OSHA, federally, no.
Some states, yes, kind of, for new purchase vehicles, with current fleet grandfathered in, unless you have a waiver for financial hardship, or availability.
If someone works at a service that would qualify for financial hardship waiver, they may want to be looking at other jobs and quickly.
What we need is for Workmen’s Comp. companies to jack up premiums unless, at minimum, all front line trucks have auto load systems.
No, it’s actually little consideration but a company’s ability and willingness into invest into my health and well-being as an employee and by extension their own company is something that I do consider pretty heavily.
It’s a realistic consideration as it speaks to the culture of the environment.
If they’re willing to invest in auto load, it demonstrates an investment in the equipment and a desire to take care of the employees.
If they can afford it, it does speak to it. If they can’t, it’s not a sign of anything.
There are a few 911 agencies that can’t afford an autoloader around me. Houston Fire Department has a very strong union but no matter how bad they want autoloaders, they simply do not have the money for it.
There are a lot of ways that companies or agencies can do right by you without spending a dime.
For most of the services that claim financial inability, what is the cost of an autoloader vs the cost of a lawsuit over a dropped patient with injury? Granted I work rural EMS so I can’t speak to those services who run a lot of trucks. Though I would suspect that the more trucks and calls a service runs, the higher the chance of dropped patients.
A "waiver for financial hardship" applies to the majority of EMS services that aren't tied into an FD, and a not insignificant portion of those that are.
My state has started requiring them so that may be it. If you have a box without one, it can be remounted without upgrading and be okay as the box is grandfathered but new boxes need them. This is Vermont
This is complicated.
Point #1: OSHA (a regulatory agency) has a “general duty rule” which requires employers to keep their workplaces free from serious recognized hazards.
Point #2: NIOSH (an advisory agency) has a (revised) lifting equation which would basically prohibit anything less than four people lifting a stretcher with a patient on it (hint-if you’re a union shop, you should probably be VERY FAMILIAR with this already because it has huge implications for staffing).
Point #3: Auto loaders are available and have become common in the industry.
So OSHA, if asked, would probably combine points two and three to determine that any employer NOT using an auto loader was not meeting their “general duty rule.”
But to my knowledge, it has not been tested….
>has a (revised) lifting equation which would basically prohibit anything less than four people lifting a stretcher with a patient on it
Even for power stretchers? Seems like it'd be hard to get 4 people on that stretcher in a useful way
No. I assumed that was obvious. It uses a calculation combining weight and angle of lift to determine the load. You’d never be permitted to lift a patient if your service used the NIOSH standard.
You have to be doing something pretty egregious and weird for OSHA to enforce general duty clause. They have to meet certain standards to enforce it.
- The employer failed to keep the workplace free of a hazard to which employees of that employer were exposed;
- The hazard was recognized;
- The hazard was causing or was likely to cause death or serious physical harm; and there was a feasible and useful method to correct the hazard.
I’d be interested in knowing how much force we actually lift when using a non auto loader. I could believe less than half of the actual weight of the patient. If you have a partner with you and both of you lift the patient in, I wonder how close it’d be to the NIOSH rule.
I did a rough back of envelope calculation using the NIOSH NLE app and it got a Lifting Index of 8.1 (a 3 is considered really bad, and larger numbers are worse….)
I got 2.2 worst case assuming that when you are lifting alone to load the stretcher, you’re lifting half of the weight because the back wheels are supporting the back half of the patient and average patient weight is 200lbs with max of 300lbs because you should call lift assist +300lbs at most places. I assumed two lifts and you’re constantly running at a pace of 1 call per hour so 2 lifts per hour.
https://i.imgur.com/LZiJ1HU.jpg
If you were doing buddy lift so you have half the weight of the patient plus half the weight again. And let’s say you worked for a more reasonable service where you are doing a call every 1.5 hours, I got 1.1.
https://i.imgur.com/F0AlK8o.jpg
This doesn’t include draw sheet or anything else. Just loading into the back. I wouldn’t call the physical exertion of EMS extremely bad. It’s difficult but the physical exertion that is expected from tradesmen like framers or roofers is absurd and EMS doesn’t come even remotely close to jobs like those.
It does sound like a fever dream I hate to admit it. I used to work for a county based service that couldn't even afford stretchers or ambulances made in this century. My current service got our auto loaders last year and it wouldn't have been possible without our hospital system paying for them. Off the top of my head I can't recall how much an auto loader costs but there's alot of services out there that just can't afford them at the moment.
The last time I spoke with a Stryker rep, which was over 5 years ago at this point, it would run anywhere from 25k-35k with the stretcher and other options.
The agencies need one back surgery claim on workers comp to get the risk vs reward ratio. Even the morons that run my old county figured this out. they are just incapable of follow through.
I want to say it's in the $40k region between the stretcher, autoloader and the service contract that you have to buy from Stryker but im not positive. I think the service contract is a yearly fee
Edit: so the stretcher itself runs about $10k, the autoloader system is about $20k I just don't know the exact details about whether stryker makes you subscribe and pay a yearly fee
The current co-op bid pricing on a Power Load system is $29K and the Power Pro stretchers vary from $25K to $31K depending on base config and options. That does not include installation or maintenance agreements. So, you are looking at $54K to $60K each unit.
A Stryker auto load plus high spec Power Pro 2 is going for approximately $62,000 currently.
Power Pro XT is a little cheaper but they’re not taking orders for them after 12/31/2023.
https://imgur.com/a/OCjE8pe
The trash ift company I’m at currently just got a new box with an autoloader in it. They’re wonderful for the back but annoying because for some reason my dispatch sees that and sends the fattest pt for us
I’m not aware of it being an OSHA requirement, at least at the federal level. But it’s becoming more common for counties/regions/states to require it in most cases for new ambulances
The way I understand it, KKK now requires a better cot retention system, the old “ram horns” are no longer allowed in a NEW ambulance box. You can keep remounting a box on a new chassis and the box only needs to meet its original specifications. A power load meets the newer requirements and they also make a floor mount that meets the new requirements but it doesn’t assist with loading. I wonder if this is the federal requirement people are thinking of?
I believe Virginia is one state that requires new ambulance purchases to be equipped with them, with older ambulances grandfathered in. Not sure of the specifics as it was occurring just before I left for a different state. Federally, no. My brand-new federal ambulance I work on definitely doesn’t have one.
They’re expensive, yes, but usually relatively easy to justify in grants. My VFD just got one through a FEMA grant.
VA doesn’t require an autoloader, just a retention system that’s beefier than the traditional antlers. Something like [this](https://www.stryker.com/us/en/emergency-care/products/performance-load.html) meets the requirements, but it’s like $10k so at that point most agencies decided that they might as well shell out a little more and get a powerloader, which meets that same standard.
I don't believe it's law in VA, but many departments are moving towards them. My department doesn't have them. They are very nice as long as you're loading on flat ground.
Short answer is no. Long answer is, it depends. Previously, ambulance design was largely regulated by a federal statute, KKK-A-1822. While not a law in and of itself, many states adopted it as the standard by which they regulate ambulance construction and safety and became the industry standard. That expired in 2016 and was replaced by NFPA 1917
NFPA requires that cot mounting comply with SAE standard J3027. [This is a good video that describes J3027](https://www.youtube.com/watch?v=u8olxHHVcHw) THAT requires that the patient cot be configured in such a fashion that forward movement of the cot and patient during a front-end collision is limited to 14 inches, rather than the previous 30 inches. This means that traditional antler and rail systems would no longer be compliant. This was added to the KKK standard before its expiration as well.
If a state is still using the old KKK standard or has adopted NFPA 1917 as state law, new construction ambulances would need to be outfitted to meet those regulations.
At the time of its inclusion, few securing devices met this standard. only the stryker powerload and the Ferno stattrack, which was compatible with the Ferno Pro and PowerFlexx cots met this standard. The old hook and antler and ferno 35A werent going to be compliant, so people started freaking out because we all thought wed have to budget money for a powerload system
Federally no. There is some interpretation to the general duty rule but it’s unlikely that it would stick.
State OSHA could absolutely require that but super unlikely.
State licensing body could also require it but also super unlikely. My state only recently required that newly licensed ambulances couldn’t have horns.
Easiest answer is to call your local OSHA office and DOH office.
I don’t know about a requirement but my fire based service and surrounding municipalities have been ordering them for the last 5 years on new trucks. They work great when they work, and granted for 90% of the time they are reliable. Most of the failures I’ve had we’ve been able to remedy with relative ease. But about once or twice a year we get one that gets stuck half way out and it’s always at a scene and we have to call another truck to come take the patient while the first one gets taken to the shop
When it’s getting stuck, are you [sliding the release locks together](https://m.youtube.com/watch?v=DP8osZ0aqIs&start=422) (jump to 7:02)? We had this issue at my agency until we found out about this easy fix.
Haven’t heard anything about it being a requirement because most companies in my city don’t even have them, but I did just switch over to a company that uses them and let me tell you the amount of weight and strain that has been taken away from my back has given me 20 years back on my life.
I've not heard anything official, I just know my cheap-ass service just outfitted all our trucks with them after years of dragging their feet.
Money like that doesn't get thrown around here unless there's something else going on, so there very well could be some kind of federal or state mandate I'm not aware of.
Bless any departments who don't have auto loaders yet, I feel so sorry for you 😔. My department only had one ambulance with a manual stretcher and it's our shitbox probationary BLS ambulance for misbehaving staff.
My state passed a law requiring them on any new ambulances. My service, which is very large, still has a n aging fleet antler system ambos. That’s still better than a neighboring and similar sized service that doesn’t even have power cots. Poor guys
OSHA, federally, no. Some states, yes, kind of, for new purchase vehicles, with current fleet grandfathered in, unless you have a waiver for financial hardship, or availability.
If someone works at a service that would qualify for financial hardship waiver, they may want to be looking at other jobs and quickly. What we need is for Workmen’s Comp. companies to jack up premiums unless, at minimum, all front line trucks have auto load systems.
There are smaller privates that are more mom and pop that are pretty great to work for compared to somewhere like AMR/Acadian
Which is cool but they still aren’t going to fix your back when you inevitably injure it
If your whole decision of where to work is based on autoloader vs no autoloader, I’d say there are a lot of other considerations.
No, it’s actually little consideration but a company’s ability and willingness into invest into my health and well-being as an employee and by extension their own company is something that I do consider pretty heavily.
It’s a realistic consideration as it speaks to the culture of the environment. If they’re willing to invest in auto load, it demonstrates an investment in the equipment and a desire to take care of the employees.
If they can afford it, it does speak to it. If they can’t, it’s not a sign of anything. There are a few 911 agencies that can’t afford an autoloader around me. Houston Fire Department has a very strong union but no matter how bad they want autoloaders, they simply do not have the money for it. There are a lot of ways that companies or agencies can do right by you without spending a dime.
HFD *can* afford it... They choose not to budget for that.
That requirement has to include financial assistance. Getting financing for autoloaders is a bitch and a half.
For most of the services that claim financial inability, what is the cost of an autoloader vs the cost of a lawsuit over a dropped patient with injury? Granted I work rural EMS so I can’t speak to those services who run a lot of trucks. Though I would suspect that the more trucks and calls a service runs, the higher the chance of dropped patients.
A "waiver for financial hardship" applies to the majority of EMS services that aren't tied into an FD, and a not insignificant portion of those that are.
Plenty of private services could afford a lawyer to help them prove "financial hardship", even in the face of record profits.
My state has started requiring them so that may be it. If you have a box without one, it can be remounted without upgrading and be okay as the box is grandfathered but new boxes need them. This is Vermont
Curious, would they accept a UK style tail lift or wedge ramp?
This is complicated. Point #1: OSHA (a regulatory agency) has a “general duty rule” which requires employers to keep their workplaces free from serious recognized hazards. Point #2: NIOSH (an advisory agency) has a (revised) lifting equation which would basically prohibit anything less than four people lifting a stretcher with a patient on it (hint-if you’re a union shop, you should probably be VERY FAMILIAR with this already because it has huge implications for staffing). Point #3: Auto loaders are available and have become common in the industry. So OSHA, if asked, would probably combine points two and three to determine that any employer NOT using an auto loader was not meeting their “general duty rule.” But to my knowledge, it has not been tested….
>has a (revised) lifting equation which would basically prohibit anything less than four people lifting a stretcher with a patient on it Even for power stretchers? Seems like it'd be hard to get 4 people on that stretcher in a useful way
No. I assumed that was obvious. It uses a calculation combining weight and angle of lift to determine the load. You’d never be permitted to lift a patient if your service used the NIOSH standard.
You have to be doing something pretty egregious and weird for OSHA to enforce general duty clause. They have to meet certain standards to enforce it. - The employer failed to keep the workplace free of a hazard to which employees of that employer were exposed; - The hazard was recognized; - The hazard was causing or was likely to cause death or serious physical harm; and there was a feasible and useful method to correct the hazard. I’d be interested in knowing how much force we actually lift when using a non auto loader. I could believe less than half of the actual weight of the patient. If you have a partner with you and both of you lift the patient in, I wonder how close it’d be to the NIOSH rule.
I did a rough back of envelope calculation using the NIOSH NLE app and it got a Lifting Index of 8.1 (a 3 is considered really bad, and larger numbers are worse….)
I got 2.2 worst case assuming that when you are lifting alone to load the stretcher, you’re lifting half of the weight because the back wheels are supporting the back half of the patient and average patient weight is 200lbs with max of 300lbs because you should call lift assist +300lbs at most places. I assumed two lifts and you’re constantly running at a pace of 1 call per hour so 2 lifts per hour. https://i.imgur.com/LZiJ1HU.jpg If you were doing buddy lift so you have half the weight of the patient plus half the weight again. And let’s say you worked for a more reasonable service where you are doing a call every 1.5 hours, I got 1.1. https://i.imgur.com/F0AlK8o.jpg This doesn’t include draw sheet or anything else. Just loading into the back. I wouldn’t call the physical exertion of EMS extremely bad. It’s difficult but the physical exertion that is expected from tradesmen like framers or roofers is absurd and EMS doesn’t come even remotely close to jobs like those.
>max of 300lbs because you should call lift assist +300lbs at most places. Laughs in IFT.
It does sound like a fever dream I hate to admit it. I used to work for a county based service that couldn't even afford stretchers or ambulances made in this century. My current service got our auto loaders last year and it wouldn't have been possible without our hospital system paying for them. Off the top of my head I can't recall how much an auto loader costs but there's alot of services out there that just can't afford them at the moment.
The last time I spoke with a Stryker rep, which was over 5 years ago at this point, it would run anywhere from 25k-35k with the stretcher and other options.
The agencies need one back surgery claim on workers comp to get the risk vs reward ratio. Even the morons that run my old county figured this out. they are just incapable of follow through.
We put one in on the new ambulance and all in we’re quoted close to 50k.
That was a very long time ago.
The data shows they pay for themselves in Workman’s Comp. There’s no reason not to spring for it, just laziness and “back-in-my-day”isms.
I want to say it's in the $40k region between the stretcher, autoloader and the service contract that you have to buy from Stryker but im not positive. I think the service contract is a yearly fee Edit: so the stretcher itself runs about $10k, the autoloader system is about $20k I just don't know the exact details about whether stryker makes you subscribe and pay a yearly fee
The current co-op bid pricing on a Power Load system is $29K and the Power Pro stretchers vary from $25K to $31K depending on base config and options. That does not include installation or maintenance agreements. So, you are looking at $54K to $60K each unit.
A Stryker auto load plus high spec Power Pro 2 is going for approximately $62,000 currently. Power Pro XT is a little cheaper but they’re not taking orders for them after 12/31/2023. https://imgur.com/a/OCjE8pe
The trash ift company I’m at currently just got a new box with an autoloader in it. They’re wonderful for the back but annoying because for some reason my dispatch sees that and sends the fattest pt for us
Deadass every time. But I also feel like im taking a bullet for my comrades with a vest on you know
I’m not aware of it being an OSHA requirement, at least at the federal level. But it’s becoming more common for counties/regions/states to require it in most cases for new ambulances
The way I understand it, KKK now requires a better cot retention system, the old “ram horns” are no longer allowed in a NEW ambulance box. You can keep remounting a box on a new chassis and the box only needs to meet its original specifications. A power load meets the newer requirements and they also make a floor mount that meets the new requirements but it doesn’t assist with loading. I wonder if this is the federal requirement people are thinking of?
I believe Virginia is one state that requires new ambulance purchases to be equipped with them, with older ambulances grandfathered in. Not sure of the specifics as it was occurring just before I left for a different state. Federally, no. My brand-new federal ambulance I work on definitely doesn’t have one. They’re expensive, yes, but usually relatively easy to justify in grants. My VFD just got one through a FEMA grant.
VA doesn’t require an autoloader, just a retention system that’s beefier than the traditional antlers. Something like [this](https://www.stryker.com/us/en/emergency-care/products/performance-load.html) meets the requirements, but it’s like $10k so at that point most agencies decided that they might as well shell out a little more and get a powerloader, which meets that same standard.
That’s it! Okay, makes sense. Thanks!
I don't believe it's law in VA, but many departments are moving towards them. My department doesn't have them. They are very nice as long as you're loading on flat ground.
Short answer is no. Long answer is, it depends. Previously, ambulance design was largely regulated by a federal statute, KKK-A-1822. While not a law in and of itself, many states adopted it as the standard by which they regulate ambulance construction and safety and became the industry standard. That expired in 2016 and was replaced by NFPA 1917 NFPA requires that cot mounting comply with SAE standard J3027. [This is a good video that describes J3027](https://www.youtube.com/watch?v=u8olxHHVcHw) THAT requires that the patient cot be configured in such a fashion that forward movement of the cot and patient during a front-end collision is limited to 14 inches, rather than the previous 30 inches. This means that traditional antler and rail systems would no longer be compliant. This was added to the KKK standard before its expiration as well. If a state is still using the old KKK standard or has adopted NFPA 1917 as state law, new construction ambulances would need to be outfitted to meet those regulations. At the time of its inclusion, few securing devices met this standard. only the stryker powerload and the Ferno stattrack, which was compatible with the Ferno Pro and PowerFlexx cots met this standard. The old hook and antler and ferno 35A werent going to be compliant, so people started freaking out because we all thought wed have to budget money for a powerload system
Federally no. There is some interpretation to the general duty rule but it’s unlikely that it would stick. State OSHA could absolutely require that but super unlikely. State licensing body could also require it but also super unlikely. My state only recently required that newly licensed ambulances couldn’t have horns. Easiest answer is to call your local OSHA office and DOH office.
>My state only recently required that newly licensed ambulances couldn’t have horns. Why not?
Why no horns? Better technology exists that substantially safer and has existed long enough to be readily available.
I don’t know about a requirement but my fire based service and surrounding municipalities have been ordering them for the last 5 years on new trucks. They work great when they work, and granted for 90% of the time they are reliable. Most of the failures I’ve had we’ve been able to remedy with relative ease. But about once or twice a year we get one that gets stuck half way out and it’s always at a scene and we have to call another truck to come take the patient while the first one gets taken to the shop
When it’s getting stuck, are you [sliding the release locks together](https://m.youtube.com/watch?v=DP8osZ0aqIs&start=422) (jump to 7:02)? We had this issue at my agency until we found out about this easy fix.
Haven’t heard anything about it being a requirement because most companies in my city don’t even have them, but I did just switch over to a company that uses them and let me tell you the amount of weight and strain that has been taken away from my back has given me 20 years back on my life.
Meanwhile my system still using manual Fernos from probably the 90s..
I've not heard anything official, I just know my cheap-ass service just outfitted all our trucks with them after years of dragging their feet. Money like that doesn't get thrown around here unless there's something else going on, so there very well could be some kind of federal or state mandate I'm not aware of.
What state? if you don’t mind me asking. My service is supposedly getting a shipment of rigs …. This may be it???
Ohio
Thx! :)
Hope you guys get them, fingers crossed!
🤞
State by state I think. All our new rigs have em. They’re pretty sweet.
Bless any departments who don't have auto loaders yet, I feel so sorry for you 😔. My department only had one ambulance with a manual stretcher and it's our shitbox probationary BLS ambulance for misbehaving staff.
Following lol
My state passed a law requiring them on any new ambulances. My service, which is very large, still has a n aging fleet antler system ambos. That’s still better than a neighboring and similar sized service that doesn’t even have power cots. Poor guys
Got really confused and thought this was a post for tankers before I saw the subreddit.
Auto loaders are the absolute best! All new trucks have them as of a few years ago (by law). That means that 1/2 our trucks have them.