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“Accidental Death and Disability; The National Disease of Modern Society” published by the National Academy of Sciences, established the foundation for the Emergency Medical Services (EMS) system.

The Highway Safety Act of 1966, required states to have highway safety programs that adhered to performance standards promulgated by the US Secretary of Transportation, including EMS. Considerable resources were allocated to get this project started, including purchasing ambulances.

According to the US DOT, there were an estimated 28,000 ambulances in the US (1,200 belonged to the federal government). DOT requested the GSA to develop a standard for ambulances.

The GSA Federal Specification for Star-of-Life Ambulances (KKK-A-1822) (“K-Specs”) went into effect.

Ambulance Manufacturers Division (AMD) begins working with GSA to develop testing standards for the K-Specs

AMD becomes part of the National Truck Equipment Association and publishes Standards 001-015.

NHTSA publishes the EMS Agenda for the Future, as a collaborative effort to guide development of EMS systems.

The National Institute of Occupational Safety and Health (NIOSH) completed front impact crash tests on ambulances.

NFPA approves a request from the International Association of Fire Chiefs (IAFC or I-Chiefs) to develop standards for ground ambulances based upon GSA K-Specs and NFPA 1901 Standard for Automotive Fire Apparatus.

The Department of Homeland Security (DHS) provided funding for the Ambulance Manufacturers Division of the National Truck Equipment Association (AMD-NTEA) and NIOSH to develop standardized safety tests.

NFPA 1917 1st edition (2013) issued by NFPA Standards Council and approved by ANSI with an effective date of August 29, 2012.

The American College of Emergency Physicians (ACEP) published the Strategy for National EMS Culture of Safety.

NIST published Ambulance Patient Compartment Human Factors Design Guidebook

Ground Vehicle Standards version 1.0 published in March, with an effective date of July 1, 2016.