Standard Guide for Scope of Performance of Triage in a Prehospital Environment

SIGNIFICANCE AND USE
This guide is not intended to be used by itself, but as a component of Guide F1288. Merely conforming to the guidelines described herein will not ensure that adequate triage is carried out in a multiple casualty incident.
The purpose of this guide is to establish a methodology for performing triage.
Individuals responsible for performing triage must be proficient in triage methods and related life-saving techniques.
A basic concept of triage is to do the greatest good for the greatest number of casualties.
The assessment process must be focused so as to identify those most at risk of early death who are likely to be salvaged by rapid medical intervention.
Triage allows the most efficient use of available resources.
This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum scope of performance and encourages the addition of optional knowledge, skills and attitudinal objectives.
A vital role in the development of and operational application of triage is that of medical control. This guide should be used by medical directors in the determination of operational and medical protocols for use during MCI's.
This guide is intended to assist those who are responsible for defining the scope of performance of individuals who perform triage.
For the purpose of this guide the word “injured” includes both sick or injured patients, or both.
SCOPE
1.1 This guide covers minimum requirements for the scope of performance for individuals who perform triage at an emergency medical incident involving multiple casualties in a pre-hospital environment.
1.2 This guide acknowledges objectives based on an individual's required knowledge of signs and symptoms, patient assessment and basic life support.
1.3 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031, Guides F1219, F1253, F1285, F1287, F1288, F1489 and F1651.
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see Footnote 3.

General Information

Status
Historical
Publication Date
30-Jun-2012
Current Stage
Ref Project

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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: F1653 − 95 (Reapproved 2012)
Standard Guide for
Scope of Performance of Triage in a Prehospital
1
Environment
This standard is issued under the fixed designation F1653; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
INTRODUCTION
Triage is a word taken from the French verb trier, that means “to sort”. During the time of the
Napoleonic wars, a technique for assigning priorities to the treatment of battlefield casualties was
established in order to maximize the use of limited resources. The basic principle of triage is to do the
greatestgoodforthegreatestnumberofcasualties.Careisprovidedfirsttothosewiththemostserious
emergencies and to those who are most salvageable. This technique is identified as essential for good
disaster medical care.
1. Scope 2. Referenced Documents
3
1.1 This guide covers minimum requirements for the scope 2.1 ASTM Standards:
of performance for individuals who perform triage at an F1031 Practice for Training the Emergency Medical Tech-
emergency medical incident involving multiple casualties in a nician (Basic)
pre-hospital environment. F1177 Terminology Relating to Emergency Medical Ser-
vices
1.2 This guide acknowledges objectives based on an indi-
F1219 Guide for Training the Emergency Medical Techni-
vidual’s required knowledge of signs and symptoms, patient
cian (Basic) to Perform Patient Initial and Detailed As-
assessment and basic life support.
4
sessment (Withdrawn 2006)
1.3 Operating within the framework of this guide may
F1253 Guide for Training the Emergency Medical Techni-
expose personnel to hazardous materials, procedures, and
cian (Basic) to Perform Patient Secondary Assessment
4
equipment. For additional information see Practice F1031,
(Withdrawn 1999)
Guides F1219, F1253, F1285, F1287, F1288, F1489 and
F1285 Guide for Training the Emergency Medical Techni-
F1651.
cian (Basic) to Perform Patient Examination Techniques
1.4 This standard does not purport to address all of the F1287 Guide for Scope of Performance of First Responders
safety concerns, if any, associated with its use. It is the
Who Provide Emergency Medical Care
responsibility of the user of this standard to establish appro- F1288 Guide for Planning for and Response to a Multiple
priate safety and health practices and determine the applica-
Casualty Incident
bility of regulatory limitations prior to use. For specific F1489 Guide for Performance of Patient Assessment by the
2
precautionary statements, see Footnote 3.
Emergency Medical Technician (Paramedic) (Withdrawn
4
2003)
F1651 Guide for Training the Emergency Medical Techni-
1
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
cian (Paramedic)
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
Current edition approved July 1, 2012. Published August 2012. Originally
3
approved in 1995. Last previous edition approved in 2007 as F1653 – 95 (2007). For referenced ASTM standards, visit the ASTM website, www.astm.org, or
DOI: 10.1520/F1653-95R12. contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
2
Most recent “Guidelines for Cardiopulmonary Resuscitation and Emergency Standards volume information, refer to the standard’s Document Summary page on
Cardiac Care,” as reprinted from the Journal of the American Medical Association, the ASTM website.
4
available from American Heart Association, 7272 Greenville Ave., Dallas, TX The last approved version of this historical standard is referenced on
75231. www.astm.org.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
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F1653 − 95 (2012)
3. Terminology require performance of all objectives. Individuals who perform
triage shall be able to:
3.1 Definitions of Terms Specific to This Standard:
5.1.1 Identify health and safety hazards and initiate appro-
3.1.1 ongoing triage, n—the continuing process of patient
priate actions.
assessment and prioritization in a multiple casualty incident.
5.1.2 Recognize an incident that may require triage.
(Also known as secondary and tertiary).
5.1.3 Determine the need for and request additional re-
3.1.2 primary triage, n—the initial process of rapid
sources.
assessment, provision of life saving interventions and assign-
5.1.4 Initiate incident command Guide F1288.
ment of visual priority identification to each patient in a
5.1.5 Identify conditions which may dictate a decision to
multiple casualty incident.
treat patients at the scene or transfer
...

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