ASTM F1655-95
(Guide)Standard Guide for Training First Responders Who Practice in Wilderness, Delayed, or Prolonged Transport Settings
Standard Guide for Training First Responders Who Practice in Wilderness, Delayed, or Prolonged Transport Settings
SCOPE
1.1 This guide covers minimum training standards for first responders who may care for sick or injured persons in the specialized pre-hospital situations of the wilderness, delayed, or prolonged transport settings, including catastrophic disasters.
1.2 This guide establishes supplemental or continuing education programs that will be taught to individuals trained to the first responder level by an appropriate authority.
1.3 This guide does not provide training to be used, ordinarily, in the traditional EMS or ambulance transportation environments.
1.4 Included in this guide is a standard for the evaluation of the knowledge and skills defined within this guide.
1.5 Successful completion of a course based on this guide neither constitutes nor implies certification or licensure.
1.6 This guide does not establish medical protocols, nor does it authorize invasive procedures without specific authorization and medical control.
1.7 The values stated in inch-pound units are to be regarded as the standard.
1.8 Operating within the framework of this guide may expose personnel to hazardous materials or environments, procedures, and equipment or all of these.
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 and health practices and determine the applicability of regulatory limitations prior to use.
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Designation: F 1655 – 95
Standard Guide for
Training First Responders Who Practice in Wilderness,
Delayed, or Prolonged Transport Settings
This standard is issued under the fixed designation F 1655; 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. Terminology
1.1 This guide covers minimum training standards for first 3.1 Definitions:
responders who may care for sick or injured persons in the 3.1.1 access, n—the process of reaching the patient/subject
specialized pre-hospital situations of the wilderness, delayed, and establishing physical contact.
or prolonged transport settings, including catastrophic disas- 3.1.2 basic life support/cardiopulmonary resuscitation
ters. (BLS/CPR), n—a set of skills that includes airway manage-
1.2 This guide establishes supplemental or continuing edu- ment, chest compressions, and others as defined by the
cation programs that will be taught to individuals trained to the American Heart Association.
first responder level by an appropriate authority. 3.1.3 definitive care, n—a level of therapeutic intervention
1.3 This guide does not provide training to be used, ordi- capable of providing comprehensive health care services for a
narily, in the traditional EMS or ambulance transportation specific condition. (See Terminology F 1177.)
environments. 3.1.4 evacuation, n—the process used between the time of
1.4 Included in this guide is a standard for the evaluation of extraction and transportation. (See Terminology F 1490.)
the knowledge and skills defined within this guide. 3.1.5 extraction, n—the process of initial assessment, treat-
1.5 Successful completion of a course based on this guide ment, stabilization, and packaging of the patient as well as the
neither constitutes nor implies certification or licensure. removal of the patient/subject from the immediately hazardous
1.6 This guide does not establish medical protocols, nor environment. (See Terminology F 1490.)
does it authorize invasive procedures without specific authori- 3.1.6 first responder, n—an individual trained in accordance
zation and medical control. with Guide F 1453.
1.7 The values stated in inch-pound units are to be regarded 3.1.7 transportation, n—the use of a dedicated vehicle for
as the standard. the removal of the patient to a medical facility or definitive care
1.8 Operating within the framework of this guide may facility.
expose personnel to hazardous materials or environments, 3.2 Definitions of Terms Specific to This Standard:
procedures, and equipment or all of these. 3.2.1 delayed or prolonged transport, n—when time be-
1.9 This standard does not purport to address all of the tween patient injury and arrival to a definitive care facility is
safety concerns, if any, associated with its use. It is the greater than 60 min.
responsibility of the user of this standard to establish appro- 3.2.2 non-traditional EMS environment, n—environments
priate safety and health practices and determine the applica- not readily accessible to a ground ambulance.
bility of regulatory limitations prior to use. 3.2.3 wilderness first responder (WFR), n—an individual
trained to meet the requirements of this guide.
2. Referenced Documents
3.2.4 wilderness setting, n—situations in which EMS deliv-
2.1 ASTM Standards:
ery is complicated by one or more of the following four factors:
F 1177 Terminology Relating to Emergency Medical Ser- (1) remoteness as far as logistics and access; (2) a significant
vices
delay in the delivery of care to the patient; (3) an environment
F 1287 Guide for Scope of Performance of First Responders that is stressful to both patients and rescuers; and (4) a lack of
Who Provide Medical Care
equipment and supplies.
F 1453 Guide for the Training and Evaluation of First
2 4. Significance and Use
Responders Who Provide Medical Care
F 1490 Terminology Relating to Search and Rescue 4.1 Individuals will be initially or concurrently trained in
accordance with U.S. D.O.T. Course Guide for First Respond-
1 ers and Guide F 1453.
This guide is under the jurisdiction of ASTM Committee F-30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
Current edition approved Oct. 10, 1995. Published December 1995. U.S. D.O.T. HS 900-025, Course Guide, Emergency Medical Services, First
Annual Book of ASTM Standards, Vol 13.01. Responder Training Course, March 1979.
Copyright © ASTM, 100 Barr Harbor Drive, West Conshohocken, PA 19428-2959, United States.
F 1655
4.2 This guide does not suggest a particular training se- 5.3.3 No medical personnel were available to render care
quence. such as IV hydration, so the construction workers immediately
4.3 This guide may be used by individuals developing extricated him. Despite later attempts at hydration, he later
training programs for non-traditional EMS environments. developed kidney failure and then sepsis; he died a few days
4.4 This guide acknowledges the need to provide additional later.
specific training for first responders who will practice in the 5.4 Borderline Wilderness Settings:
wilderness, delayed or prolonged transport settings. 5.4.1 Several years ago, a light civil aircraft crashed near the
4.5 Individuals responsible for training first responders top of Tinker Mountain in southwest Virginia. Atop Tinker
should identify those who will practice in the wilderness, Mountain’s rugged, cliff-strewn ridgeline is the Appalachian
delayed or prolonged transport settings and must ensure that Trail; the area is a favorite of hikers and climbers. The aircraft
such personnel are competent in all skills needed for the unique was located from the air, and a team responded to the site. The
settings. quickest way to reach the site was from a road near the bottom
of the ridge. Those responding to the site fell into two groups:
5. Illustrative Examples
mountain rescue team members and “regular” fire/EMS per-
5.1 Wilderness Settings:
sonnel. Protocols for the fire/EMS personnel required them,
5.1.1 In May 1983, two climbers were at about 18 000 ft,
when responding to an air crash, to wear full turnout gear and
near Denali Pass, on Mount McKinley, Alaska. These climbers
self-contained breathing apparatus, and to carry fire suppres-
took a tumbling 800 ft fall before coming to rest. One of the
sion equipment. The standard practice for the mountain rescue
climbers was only responsive to pain, with a lacerated face and
was to carry minimal lightweight equipment, to dress appro-
the pick end of his ice axe impaled in the right side of his chest,
priately for the weather and brush, to drink plenty of fluids, and
just below the nipple line. A nearby climbing party responded.
to pace themselves.
They first attempted to stabilize the ice axe in place as per
5.4.2 The Virginia summer weather was particularly hot and
standard EMS protocols. They improvised a rescue toboggan
humid, and the mountainside very steep. Soon many of the
using two plastic sleds, but moving the patient was very
fire/EMS personnel were disabled from heat exhaustion, and
difficult with the ice axe still in his chest. And, with tempera-
one even had to be evacuated. The mountain rescue personnel
tures ranging from − 50 to − 70°F (in accordance with National
were able to handle all nece
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