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ASTM F1517-94(2002)

(Guide)

Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations

Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations

SCOPE
1.1 This guide covers minimum standards for the performance of emergency medical services (EMS) ambulance operators, including: operator qualifications, pre-run operation, and post-run aspects.
1.2 This guide shall promote the safe and efficient delivery of the ambulance, equipment, crew, passengers and patients, during all phases of the delivery of EMS involving the ambulance; at all times exercising the highest degree of care for the safety of the public. This guide may be applied to other EMS vehicles that do not necessarily provide patient transport.
1.3 This guide shall be used as the basis for training guides of the emergency medical services ambulance operator.
1.4 The values stated in SI units are to be regarded as the standard. The SI units given in parentheses are for information only.
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 and health practices and determine the applicability of regulatory limitations prior to use.

General Information

Status
Historical
Publication Date
14-May-1994
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.02 - Personnel, Training and Education
Current Stage
Ref Project

Relations

Replaces
ASTM F1517-94 - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
Effective Date
15-May-1994
Replaced By
ASTM F1517-94(2007) - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
Effective Date
01-Feb-2007
Referred By
ASTM F1220-95(2022) - Standard Guide for Emergency Medical Services System (EMSS) Telecommunications
Effective Date
15-May-1994
Referred By
ASTM F1705-96(2020) - Standard Guide for Training Emergency Medical Services Ambulance Operations
Effective Date
15-May-1994

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ASTM F1517-94(2002) - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.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:F1517–94 (Reapproved2002)
Standard Guide for
Scope of Performance of Emergency Medical Services
Ambulance Operations
This standard is issued under the fixed designation F 1517; 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 (e) indicates an editorial change since the last revision or reapproval.
1. Scope 3.1.1 The definitions given in Terminology F 1177 are
applicable to this guide.
1.1 This guide covers minimum standards for the perfor-
3.1.2 ambulance—See Terminology F 1177.
mance of emergency medical services (EMS) ambulance
3.2 Definitions of Terms Specific to This Standard:
operators, including: operator qualifications, pre-run operation,
3.2.1 ambulance operations—the efficient delivery of the
and post-run aspects.
ambulance, equipment, crew, passengers and patients, during
1.2 This guide shall promote the safe and efficient delivery
all phases of the delivery of EMS involving the ambulance at
of the ambulance, equipment, crew, passengers and patients,
all times exercising the highest degree of care for the safety of
during all phases of the delivery of EMS involving the
the public.
ambulance; at all times exercising the highest degree of care
3.2.2 ambulance service provider—asoutlinedinthisguide,
for the safety of the public. This guide may be applied to other
a person, company, corporation or political entity responsible
EMS vehicles that do not necessarily provide patient transport.
for operation, maintenance, or policy making, or combination
1.3 This guide shall be used as the basis for training guides
thereof, regarding emergency medical vehicle operations.
of the emergency medical services ambulance operator.
3.2.3 bona fide occupational qualification (BFOQ)—the
1.4 The values stated in SI units are to be regarded as the
skills and knowledge relevant to the performance of a specific
standard. The SI units given in parentheses are for information
task.
only.
3.2.4 departure check—the visual check of the vehicle and
1.5 This standard does not purport to address all of the
surrounding area ensuring that equipment and supplies have
safety concerns, if any, associated with its use. It is the
been retrieved and properly stored and that all compartment
responsibility of the user of this standard to establish appro-
doors are secured.
priate safety and health practices and determine the applica-
3.2.5 egress check—the visual check of the vehicle and
bility of regulatory limitations prior to use.
surrounding area prior to operating the ambulance.
2. Referenced Documents 3.2.6 emergency mode—as defined by individual state stat-
ues that refer to emergency vehicles, equipment, and opera-
2.1 ASTM Standards:
tions.
F 1031 Practice for Training the Emergency Medical Tech-
3.2.7 full check—a comprehensive and systematic evalua-
nician (Basic)
tion of the ambulance at specified intervals, including docu-
F 1177 Terminology Relating to Emergency Medical Ser-
mentation of the inspection, any deficiencies found and their
vices
corrective actions.
F 1230 Specification for Minimum Performance Require-
3.2.8 operator—a person who operates or assists with the
ments for Emergency Medical Service (EMS) Ground
operation of an ambulance.
Vehicles
3.2.9 post-run—the managed return of the ambulance and
F 1258 Practice for Emergency Medical Dispatch
operators to optimal pre-run readiness.
3. Terminology
3.2.10 pre-run—all aspects of assuring response readiness.
3.2.11 quick check—an abbreviated version of the full
3.1 Definitions:
check, focusing on the major operational functions of the
vehicle.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
4. Significance and Use
Personnel, Training, and Education.
4.1 This guide provides minimum guidelines for safe and
Current edition approved May 15, 1994. Published July 1994.
efficient ambulance operation.
Annual Book of ASTM Standards, Vol 13.02.
Discontinued; see 1996 Annual Book of ASTM Standards, Vol 13.01.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
F1517–94 (2002)
4.2 All ambulance operations and operators should follow 6.3 A review of the state motor vehicle record for the
this guide for the development of educational and training previous three years with specific attention to traffic convic-
programs. tions concerning:
4.3 This guide is intended to promote safe and efficient 6.3.1 Speed,
ambulance operations and to reduce morbidity, mortality, and 6.3.2 Careless and imprudent driving,
property loss associated with ambulance operations. 6.3.3 Driving under the influence of alcohol or other mind-
4.4 This guide is intended to assist those who are respon- altering substances, and
sible for the development and implementation of policies and 6.3.4 Moving violations.
procedures for ambulance operations. 6.4 A review of motor vehicle accidents for the previous
five years.
6.5 The operator shall possess a valid motor vehicle opera-
5. Medical Fitness to Drive
tors license, and any other certification required by state or
5.1 Because of the complex relationship of certain medical
local laws or regulations.
and mental impairments, a medical screening program shall be
established by all EMS entities bestowing the privilege of
7. Pre-Run
ambulance driving.
7.1 The operator shall have knowledge of and shall comply
5.2 The authorization of ambulance drivers must always be
with all applicable federal, state statues, local ordinances, and
based on bona fide occupational qualifications (BFOQ) pursu-
regulations.
ant to the task of ambulance operation. The following consid-
7.2 The operator shall have knowledge of the provider’s
erations must be evaluated:
policies and procedures.
5.2.1 Amedical exam of the applicant by a licensed M.D. or
7.3 The operator shall have knowledge of roads, highways,
D.O. attesting that the history and physical reveals no evidence
and the locations of and accesses to major public facilities
of any medical or physical condition which would prove
within the service area.
detrimental to operating an ambulance.
7.4 The provider shall have a process by which the operator
5.2.2 Eye exam by a licensed ophthalmologist/optometrist
is made aware of conditions that may affect traffic flow within
to include:
the service area (street closures, construction, special events,
5.2.2.1 Visual acuity,
and so forth).
5.2.2.2 Depth perception,
7.5 The provider shall have a process by which the operator
5.2.2.3 Peripheral vision,
is made aware of present or forecasted environmental condi-
5.2.2.4 Night blindness,
tions affecting traffic flow within the service area (ice, snow,
5.2.2.5 Color blindness, and
rain, and so forth).
5.2.2.6 Amblyopia.
7.6 Uponunitavailability,theoperatorshallvisuallyinspect
5.2.3 An examination of the medical history of the indi-
the ambulance, and document the inspection in accordance
vidual, designed to identify drivers who may be impaired by:
with one of the methods as shown in Table 1. The vehicle shall
5.2.3.1 Loss of consciousness,
be inspected for the following:
5.2.3.2 Cardiovascular disease,
7.6.1 Apparent body or glass damage,
5.2.3.3 Neurological/neurovascular disorder,
7.6.2 Proper function of emergency lights:
5.2.3.4 Mental illness,
7.6.2.1 Beacons or strobe,
5.2.3.5 Substance abuse/dependency,
7.6.2.2 Light bar,
5.2.3.6 Insulin-dependent diabetes, and
7.6.2.3 Tunnel lights/flashers, and
5.2.3.7 Rheumatic, arthritic, orthopedic, muscular, neuro-
7.6.2.4 Other warning lights.
muscular, or vascular disease that interferes with the ability to
7.6.3 Vehicle operating lights:
control and operate a motor vehicle safely.
7.6.3.1 Headlights (high/low),
5.2.4 The presence of a medical condition by itself may not
7.6.3.2 Emergency flashers,
constitute an impaired operator, but shall identify an area for
7.6.3.3 Parking/running lights,
consideration by the physician in making a determination of
7.6.3.4 Interior and exterior turn signal,
the medical fitness to operating an ambulance.
7.6.3.5 Brake lights,
7.6.3.6 Back up lights,
6. Qualifications to Drive
7.6.3.7 Flood or scene lights,
6.1 Authorization shall be based upon cognitive evaluation
7.6.3.8 Dome lights: cab and patient compartment, and
of the operator regarding laws, guidelines, and policies relating
to ambulance operation during emergency and non-emergency
TABLE 1 Emergency Medical Services Ambulance Maintenance
modes. Guidelines for Checklist Completion
6.1.1 The provider shall have a policy that addresses opera-
Runs per Week Full Check, h Quick Check, h
tor fatigue.
0 to 1 every 96 every 24
6.2 An ambulance driving evaluation by the provider cov- 2 to 3 every 72 every 24
4 to 7 every 48 every 24
ering warning device operation, passing, intersection approach
8 to 50 every 24 every 12
precautions, turning, backing, and parking techniques during
50 + every 24 every 8
emergency and non-emergency modes.
F1517–94 (2002)
7.6.3.9 Spotlights. 7.7.3.8 Battery water level.
7.6.4 Damage, wear, and pressure in tires, 7.7.4 Wear and tension of belts,
7.7.5 Wear and pressure of tires,
7.6.5 Damage, loose, or missing lugs on wheels,
7.6.6 Proper opening, closing, locking, and seals of entry 7.7.6 Emergency lights,
and compartment doors, 7.7.7 Function of lighting systems:
7.7.7.1 Emergency lights,
7.6.7 Fluid levels:
7.6.7.1 Automatic transmission, 7.7.7.2 Running lights,
7.7.7.3 Vehicle exterior, and
7.6.7.2 Battery,
7.7.7.4 Vehicle interior.
7.6.7.3 Brakes,
7.6.7.4 Engine oil, 7.7.8 Proper function of horn and each siren position,
7.7.9 Vehicle cleanliness, and
7.6.7.5 Engine coolant,
7.7.10 Proper function of two-way radio and other commu-
7.6.7.6 Power steering, and
nications equipment.
7.6.7.7 Windshield washer.
7.6.8 Fluid leakage on, around, or under the vehicle,
8. Operations
7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel,
heater, and other hoses,
8.1 Response Mode Management:
7.6.10 Wear, abraded, or cracked engine drive or accessory
8.1.1 The response mode of the ambulance shall be deter-
belts,
mined by dispatch protocol based on dispatch determinants as
7.6.11 Cleanliness of exterior, crew cab, and patient com-
approved by the medical director. These determinants shall be
partments,
consistent with Practice F 1258.
7.6.12 Wear, abrasion, and proper function of operator,
8.2 The operator shall, on the basis of known information,
passenger, and patient restraint,
determine the best route to the scene and end destination.
7.6.13 Indications and function of gages:
8.3 Before beginning the response, the operator shall con-
7.6.13.1 Electrical charging system,
duct a brief egress check consisting of the following:
7.6.13.2 Emergency brake,
8.3.1 Vehicle doors are securely closed and latched,
7.6.13.3 Fuel,
8.3.2 Vehicle hood is closed and securely latched,
7.6.13.4 Oil pressure,
8.3.3 Vehicle shore line is disconnected,
7.6.13.5 Tachometer, and
8.3.4 All equipment is secured,
7.6.13.6 Temperature.
8.3.5 Egress door is open, and
7.6.14 Wear, abrasion, and proper function of windshield
8.3.6 Patient stretcher is in place and secured.
wipers,
8.4 Operational Check Sequence:
7.6.15 Proper function and aim of windshield washer,
8.4.1 Ensure crew is on board and properly restrained,
7.6.16 Proper function and clarity of two-way radio and 8.4.2 Adjust the operator’s seat,
other communication devices,
8.4.3 Adjust mirrors,
7.6.17 Damage, stability, and adjustment of outside and
8.4.4 Turn on battery(s),
inside mirrors,
8.4.5 Start the engine,
7.6.18 Proper function and clarity of emergency siren,
8.4.6 Review all gages,
public address, and other warning devices,
8.4.7 Adjust environmental controls consistent with appli-
7.6.19 Proper adjustment of all seats,
cable needs,
7.6.20 Proper adjustment and function of steering wheel,
8.4.8 Turn radio on and contact dispatch,
7.6.21 Charged and properly stored fire extinguishers,
8.4.9 Adjust the tilt wheel,
7.6.22 Proper function of heating and air conditioning
8.4.10 Turn the headlights on,
systems,
8.4.11 Activate the emergency warning lights (if appli-
7.6.23 Proper inventory and condition of medical equip-
cable),
ment and supplies, and
8.4.12 Turn on power to siren/public address control system
7.6.24 Level and alignment of chassis.
(if applicable),
7.7 The quick check shall be constituted by:
8.4.13 Partially open the driver side window,
7.7.1 Visually checking for any fluid leakage on or around
8.4.14 Evaluate brake pedal resistance,
the ambulance,
8.4.15 Place the vehicle in gear,
7.7.2 Conducting vehicle warmup,
8.4.16 Activate the siren (if applicable), and
7.7.3 Checking fluid levels:
8.4.17 Activate the turn signal (if applicable).
7.7.3.1 Fuel,
8.5 Crew Roles—The operator/crew member is responsible
7.7.3.2 Engine oil,
for:
7.7.3.3 Power steering,
8.5.1 Operating the ambulance in a safe and efficient man-
7.7.3.4 Water/coolant level, ner, exercising the highest degree of care,
7.7.3.5 Brake fluid, 8.5.2 Safely passing other vehicles,
7.7.3.6 Transmission fluid, 8.5.3 Utilizing eye sweep,
7.7.3.7 Windshield washer fluid, and 8.5.4 Maintaininga3to4-s following distance, and
F1517–94 (2002)
8.5.5 Maintaining the vehicle at a speed that is safe for 8.6.5 Look to the left, look to the immediate front, look to
conditions. the right, and then again to the left. The operator may then
proceed through the intersection under ten miles per hour if
8.5.5.1 Under emergency response conditions the speed
traffic is stopped in all lanes to the left, in front of, and to the
shall not exceed that which is safe for road or environmental
rightoftheambulance.Aftertheoperatorhasmadeeyecontact
conditions; in no case shall the speed exceed ten miles per hour
with all stopped vehicle drivers, the ambulance may proceed
over the posted speed limit.
through the intersection exercising the highest degree of care.
8.5.5.2 Under non-emergency operations the operator shall
8.6.6 Continue the siren yelp mode activation and proceed
comply with all local and state traffic laws.
through the intersection exercising the highest degree of care.
8.5.6 Controlling the operation of the appropriate audible
8.6.7 When there are vacant lanes to the left or right, the
warning device for the current traffic conditions.
operatormustcompletethepreviousstepsofclearingeachlane
8.5.7 Utilizing the vehicle communication system,
of traffic prior to crossing that lane.
8.5.8 Applying policies and procedures in the d
...

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Standard Practice for Qualifications, Responsibilities, and Authority of Individuals and Institutions Providing Medical Direction of Emergency Medical Services

SIGNIFICANCE AND USE
4.1 Implementation of this practice will ensure that the EMS system has the authority commensurate with the responsibility to ensure adequate medical direction of all pre-hospital providers, as well as personnel and facilities that meet minimum criteria to implement medical direction of pre-hospital services.  
4.1.1 The state will develop, recommend, and encourage use of a plan that would ensure the standards outlined in this document can be implemented as appropriate at the local, regional, or state level (see Guide F1086).  
4.1.2 This practice is intended to describe and define responsibility for medical directions during transfers. It is not intended to determine the medical or legal, or both, appropriateness of transfers under the Consolidated Omnibus Budget Reconciliation Act and other similar federal or state laws, or both.
SCOPE
1.1 This practice covers the qualifications, responsibilities, and authority of individuals and institutions providing medical direction of emergency medical services.  
1.2 This practice addresses the qualifications, authority, and responsibility of a Medical Director (off-line) and the relationship of the EMS (Emergency Medical Services) provider to this individual.  
1.3 This practice also addresses components of on-line medical direction (direct medical control) including the qualifications and responsibilities of on-line medical physicians and the relationship of the pre-hospital provider to on-line medical direction.  
1.4 This practice addresses the relationship of the on-line medical physician to the off-line Medical Director.  
1.5 The authority for control of medical services at the scene of a medical emergency is addressed in this practice.  
1.6 The requirements for a Communication Resource are also addressed within this practice.  
1.7 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 F1257-22(Guide)
Standard Guide for Selection and Practice of Emergency Medical Services Instructor for Advanced Emergency Medical Technician

SIGNIFICANCE AND USE
4.1 Since the quality of pre-hospital AEMT training depends, in large measure, on the instructional abilities and competencies of the AEMT 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 AEMT 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.  
4.3 Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of ALS/EMT instructors for ALS/EMT training and education programs.
SCOPE
1.1 This guide is intended to assist emergency medical services (EMS) agencies and institutions in selecting and utilizing individuals who teach in EMT (emergency medical technician) training programs that include instruction in advanced life support knowledge and skills.  
1.2 This guide identifies six categories of instructor in an AEMT (advanced emergency medical technician) training program: adjunct instructor, clinical/field preceptor, practical skills instructor, associate instructor, course instructor/coordinator (I/C), and course administrator. The guide recognizes that an individual may, depending on his/her level of practice and the training program involved, function in any or all of these categories.  
1.3 This guide includes specific guidelines for qualifications, training, education, experience, scope of authority, responsibilities, continuing education, evaluation, and maintenance of competency when applicable.  
1.4 This guide does not include specific guidelines for the course administrator or the adjunct instructor. While the guide recognizes, by offering a definition of each category, that these types of individuals function in many AEMT training programs, the limited instructional roles played by these individuals preclude the need for specific selection and utilization guidelines.  
1.5 This guide is intended to apply to any individual who teaches in an AEMT training program regardless of the individual's present level of clinical practice.  
1.6 This guide intentionally omits references to length of pre-hospital care experience, teaching experience, and continuing education requirements. This guide also omits reference to waiver or equivalency. These issues should be addressed by the appropriate agency.  
1.7 This guide applies only to instructors who teach in AEMT training courses designed to prepare an individual for certification to practice above the level of the EMT. It does not apply to instructors who teach in specialized courses that do not in themselves qualify the individual for a level of EMT certification.  
1.8 This guide does not establish certification requirements. Such requirements should be established by the certifying agency in the jurisdiction in which the AEMT 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.
Note 1: Also see Practice F1031.  
1.10 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 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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ASTM F1268-90(2020)(Guide)
Standard Guide for Establishing and Operating a Public Information, Education, and Relations Program for Emergency Medical Service Systems

SIGNIFICANCE AND USE
4.1 It is essential to have the public's understanding and support for the EMS system to ensure its proper development and utilization.  
4.2 This guide encompasses those procedures, considerations, and resources that are necessary for a successful EMS public information, education, and relations program. Complex EMS systems may integrate or augment, or both, this guide in its entirety. Less complex systems may need to collaborate with other EMS organizations and related agencies. Responsibility for this guide will vary by level of authority, that is, state, regional, and local. (See Guide F1086.)  
4.3 The PIER tasks involve research, planning, production, distribution, and evaluation. Production requires significant resources and expertise and may be done most appropriately at the higher level, such as regional, state, and national levels.
SCOPE
1.1 The purpose of this guide is to provide national voluntary standards and recommendations to effectively provide emergency medical service system information and education to the public.  
1.2 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 F1653-95(2020)(Guide)
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.

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