ASTM F1258-95(2006)
(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)
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Designation: F1258 − 95(Reapproved 2006)
Standard Practice for
Emergency Medical Dispatch
This standard is issued under the fixed designation F1258; 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.
1. Scope 3.1.2 emergency medical dispatching—the reception and
management of requests for emergency medical assistance.
1.1 This practice covers the definition of responsibilities,
knowledge, practices, and organizational support required to
3.1.3 emergency medical dispatch priority reference system
implement, perform, and manage effectively the emergency
(EMDPRS)—a medically approved system used by a dispatch
medical dispatch function.
agency to provide aid to medical emergencies that includes:
systematized caller interrogation questions, systematized pre-
1.2 This practice is useful for planning and evaluating the
arrival instructions, and protocols matching the dispatcher’s
training, implementation, and organizational support to satisfy
evaluation of injury or illness severity with vehicle response
the functional needs of emergency medical dispatching.
mode and configuration.
1.3 This standard does not purport to address all of the
safety concerns, if any, associated with its use. It is the
3.1.4 medical direction—the management and accountabil-
responsibility of the user of this standard to establish appro-
ity for the medical care aspects of an emergency medical
priate safety and health practices and determine the applica-
dispatch (EMD) program including: the medical monitoring
bility of regulatory limitations prior to use.
oversight of the training of the EMD personnel; approval and
medical control of the operational emergency medical dispatch
2. Referenced Documents
priority reference system (EMDPRS); evaluation of the medi-
2.1 ASTM Standards:
cal care and prearrival instructions rendered by the EMD
F1031 Practice for Training the Emergency Medical Tech-
personnel; direct participation in the EMD system evaluation,
nician (Basic)
quality, assurance, and quality improvement process and
F1381 Guide for Planning and Developing 9-1-1 Enhanced
mechanisms; and, responsibility for the medical decisions and
Telephone Systems (Withdrawn 2008)
care rendered by the emergency medical dispatcher and emer-
F1552 Practice for Training Instructor Qualification and
gency medical dispatch program.
Certification Eligibility of Emergency Medical Dispatch-
3.1.5 public safety telecommunicator—an individual trained
ers
to communicate remotely with persons seeking emergency
F1560 Practice for Emergency Medical Dispatch Manage-
assistance and with agencies and individuals providing such
ment
assistance.
3. Terminology
3.1.6 telephone aid—consists of “ad-libbed” telephone in-
3.1 Definitions of Terms Specific to This Standard:
structions provided by either trained or untrained dispatchers
3.1.1 emergency medical dispatcher (EMD)—a trained pub- and differs from DLS-based prearrival instructions in that the
lic safety telecommunicator with additional training and spe-
instructions provided to the caller are based on the dispatcher’s
cific emergency medical knowledge essential for the efficient
knowledge or previous training in a procedure or treatment
management of emergency medical communications.
without following a scripted prearrival instruction protocol.
They cannot be medically preapproved since they do not exist
in written form.
This practice is under the jurisdiction ofASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.04 on
3.1.7 telephone treatment sequence protocols— specific
Communications.
treatment strategies designed in a conversational script format
Current edition approved March 1, 2006. Published March 2006. Originally
approved in 1990. Last previous edition approved in 2001 as F1258 – 95 (2001). that direct the EMD step by step in giving critical prearrival
DOI: 10.1520/F1258-95R06.
instructions such as CPR, Heimlich maneuver, mouth-to-
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
mouth breathing, and childbirth instruction.
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on
3.1.8 vehicle response configuration—thespecificvehicle(s)
the ASTM website.
3 of varied types, capabilities, and numbers responding to render
The last approved version of this historical standard is referenced on
www.astm.org. assistance.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1258 − 95 (2006)
3.1.9 vehicle response mode—the use of emergency driving 4.4 This practice establishes the EMD’s role and responsi-
techniques, such as warning lights and siren, versus a routine bilities in receiving, managing, and dispatching calls for
driving response. medical assistance and related agency coordination.
4.5 An organizational structure as defined in Practice F1560
4. Summary of Practice
must be in place before implementing the EMD program;
therefore, this practice establishes some general recommenda-
4.1 An emergency medical dispatcher is a trained public
tions concerning the development of a supportive structure and
safety telecommunicator with additional training and specific
program content.
emergency medical knowledge essential for assessment of
medical emergencies and limited remote treatment and appor-
4.6 Use of this practice is not intended to protect the EMD
tionment of medical priorities. The EMD functions under the
or dispatch organization from liability for negligent actions or
medical authority of an off-line medical director to receive and
failure to perform in accordance with established and approved
manage calls for emergency medical assistance through the
medical practices and protocols.
systematic interrogation of callers, using procedures estab-
4.7 The EMD must be certified through either state govern-
lished by the off-line medical director who remains responsible
ment processes or by professional medical dispatch standard-
for the medical quality assurance of the EMD program.
setting organizations.
4.1.1 The EMD’s role includes the ability to:
4.7.1 When certification is achieved by recognition of a
4.1.1.1 Remotely evaluate the patient or incident,
professional medical dispatch standard-setting organization, it
shall clearly demonstrate compliance with all criteria enumer-
4.1.1.2 Interpret the requirement and need for emergency
medical resources, ated in this practice and within Practice F1560 and Practice
F1552.
4.1.1.3 Allocate the appropriate resources,
4.1.1.4 Identify conditions requiring prearrival instructions
5. Significance and Use
and provide them to the caller when necessary, possible and
appropriate, 5.1 This practice is intended to promote the use of trained
telecommunicators in the role of emergency medical dis-
4.1.1.5 Coordinate the response of emergency medical and
patcher. It defines the basic skills and medical knowledge to
other public safety resources,
permit understanding and resolution of the problems that
4.1.1.6 Provide information to the responding units regard-
constitutetheirdailyroutine.Tousetrainedtelecommunicators
ing the emergency scene and patient, and
fully as functioning members of the emergency medical team,
4.1.1.7 Record and retrieve emergency medical response
it is deemed necessary to upgrade the telecommunicators’
records.
training by the addition of the concept of emergency medical
4.1.2 There must be continuity in the delivery of EMD care.
dispatch priorities.
To provide correct medical care safely and effectively, the
5.2 All agencies or individuals who routinely accept calls
EMD that is medically directing, evaluating, and coding must
for emergency medical assistance from the public and dispatch
maintain direct access to the calling party and must use a
emergency medical personnel shall have in effect an emer-
medically approved emergency medical dispatch priority ref-
gency medical dispatcher program in accordance with this
erencesystem.Thepersongivingthemedicalinstructiontothe
practice. The program shall include medical direction and
caller must be the same person that asks the systematic
oversight and an emergency medical dispatch priority refer-
interrogation questions.
ence system.
4.1.3 To accomplish the above safely and effectively, the
5.3 The successful use of the EMD concept depends on the
EMD must use a medically approved EMDPRS that includes:
medical community’s awareness of the “prearrival” state of
4.1.3.1 Systematized caller interrogation questions,
EMS affairs and their willingness to provide medical direction
4.1.3.2 Systematized prearrival instructions, and
in dispatch.
4.1.3.3 Protocols that determine vehicle response mode and
5.4 This practice may assist in overcoming some of the
configuration based on the EMD’s evaluation of injury or
misconceptions regarding emergency medical dispatching.
illness severity.
These include the uncontrollable nature of the caller’s hysteria,
4.2 This practice is intended to be used by agencies as a
lack of time of the dispatcher, potential danger and liability to
baseline for establishing a certifying emergency medical dis-
the EMD, lack of recognition of the benefits of dispatch
patch training program that includes the implementation of the
prearrival instructions, and misconceptions that red lights,
emergency medical dispatch priority reference system, under
siren, and maximal response are always necessary.
medical direction, and provides a means of evaluating the
5.5 TheEMDisthememberoftheEMSresponseteamwith
EMD program.
the broadest view of the entire emergency system’s current
4.3 This practice will provide a common set of expectations status and capabilities. The EMD has immediate lifesaving
for training, performance, and preplanned response based on capability in converting the caller into an effective first
understanding of the medical condition, thorough responder. This practice recognizes the EMD’s role as includ-
ing:
interrogation,callerintervention,saferesponses,andprearrival
instructions. 5.5.1 Interrogation techniques,
F1258 − 95 (2006)
5.5.2 Triage decisions, 6.1.2.2 An established, medically approved, quantitative
coding system for quality assurance/improvement and statisti-
5.5.3 Information transmission,
cal analysis.
5.5.4 Telephone medical intervention, and
6.1.3 Asetofsystematicprearrivalinstructionsthatinclude:
5.5.5 Logistics and resource coordination during the event.
6.1.3.1 ChiefcomplaintspecificcallerandEMDadvise,and
5.6 For the EMD, this practice supersedes any other EMSS
6.1.3.2 Scripted prearrival instructions.
standards under which an individual may be qualified, such as
Practice F1031. It is not the role of the EMD to generate a
6.1.4 In addition to the EMDPRS, an emergency medical
specific diagnosis but rather to elicit accurately a finite body of
dispatch system should include:
information, assign the appropriate response, and to commu-
6.1.4.1 A mass casualty plan for notification and operation
nicate clearly among persons and units involved in the re-
in a disaster situation,
sponse. The protocols for inquiry, response, and resource
6.1.4.2 A directory of emergency response resources and
coordination are essential and must not be modified based on
information resources,
an individual’s possible experiences as a responder.
6.1.4.3 Awritten description of the communications system
5.7 As an initial contact with the EMS system, the EMD is
configuration for the service area, and
subject to questioning of actions as they relate to medical
6.1.4.4 A record-keeping system, including report forms or
practice.Thispracticemaybeusedbyagenciesasarecognized
a computer data management system to permit evaluation of
baseline for EMD training, practice, and organization and is
EMD compliance with the EMDPRS, evaluation of protocol
intendedtosupplant de factostandardsthatexistinsomeareas.
effectiveness, and timeliness of interrogation and dispatch.
This practice will assist in developing sound EMD programs
that will reduce the need and potential for legal action and
7. Functions of Emergency Medical Dispatch
provide a common set of expectations for performance.
7.1 Receive and Process Calls for Assistance—The EMD
5.8 It will bring more accurate information into the dispatch
mustreceiveandrecordcallsforemergencymedicalassistance
office by way of appropriate understanding of the medical
from various sources. This function includes the establishment
conditionandthereforebetterinterrogation,callerintervention,
of effective communication with the person requesting
and decision-making. It allows for preplanned responses, safer
assistance, using the EMDPRS to evaluate the patient or
responses (fewer units responding with lights and siren), fuel
and energy savings (smaller units and fewer units used when situation,provideappropriateprearrivalinstructions,andselect
the most appropriate EMS system action in response to each
possible),andmaysaveadvancedlifesupportresourcesfortrue
advanced life-support emergencies when a tiered-level re- call.
sponse is available.
7.2 Dispatch and Coordinate Appropriate, Available Re-
sponse Resources—The EMD must select and dispatch the
6. System Components
necessary EMS vehicles and personnel to the scene of an
6.1 Emergency Medical Dispatch Priority Reference System
emergency in an appropriate time frame. The EMD functions
(EMDPRS):
incoordinatingthemovementsofEMSvehiclesenroutetothe
6.1.1 This system is a written, reproducible document in a scene, en route to the medical facility, and back to the base of
uniform format based on medical and administrative protocols. operations. This requires that the EMD have current knowl-
The emergency medical dispatch priority reference system edge of the status of all EMS resources in the dispatch area and
directs the EMD to complete a full, programmed interrogation.
the geographic constraints that will affect the EMS response.
The information from the caller is paired with preset problem
ThisalsorequiresthattheEMDhavedispatch-specificmedical
groups to determine the appropriate response level. It shall
training and understands the use of systematized interrogation
include the following:
and response assignment protocols.
6.1.1.1 A set of systematized caller interrogation (key)
7.3 Provide Information and Prearrival Instructions:
questions.Thekeyquestionsmustobtaintheminimumamount
7.3.1 To th
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