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ASTM F1653-95(2020)

(Guide)

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

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

SIGNIFICANCE AND USE
4.1 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.  
4.2 The purpose of this guide is to establish a methodology for performing triage.  
4.3 Individuals responsible for performing triage must be proficient in triage methods and related life-saving techniques.  
4.4 A basic concept of triage is to do the greatest good for the greatest number of casualties.  
4.5 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.  
4.6 Triage allows the most efficient use of available resources.  
4.7 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.  
4.8 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 MCIs.  
4.9 This guide is intended to assist those who are responsible for defining the scope of performance of individuals who perform triage.  
4.10 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 and 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see Footnote 2.2  
1.5 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

General Information

Status
Published
Publication Date
31-Oct-2020
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.02 - Personnel, Training and Education
Current Stage
Ref Project

Relations

Refers
ASTM F1031-00(2012) - Standard Practice for Training the Emergency Medical Technician (Basic)
Effective Date
01-Jul-2012
Refers
ASTM F1651-95(2009) - Standard Guide for Training the Emergency Medical Technician (Paramedic) (Withdrawn 2018)
Effective Date
01-Mar-2009
Refers
ASTM F1177-02(2009) - Standard Terminology Relating to Emergency Medical Services (Withdrawn 2018)
Effective Date
01-Mar-2009
Refers
ASTM F1288-90(2009) - Standard Guide for Planning for and Response to a Multiple Casualty Incident (Withdrawn 2018)
Effective Date
01-Mar-2009
Refers
ASTM F1285-90(2008) - Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Examination Techniques
Effective Date
01-Feb-2008
Refers
ASTM F1031-00(2006) - Standard Practice for Training the Emergency Medical Technician (Basic)
Effective Date
01-Mar-2006
Refers
ASTM F1285-90(2003) - Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Examination Techniques
Effective Date
10-Sep-2003
Refers
ASTM F1288-90(2003) - Standard Guide for Planning for and Response to a Multiple Casualty Incident
Effective Date
10-Sep-2003
Refers
ASTM F1177-02 - Standard Terminology Relating to Emergency Medical Services
Effective Date
10-Sep-2002
Refers
ASTM F1031-00 - Standard Practice for Training the Emergency Medical Technician (Basic)
Effective Date
10-Oct-2000
Refers
ASTM F1219-00 - Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Initial and Detailed Assessment (Withdrawn 2006)
Effective Date
10-Oct-2000
Refers
ASTM F1288-90(1998) - Standard Guide for Planning for and Response to a Multiple Casualty Incident
Effective Date
10-Nov-1998
Refers
ASTM F1285-90(1998) - Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Examination Techniques
Effective Date
10-Jun-1998
Refers
ASTM F1177-96a - Standard Terminology Relating to Emergency Medical Services
Effective Date
01-Jan-1996
Refers
ASTM F1651-95(2002) - Standard Guide for Training the Emergency Medical Technician (Paramedic)
Effective Date
10-Oct-1995

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ASTM F1653-95(2020) - Standard Guide for Scope of Performance of Triage in a Prehospital EnvironmentASTM F1653-95(2020) - Standard Guide for Scope of Performance of Triage in a Prehospital Environment
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This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the
Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
Designation: F1653 − 95 (Reapproved 2020)
Standard Guide for
Scope of Performance of Triage in a Prehospital
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 mendations issued by the World Trade Organization Technical
Barriers to Trade (TBT) Committee.
1.1 This guide covers minimum requirements for the scope
of performance for individuals who perform triage at an
2. Referenced Documents
emergency medical incident involving multiple casualties in a
pre-hospital environment.
2.1 ASTM Standards:
F1031 Practice for Training the Emergency Medical Tech-
1.2 This guide acknowledges objectives based on an indi-
nician (Basic)
vidual’s required knowledge of signs and symptoms, patient
F1177 Terminology Relating to Emergency Medical Ser-
assessment, and basic life support.
vices (Withdrawn 2018)
1.3 Operating within the framework of this guide may
F1219 Guide for Training the Emergency Medical Techni-
expose personnel to hazardous materials, procedures, and
cian (Basic) to Perform Patient Initial and Detailed As-
equipment. For additional information see Practice F1031 and
sessment (Withdrawn 2006)
Guides F1219, F1253, F1285, F1287, F1288, F1489 and
F1253 Guide for Training the Emergency Medical Techni-
F1651.
cian (Basic) to Perform Patient Secondary Assessment
1.4 This standard does not purport to address all of the 4
(Withdrawn 1999)
safety concerns, if any, associated with its use. It is the
F1285 Guide for Training the Emergency Medical Techni-
responsibility of the user of this standard to establish appro-
cian to Perform Patient Examination Techniques
priate safety, health, and environmental practices and deter-
F1287 Guide for Scope of Performance of First Responders
mine the applicability of regulatory limitations prior to use.
Who Provide Emergency Medical Care
For specific precautionary statements, see Footnote 2.
F1288 Guide for Planning for and Response to a Multiple
1.5 This international standard was developed in accor- 4
Casualty Incident (Withdrawn 2018)
dance with internationally recognized principles on standard-
F1489 Guide for Performance of Patient Assessment by the
ization established in the Decision on Principles for the
Emergency Medical Technician (Paramedic) (Withdrawn
Development of International Standards, Guides and Recom- 4
2003)
F1651 Guide for Training the Emergency Medical Techni-
cian (Paramedic) (Withdrawn 2018)
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
Current edition approved Nov. 1, 2020. Published November 2020. Originally
approved in 1995. Last previous edition approved in 2012 as F1653 – 95 (2012). For referenced ASTM standards, visit the ASTM website, www.astm.org, or
DOI: 10.1520/F1653-95R20. contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
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.
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
F1653 − 95 (2020)
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 them to a designated
3.1.3 triage, n—the process of sorting and prioritizing care
treatment area.
of the sick and injured on the basis of urgency and type of
5.1.6 Initiate Primary Triage.
condition present, as well as the number of patients and
5.1.6.1 Identify victims who appear to be uninjured or
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4.1 This guide establishes the minimum national standard for training the Emergency Medical Technician to perform patient examination techniques on patients of all ages.  
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4.1 Since the quality of EMT training depends, in large measure, on the instructional abilities and competencies of the EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.  
4.2 An EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of instruction.  
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1.8 This guide does not establish certification requirements. Such requirements should be established by the certifying agency in the jurisdiction in which the EMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.  
1.9 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use.
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4.1 The purpose of this practice is to provide standardized means of providing Emergency Medical Technician training. The practice should be used by all individuals and agencies that train such persons.  
4.2 Successful completion of this course of training neither constitutes nor implies certification or licensure.  
4.3 This practice adopts the knowledge and skill objectives contained in the NHSTA curriculum (latest version) as the standard practice for training those persons who provide emergency medical care at the basic life support level and are known as Emergency Medical Technicians. The actual lesson plans contained in the referenced document are recommended for use; however, each instructor may modify the order of presentation according to local needs.  
4.4 This practice outlines a comprehensive course that covers most common emergencies encountered by the Emergency Medical Technician. Emergency Medicine Technician courses that do not include all of the knowledge and skill objectives of this practice may not be referred to as meeting this standard.
SCOPE
1.1 This practice covers a standard course for the training of the Emergency Medical Technician which will prepare a person to perform those skills commonly required to render lifesaving aid at the scene of an emergency and during transportation to a definitive care facility.  
1.2 It is not the intent of this practice to require that the curriculum be used exactly as presented, but only that the knowledge and skill objectives that are part of the curriculum be included in any course purporting to train an Emergency Medical Technician. It is not the intent of this practice to limit the addition of knowledge and skill objectives as required by local conditions.  
1.3 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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Standard Guide for Training and Evaluation of First Responders Who Provide Emergency Medical Care

SIGNIFICANCE AND USE
4.1 This guide is for those responsible for the development and implementation of training and evaluation programs for first responders (FRs).  
4.2 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.  
4.3 This guide is not intended for use as a training guide for emergency ambulance personnel.
SCOPE
1.1 This guide covers the minimum training standards for First Responders (FRs) who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.  
1.2 The scope of training will be in accordance with Guide F1287.  
1.3 Included in this guide is a standard for knowledge and skill evaluation.  
1.4 This guide does not suggest a particular training sequence.  
1.5 Operating within the framework of this guide may expose emergency medical service personnel to hazardous materials, procedures and equipment. 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the documents cited in 2.2.  
1.6 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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Standard Guide for Scope of Performance of First Responders Who Provide Emergency Medical Care

SIGNIFICANCE AND USE
4.1 The purpose of this guide is to improve the quality of initial emergency medical care provided to the sick and injured. As the first trained person at an emergency medical scene, it is critical that the first responder be proficient in providing patient care and minimizing further complications until more highly trained emergency medical service personnel intervene.  
4.2 In identifying these minima, the guide acknowledges many types of first responder emergency medical care courses of study. This guide allows and encourages the addition of optional knowledge, skill, and attitudinal objectives. Programs such as those for law enforcement, firefighters, and ski patrol are examples of this diversity meeting specific local community needs.  
4.3 This guide is intended to assist those who are responsible for defining the scope of performance for first responders.  
4.4 This guide is not  intended to be used as a scope of performance for emergency ambulance personnel (see Practice F1031).
SCOPE
1.1 This guide covers minimum requirements for the scope of performance of first responders who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.  
1.2 This guide includes objectives based on an individual's acquired knowledge, including signs and symptoms; patient assessment; basic life support/cardiopulmonary resuscitation (BLS/CPR); bleeding and shock; injuries to the skull, spine, chest, abdomen, and extremities; moving patients; medical and environmental emergencies; triage; gaining access; and hazardous situations that the first responder may encounter.  
1.3 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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ASTM
ASTM F1654-95(2020)(Guide)
Standard Guide for Training and Evaluation of Individuals Who Are Responsible for or Perform Triage in a Prehospital Environment

SIGNIFICANCE AND USE
4.1 This guide is intended for use by those responsible for the development and implementation of training programs, that include competency evaluation, for triage in the prehospital environment.  
4.2 This guide is not intended to be used by itself, but as a component of Guide F1288.  
4.3 This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum training standard and encourages the addition of optional knowledge, skill, and attitudinal objectives.  
4.4 A vital role in the development 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 MCIs and coordinated with those who are responsible for training.  
4.5 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.
SCOPE
1.1 This guide covers minimum requirements for the training and evaluation of individuals who perform triage at an emergency medical incident involving multiple casualties in a prehospital environment.  
1.2 All training will be in accordance with Guide F1653.  
1.3 Included in this guide is a standard for knowledge and skill evaluation.  
1.4 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031 and Guides F1219, F1253, F1285, F1288, F1453, and F1489.  
1.5 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the document cited in Footnote 3.  
1.6 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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