this year. "From the DHS Science and Technology perspective, we're trying to make both incremental and large-leap changes in the homeland security enterprise, and this project in particular is making a huge investment into the future and safety of the EMS community," says Grove. "The work and collaboration we've been able to do with the EMS associations and manufacturing commu- nity has advanced our work and theirs as well. In the end, the folks who ride in the backs of these ambulances, and the folks who work in them day to day, are the folks we're trying to protect." Stay abreast of developments at www.frstresponder.gov or by following the DHS S&T; on Twitter, @dhsscitech.• Some of NIST's ideas should make their way into next year's revision of NFPA 1917. NIST's suggested design entails twin attendant seats on either side of the patient and cot. 40 APRIL 2014 | EMSWORLD.com EMS_39-40_EMS2020.indd 40 3/13/14 2:42 PM