When the EMS White Paper (Accidental Death and Disability; The Neglected Disease of Modern Society) was published in 1966, the focus was patient centric on areas such as: prevention, first aid and medical care, communications, trauma, hospitals, and rehabilitation.
Several years later, attention turned to establishing a standard for equipment and ambulances and in 1974, at the request of the Department of Transportation the General Services Administration (GSA) published the first edition of the Federal Specification for Star-of-Life Ambulances (KKK-A-1822, also known as K-Specs). The K-Specs continue to be regularly updated through revisions and interim change orders.
K-Specs were only mandatory for ambulances purchased with federal funds, but were adopted in whole or in part by many state EMS offices as a licensing requirement.
At the turn of the 21st century, several activities happened on parallel tracks.
- Data about ambulance crashes were being analyzed
- Research about restraint systems and ambulance designs were conducted
- GSA expressed an interest in retiring the K-Specs when an accepted alternative was available
In 2008, as a result of a new project request, the National Fire Protection Association (NFPA) began the process to develop ground ambulance standards based upon the K-Specs and NFPA 1901: Standard for Automotive Fire Apparatus. The result was NFPA 1917: Standard for Automotive Ambulances, which was first published in August 2012. A second edition, NFPA 1917 (2016) was published in August 2015; and the third edition (2019) was published in 2018.
In 2013, the Board of Directors of the Commission on Accreditation of Ambulance Services requested a Steering Committee to evaluate the impact of NFPA 1917. The results of that evaluation led to the establishment of a GVS Action Committee to develop ambulance standards based upon the K-Specs. Ground Vehicle Standards V1.0, was published in 2016 and has been updated with Ground Vehicle Standards V2.0.
Each state, most often the state EMS office, is responsible for the regulatory decision regarding which, if any, standard is adopted for licensing purposes.