CEN 1789
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CEN 1789:2020 is the
History
The current version of standard CEN 1789 was published by the
While CEN 1789:2020 represents the current European standard for the design of ambulances, it is by no means the only example of such a standard. Standards for ambulance design have existed in the
Intent
The standard is intended to gradually transform the existing 'patchwork' of ambulance design and equipment across Europe into a single set of standards. An ambulance from one country would possess sufficiently common characteristics to be immediately recognizable by the residents of another country. Such vehicles would be similar enough in design to be interchangeable, with emergency medical services personnel from one country able to quickly adapt to the use of a vehicle from another country, if required. Above all, such vehicles would be safe for those being transported in them,[4] those working in them, other users of the road, and the general public.
Vehicle standards
Requirements are specified for categories of road ambulances based in increasing order of the level of treatment that can be carried out. The standard includes both vehicle type and also engine type and performance characteristics, including vehicle dimensions, acceleration rate, braking capacity, traction control, fire safety, and heating/cooling.[2]
Interior design standards
The standard contains
Medical devices
This Standard gives general requirements for medical devices carried in road ambulances and used therein and outside hospitals and clinics in situations where the ambient conditions can differ from normal indoor conditions.[6]
Safety
The standard states that medical Devices, equipment and controls which are required while the vehicle is in motion should be positioned so that they can be operated by a paramedic with their seat belt fastened when the vehicle is in motion.
Patient and crew Seating
The standard states that crew seating must be fitted with a seatbelt alarm to alert the driver visually or acoustically when someone is seated in the patient compartment but not secured by the seatbelt.[7]
Classification of ambulances
Please note that while the classification is standardized in the European Union, the crew and its abilities are not. The same vehicle may be used differently in varying countries. There are also emergency physician based systems in some European states, often with (non-EU regulated) vehicles with medical equipment and therefore lowering the need for the amount of equipment in the ambulance.
- Patient transport ambulances (Types A1 and A2)
Type A1 is without lights and sirens Type A2 with lights and sirens and can function as emergency ambulances. Generally only used for the non-emergency transportation of patients, either between facilities or between a facility and a residence. The emphasis is on transportation; such ambulances have limited treatment or equipment space. Such ambulances may also be used because of cost by smaller communities, particularly if there is no ALS service.
- Emergency ambulances (Type B)
The most commonly seen type of emergency ambulance. This vehicle type permits increased treatment space and also the ability to store significantly larger amounts of medical equipment. Such vehicles will typically respond independently to emergency calls, providing some level of treatment.
- Mobile intensive care unit (Type C)
This type of ambulance is commonly seen in the movement of high acuity (ICU) patients between hospitals. It provides adequate space for not only the medical equipment commonly seen in ambulances, but also to accommodate hospital equipment, such as ventilators, during transport. In some locations, vehicles of this design may be used to provide mobile resuscitation services, either supplemented by an emergency physician response, or with the physician as a part of the crew. In Germany, the vast majority of primary emergency ambulances (Rettungswagen) are required to be Type C ambulance without being dedicated to intensive care transports.[8]
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Type A Ambulance in Poland
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Type B Ambulance in Switzerland
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Type C Ambulance in Germany
Ambulance Identity
Active Warning Systems
Emergency Lights
All ambulances will be equipped with flashing blue lights, visible for 360 degrees around the vehicle.[9]
Siren
All vehicles must also be equipped with an audible warning system (siren) which meets specified standards for both sound pattern and volume.
Passive Warning Systems
Vehicle colour
The Standard specifies that all ambulances will be painted yellow, with specific colour standards, as their primary body colour.[10] The colour yellow was chosen primarily because it remains visible to almost all people in all lighting conditions, including the majority of those with colour-blindness. One ambulance service in Europe that does not conform to the standard is the Scottish Ambulance Service, who use white vehicles with ambulance Battenburg markings.
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English ambulance which meets the colour and livery standards
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Euro Yellow RAL1016 - the colour Standard for Ambulances
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Swedish Ambulance which meets the colour and livery standards: note the similarities.
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Ambulance marking scheme
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Police marking scheme
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Fire and Rescue marking scheme
Battenburg Pattern
All ambulances are to be equipped with highly reflective green and yellow 'checkerboard' markings (the English term is '
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Normal range of colour vision
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Same image with one form of red/green colour-blindness (1% of males)
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Most common form of colour-blindness (5% of males)
Star of Life
The blue Star of Life, the international EMS emblem, must be painted on both sides and on top of the vehicle. The mark must be a minimum of 500mm in diameter. This requirement may be waived if the ambulance is part of a national affiliate of the International Red Cross and Red Crescent Society. In this case, the Red Cross (or other authorized ICRC emblem) should be used instead. Emblems of the International Red Cross and Red Crescent Movement. This requirement may also be waived if use of the Star of Life emblem is restricted by local law. The standard also calls for the Star of Life to be used on EMS clothing and apparel. [12]
Word Markings
The vehicle must be marked with the English word "AMBULANCE" and/or the equivalent word in the local language. The text must utilize capital letters, have a letter height of at least 100mm, and the letters must contrast with the background colours.[12]
Application and compliance
As with most European standards, compliance by the member countries of the European Union is purely voluntary, and to be determined at the level of the member country, usually by means of legislation, or by its own standards organization.[13] To illustrate, this standard, which has been accepted by the United Kingdom, is known locally as BS EN 1789:2007, with the 'BS' referring to British Standards. As a result, the adoption of this standard has varied considerably from one country to another. Most countries, for example, have adopted the sections dealing with vehicle design and performance, while only a few (the UK, Ireland, and Sweden at this writing), have fully adopted the colour, warning system, and livery schemes for such vehicles. To further complicate matters, some countries have adopted some portion of the visual identity standards, but not all. In the Netherlands, Belgium, and some parts of Germany, the conversion to the basic identifying colour (yellow) is occurring, but the balance of visual identity provisions are not. In addition, some countries which are not currently members of the European Union, such as Norway are adopting some portions of the standards, primarily because few other good standards exist for this purpose, particularly those that reflect European realities. The rate and degree of compliance with the standard is a conscious choice by individual countries, while in others, compliance is a matter of the priorities for the changing of older, country specific, legislation. As previously stated, compliance with the standard is purely voluntary. There are no untoward financial implications to compliance, since only ambulances purchased after ratification of the standard by each country are required to be compliant. There is no mandatory provision for the retrofitting of existing ambulances.
References
- ^ "Ambulance CEN Approval". Retrieved 2021-06-15.
- ^ a b Committee on European Standards (2007). "Medical Vehicles and their Equipment 1". Cen - en 1789.
- PMID 1028572. Archived from the original(PDF) on 2013-10-20.
- S2CID 5778449.
- PMID 15627427. Archived from the original(PDF) on 2006-09-02.
- PMID 16137381.
- ^ BS EN 1789:2020 Section 4.4.5
- ^ "Erlasse - Landesrecht NRW". recht.nrw.de. Ministerium des Innern des Landes Nordrhein-Westfalen.
- ^ "RVLR Requirements about using Blue warning beacons".
- ^ Hall, Sarah (2002-03-07). "Ambulances Turn Yellow for Europe (Manchester Guardian article)". The Guardian. London. Retrieved 2008-10-01.
- ISBN 978-0-521-00439-8.
- ^ a b "CEN 1789, Annex A Page 39" (PDF). Archived from the original (PDF) on 2014-10-24.
- ^ "European Standards website". Archived from the original on 2008-12-09. Retrieved 2008-10-01.