ASTM F1258-95
(Practice)Standard Practice for Emergency Medical Dispatch
Standard Practice for Emergency Medical Dispatch
SCOPE
1.1 This practice covers the definition of responsibilities, knowledge, practices, and organizational support required to effectively implement, perform, and manage the emergency medical dispatch function.
1.2 This practice is useful for planning and evaluating the training, implementation, and organizational support to satisfy the functional needs of emergency medical dispatching.
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 and health practices and determine the applicability of regulatory limitations prior to use.
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Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or discontinued.
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Designation: F 1258 – 95
Standard Practice for
Emergency Medical Dispatch
This standard is issued under the fixed designation F 1258; 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 evaluation of injury or illness severity with vehicle response
mode and configuration.
1.1 This practice covers the definition of responsibilities,
3.1.4 medical direction—the management and accountabil-
knowledge, practices, and organizational support required to
ity for the medical care aspects of an emergency medical
effectively implement, perform, and manage the emergency
dispatch (EMD) program including: the medical monitoring
medical dispatch function.
oversight of the training of the EMD personnel; approval and
1.2 This practice is useful for planning and evaluating the
medical control of the operational emergency medical dispatch
training, implementation, and organizational support to satisfy
priority reference system (EMDPRS); evaluation of the medi-
the functional needs of emergency medical dispatching.
cal care and pre-arrival instructions rendered by the EMD
1.3 This standard does not purport to address all of the
personnel; direct participation in the EMD system evaluation,
safety concerns, if any, associated with its use. It is the
quality, assurance, and quality improvement process and
responsibility of the user of this standard to establish appro-
mechanisms; and, responsibility for the medical decisions and
priate safety and health practices and determine the applica-
care rendered by the emergency medical dispatcher and emer-
bility of regulatory limitations prior to use.
gency medical dispatch program.
2. Referenced Documents
3.1.5 public safety telecommunicator—an individual trained
to remotely communicate with persons seeking emergency
2.1 ASTM Standards:
assistance and with agencies and individuals providing such
F 1031 Practice for Training the Emergency Medical Tech-
assistance.
nician (Basic)
3.1.6 telephone aid—consists of “ad libbed” telephone in-
F 1381 Guide for Planning and Developing 9-1-1 Enhanced
structions provided by either trained or untrained dispatchers
Telephone Systems
and differs from DLS-based pre-arrival instructions in that the
F 1552 Guide for Training, Instructor Qualification, and
instructions provided to the caller are based on the dispatcher’s
Certification Eligibility of Emergency Medical Dispatch-
knowledge or previous training in a procedure or treatment
ers
without following a scripted pre-arrival instruction protocol.
F 1560 Practice for Emergency Medical Dispatch Manage-
They cannot be medically pre-approved since they do not exist
ment
in written form.
3. Terminology
3.1.7 telephone treatment sequence protocols—specific
treatment strategies designed in a conversational script format
3.1 Definitions of Terms Specific to This Standard:
that direct the EMD step-by-step in giving critical pre-arrival
3.1.1 emergency medical dispatcher (EMD)—a trained pub-
instructions such as CPR, Heimlich maneuver, mouth-to-
lic safety telecommunicator with additional training and spe-
mouth breathing, and childbirth instruction.
cific emergency medical knowledge essential for the efficient
3.1.8 vehicle response configuration—the specific ve-
management of emergency medical communications.
hicle(s) of varied types, capabilities, and numbers responding
3.1.2 emergency medical dispatching—the reception and
to render assistance.
management of requests for emergency medical assistance.
3.1.9 vehicle response mode—the use of emergency driving
3.1.3 emergency medical dispatch priority reference system
techniques, such as warning lights and siren, versus a routine
(EMDPRS)—a medically approved system used by a dispatch
driving response.
agency to provide aid to medical emergencies, that includes:
systematized caller interrogation questions, systematized pre-
4. Summary of Practice
arrival instructions, and protocols matching the dispatcher’s
4.1 An emergency medical dispatcher is a trained public
safety telecommunicator with additional training and specific
This practice is under the jurisdiction of ASTM Committee F-30 on Emergency
emergency medical knowledge essential for assessment of
Medical Services and is the direct responsibility of Subcommittee F30.04 on
Communications. medical emergencies and limited remote treatment and appor-
Current edition approved Oct. 10, 1995. Published December 1995. Originally
tionment of medical priorities. The EMD functions under the
published as F 1258 – 90. Last previous edition F 1258 – 90.
medical authority of an off-line medical director to receive and
Annual Book of ASTM Standards, Vol 13.01.
Copyright © ASTM, 100 Barr Harbor Drive, West Conshohocken, PA 19428-2959, United States.
F 1258
manage calls for emergency medical assistance through the ment processes or by professional medical dispatch standard-
systematic interrogation of callers, using procedures estab- setting organizations.
lished by the off-line medical director who remains responsible 4.7.1 When certification is achieved by recognition of a
for the medical quality assurance of the EMD program. professional medical dispatch standard-setting organization it
shall clearly demonstrate compliance with all criteria enumer-
4.1.1 The EMD’s role includes the ability to:
ated in this practice and within Practice F 1560 and Practice
4.1.1.1 Remotely evaluate the patient or incident,
F 1552.
4.1.1.2 Interpret the requirement and need for emergency
medical resources,
5. Significance and Use
4.1.1.3 Allocate the appropriate resources,
5.1 This practice is intended to promote the use of trained
4.1.1.4 Identify conditions requiring pre-arrival instructions
telecommunicators in the role of emergency medical dis-
and provide them to the caller when necessary, possible and
patcher. It defines the basic skills and medical knowledge to
appropriate,
permit understanding and resolution of the problems that
4.1.1.5 Coordinate the response of emergency medical and
constitute their daily routine. In order to fully utilize trained
other public safety resources,
telecommunicators as functioning members of the emergency
4.1.1.6 Provide information to the responding units regard-
medical team, it is deemed necessary to upgrade the telecom-
ing the emergency scene and patient, and
municators’ training by the addition of the concept of emer-
4.1.1.7 Record and retrieve emergency medical response
gency medical dispatch priorities.
records.
5.2 All agencies or individuals who routinely accept calls
4.1.2 There must be continuity in the delivery of EMD care.
for emergency medical assistance from the public and dispatch
To safely and effectively provide correct medical care, the
emergency medical personnel shall have in effect an emer-
EMD that is medically directing, evaluating coding and, must
gency medical dispatcher program in accordance with this
maintain direct access to the calling party and must use a
practice. The program shall include medical direction and
medically approved emergency medical dispatch priority ref-
oversight and an emergency medical dispatch priority refer-
erence system. The person giving the medical instruction to the
ence system.
caller must be the same person that asks the systematic
5.3 The successful use of the EMD concept depends on the
interrogation questions.
medical community’s awareness of the “pre-arrival” state of
4.1.3 To safely and effectively accomplish the above, the
EMS affairs, and their willingness to provide medical direction
EMD must utilize a medically approved EMDPRS that in-
in dispatch.
cludes:
5.4 This practice may assist in overcoming some of the
4.1.3.1 Systematized caller interrogation questions,
misconceptions regarding emergency medical dispatching.
4.1.3.2 Systematized pre-arrival instructions, and
These include the uncontrollable nature of the caller’s hysteria,
4.1.3.3 Protocols that determine vehicle response mode and
lack of time of the dispatcher, potential danger and liability to
configuration based on the EMD’s evaluation of injury or
the EMD, lack of recognition of the benefits of dispatch
illness severity.
pre-arrival instructions, and misconceptions that red lights,
4.2 This practice is intended to be used by agencies as a
siren, and maximal response are always necessary.
baseline for establishing a certifying emergency medical dis-
5.5 The EMD is the member of the EMS response team with
patch training program that includes the implementation of the
the broadest view of the entire emergency system’s current
emergency medical dispatch priority reference system, under
status and capabilities. The EMD has immediate lifesaving
medical direction, and provides a means of evaluating the
capability in converting the caller into an effective first
EMD program.
responder. This practice recognizes the EMD’s role as includ-
4.3 This practice will provide a common set of expectations
ing:
for training, performance, and preplanned response based on
5.5.1 Interrogation techniques,
understanding of the medical condition, thorough interroga-
5.5.2 Triage decisions,
tion, caller intervention, safe responses, and pre-arrival instruc-
5.5.3 Information transmission,
tions.
5.5.4 Telephone medical intervention, and
4.4 This practice establishes the EMD’s role and responsi-
5.5.5 Logistics and resource coordination during the event.
bilities in receiving, managing, and dispatching calls for
5.6 For the EMD this practice supersedes any other EMSS
medical assistance and related agency coordination.
standards under which an individual may be qualified, such as
4.5 An organizational structure as defined in Practice
Practice F 1031. It is not the role of the EMD to generate a
F 1560 must be in place prior to implementing the EMD
specific diagnosis but rather to accurately elicit a finite body of
program, therefore, this practice establishes some general
information, assign the appropriate response, and to clearly
recommendations concerning the development of a supportive
communicate among persons and units involved in the re-
structure and program content.
sponse. The protocols for inquiry, response, and resource
4.6 Use of this practice is not intended to protect the EMD coordination are essential and must not be modified based on
or dispatch organization from liability for negligent actions or
an individual’s possible experiences as a responder.
failure to perform in accordance with established and approved 5.7 As an initial contact with the EMS system, the EMD is
medical practices and protocols.
subject to questioning of actions as they relate to medical
4.7 The EMD must be certified through either state govern- practice. This practice may be used by agencies as a recognized
F 1258
baseline for EMD training, practice, and organization and is EMD compliance with the EMDPRS, evaluation of protocol
intended to supplant de facto standards that exist in some areas. effectiveness, and timeliness of interrogation and dispatch.
This practice will assist in developing sound EMD programs
7. Functions of Emergency Medical Dispatch
that will reduce the need and potential for legal action and
7.1 Receive and Process Calls for Assistance—The EMD
provide a common set of expectations for performance.
must receive and record calls for emergency medical assistance
5.8 It will bring more accurate information into the dispatch
from various sources. This function includes the establishment
office by way of appropriate understanding of the medical
of effective communication with the person requesting assis-
condition and therefore better interrogation, caller intervention,
tance, using the EMDPRS to evaluate the patient or situation,
and decision-making. It allows for preplanned responses, safer
provide appropriate pre-arrival instructions, and select the most
responses (fewer units responding with lights and siren), fuel
appropriate EMS system action in response to each call.
and energy savings (smaller units and fewer units used when
7.2 Dispatch and Coordinate Appropriate, Available Re-
possible), and may save advanced lifesupport resources for true
sponse Resources—The EMD must select and dispatch the
advanced life-support emergencies when a tiered-level re-
necessary EMS vehicles and personnel to the scene of an
sponse is available.
emergency in an appropriate time frame. The EMD functions
6. System Components
in coordinating the movements of EMS vehicles en route to the
6.1 Emergency Medical Dispatch Priority Reference System
scene, en route to the medical facility, and back to the base of
(EMDPRS):
operations. This requires that the EMD have current knowl-
6.1.1 This system is a written, reproducible document in a
edge of the status of all EMS resources in the dispatch area and
uniform format based on medical and administrative protocols.
the geographic constraints which will affect the EMS response.
The emergency medical dispatch priority reference system
This also requires that the EMD have dispatch-specific medical
directs the EMD to complete a full, programmed interrogation. training and understands the use of systematized interrogation
The information from the caller is paired with preset problem
and response assignment protocols.
groups to determine the appropriate response level. It shall 7.3 Provide Information and Pre-Arrival Instructions:
include the following:
7.3.1 To the caller, the EMD is the contact with the
6.1.1.1 A set of systematized caller interrogation (key) emergency response agency and must be prepared to provide
questions. The key questions must obtain the minimum amount
emergency care instructions to callers waiting for an EMS
of information necessary to: response. These instructions should enable the caller to prevent
6.1.1.1.1 (a) Adequately establish the correct level of re-
or reduce further injury to the victim and to do as much as
sponse, possible under the circumstances to intervene in any life-
6.1.1.1.2 (b) Establish the need for pre-arrival instructions,
threatening situation which exists. These instructions should
and also include appropriate warnings and safety messages regard-
6.1.1.1.3 (c) Provide responders with adequate patient and
ing potential dangers that can be reasonably foreseen through
incident information.
correct use of the EMDPRS.
6.1.2 A set of systematized coding and response protocols
7.3.2 All dispatch life-support-based instructions and infor-
that include:
mation should be given directly from the EMDPRS rather than
...
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