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EMSWORLD.com | APRIL 2016 25 "We are seeing more and more customers move away from traditional bench seating and opting for safety seating," says Benoit Lafortune, co-owner and executive vice president of Demers Ambulances. Demers' answer is its Mobility Sliding Seat design, an ergonomic captain's chair that swivels and moves both front to back and laterally, allowing users to remain safety restrained while they tend to patients. "Critical equipment and supplies remain accessible from that seat-belted position," Lafortune notes, "enabling the paramedic to focus on patient care." Crestline reports the same: "We're starting to see a slow demise of the traditional squad bench, although there are many reasons why people like working on them and may still utilize them in their design," says Sawatsky. "I think we all know it's something that needs to eventually go away, but until we do that, you need a proper design inside: a workspace and environment where medics can stay seated and belted and still have access to the equipment and supplies they need during the call. "That's the biggest challenge: to deliver an environ- ment that's safer and more ergonomically conducive. If you don't do that, medics will resort back to their old ways of working. So that's the challenge for us." All the recent testing and attempts to better inform ambulance-industry standards and guidance with scientifically sound evidence and research haven't gone unnoticed either. Customers are increasingly looking for that kind of validation. "We are seeing more and more customers requiring scientific data and safety test results from manu- facturers as part of their bid requirements," says Lafortune. "We're strong believers in product test- ing and are pleased to see EMS agencies move in this direction." The SAE guidance is also cited in both of the main U.S. ambulance industry standards documents: the 2016 revision of NFPA 1917 and the inaugural Ground Vehicle Standard from the Commission on Accredita- tion of Ambulance Services (CAAS). 'A Lot More Dialogue' Those are national standards but of course don't apply to everyone. Only around 30 states, for exam- ple, have adopted the KKK specifications wholly or partly into law. Still, they represent a consensus embrace and de facto conventional wisdom for the U.S. And while things here aren't optimal and can vary by state and locality, that kind of national codification can actually be a cause for envy, even in advanced locales. "The U.S. has a bit of advantage in that you've got a national standard—NFPA and CAAS now, and still the AMD Triple-K standard," says Sawatsky. "But there's a lot more dialogue in the U.S. going on across the board, I think. In Canada it's still very jurisdictional-based, and I think that's something that there's a desire to look at" and potentially reform. Observes Rowland: "The beauty of these documents referencing the same SAE-recommended practices is that the manufacturers of seating and cots are able to design and test to one solid standard, and ambulance manufacturers do not need to build 'state-specific' ambulances to provide these integrated options." That's not to say the bar is lower in Canada. There, like here, the bar's height varies. "There are more strict standards in Canada," Sawatsky adds. "[The changes in Change Notice 8] aren't a huge departure from where Crestline is at. One of our advantages is we deal with some pretty strict standards—Ontario, Quebec and Alberta are the three primary provinces that kind of drive the safety standards here. Some of that we've had to build to over the years, and then you tap into the European standards we've built to at times, and it's kind of encompassing. We've adopted some of those technologies into our normal ambulances, whether we distribute them in Canada or the U.S. It becomes part of our standard product offerings." Crestline's ICON 2.0 uses the new Ford Transit cutaway chassis and incorporates Ferno's iN∫X, iN∫TRAXX and associated SAFEPAKs. The ICON 2.0 was developed by Crestline through a joint collaboration with Frontenac Paramedic Services and Ferno.