ASTM F1616-95(2016)

Standard Guide for Scope of Performance of First Responders Who Practice in the Wilderness or Delayed or Prolonged Transport Settings

SIGNIFICANCE AND USE
4.1 This guide is intended to expand the scope of the practice of first responders and improve the emergency medical care delivered to patients in the wilderness or delayed or prolonged transport settings.  
4.2 This guide does not suggest a particular performance sequence.  
4.3 Individuals will be trained initially or concurrently in accordance with the U.S. DOT HS 900-25, Course Guide, and Guide F1453.  
4.4 This guide may be used by individuals who develop training programs for nontraditional EMS environments.  
4.5 This guide acknowledges the need for additional or specific training required for the wilderness or delayed or prolonged transport settings.
SCOPE
1.1 This guide covers minimum performance requirements for first responders who may initially provide care for sick or injured persons in the specialized pre-hospital situations of the wilderness or delayed or prolonged transport settings, including catastrophic disasters.  
1.2 Individuals who will operate in the wilderness or delayed or prolonged transport settings need to be aware of the physical requirements necessary to be able to perform all identified objectives and necessary skills required for the setting.  
1.3 This guide establishes supplemental or continuing education programs that will be taught to individuals trained to the first responder level by an appropriate authority.  
1.4 This guide does not establish performance standards for use in the traditional emergency medical services (EMS) or ambulance transportation environment.  
1.5 This guide does not establish medical protocols; nor does it authorize invasive procedures without specific authorization and medical control.  
1.6 Successful completion of a course based on this guide does not constitute or imply certification or licensure.  
1.7 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: Published
• Publication Date: 31-May-2016
• ICS: 11.140 - Hospital equipment
• ICS: 11.160 - First aid
• Technical Committee: F30 - Emergency Medical Services
• Drafting Committee: F30.02 - Personnel, Training and Education

Relations

• Replaces: ASTM F1616-95(2009) - Standard Guide for Scope of Performance of First Responders Who Practice in the Wilderness or Delayed or Prolonged Transport Settings
• Effective Date: 01-Jun-2016
• Refers: ASTM F1177-02(2009) - Standard Terminology Relating to Emergency Medical Services (Withdrawn 2018)
• Effective Date: 01-Mar-2009
• Refers: ASTM F1490-04a - Standard Terminology Relating to Search and Rescue (Withdrawn 2010)
• Effective Date: 01-May-2004
• Refers: ASTM F1490-04 - Standard Terminology Relating to Search and Rescue
• Effective Date: 01-Jan-2004
• Refers: ASTM F1177-02 - Standard Terminology Relating to Emergency Medical Services
• Effective Date: 10-Sep-2002
• Refers: ASTM F1177-96a - Standard Terminology Relating to Emergency Medical Services
• Effective Date: 01-Jan-1996
• Refers: ASTM F1490-96 - Standard Terminology Relating to Search and Rescue
• Effective Date: 01-Jan-1996
• Referred By: ASTM F3222-16 - Standard Terminology Relating to F32 Land Search and Rescue Standards and Guides
• Effective Date: 01-Jun-2016

Overview

ASTM F1616-95(2016): Standard Guide for Scope of Performance of First Responders Who Practice in the Wilderness or Delayed or Prolonged Transport Settings is an essential guideline developed by ASTM International. This standard defines the minimum performance requirements for first responders providing emergency medical care in specialized pre-hospital environments, such as wilderness areas or situations involving delayed or prolonged patient transport. It is particularly relevant when conventional emergency medical services (EMS) or ambulance transportation are inaccessible, including catastrophic disasters, remote locations, or other nontraditional EMS environments.

The standard’s main goal is to ensure high-quality emergency medical care in environments where challenges such as remoteness, environmental hazards, limited resources, and extended transport times significantly impact patient outcomes.

Key Topics

• Minimum Performance Requirements: Establishes baseline competencies and skills required for first responders working in wilderness or prolonged transport environments.
• Unique Environmental Challenges: Addresses problems related to geography, environmental extremes, limited equipment, and delayed access to definitive care facilities.
• Targeted Medical Knowledge: Focuses on managing a wide range of emergencies, including:
  • Environmental illnesses (hypothermia, heat illness, altitude sickness)
  • Trauma (wounds, fractures, spinal injuries, dislocations)
  • Medical emergencies (cardiac issues, diabetes, seizures, allergies, dehydration)
  • Patient packaging, evacuation, and extraction
• Supplemental & Continuing Education: Highlights the need for specialized and ongoing training tailored to nontraditional EMS scenarios.
• Safety and Legal Considerations: Recommends stringent safety, health practices, and awareness of unique legal implications when providing care in wilderness or delayed transport settings.
• Non-Prescriptive Guidance: The guide does not prescribe specific medical protocols or authorize invasive procedures without proper medical control and authorization.

Applications

The ASTM F1616-95(2016) standard is widely used in various contexts, such as:

• Wilderness First Responder Training: Curriculum developers utilize this guide to shape educational programs, ensuring responders gain the skills necessary to deliver care amidst environmental and logistical challenges.
• Disaster and Remote Site Response: Organizations and agencies responsible for disaster preparedness, search and rescue, or remote site management reference this standard to define responder capabilities in catastrophic or inaccessible environments.
• Supplemental EMS Training: EMS agencies and first responder units operating in rural, remote, or nontraditional settings use the standard for targeted training and continuing education, enhancing preparedness for situations with extended response or transport times.
• Occupational & Recreational Safety: Companies and organizations engaged in outdoor activities or expeditions adopt the standard as a benchmark for emergency readiness and responder performance.
• Healthcare Policy and Planning: Emergency managers and healthcare planners apply the guidelines to assess and improve the effectiveness of pre-hospital emergency medical care in challenging or delayed transport situations.

Related Standards

This ASTM guide references and complements several standards and documents, including:

• ASTM F1287: Guide for Scope of Performance of First Responders Who Provide Emergency Medical Care
• ASTM F1453: Guide for Training and Evaluation of First Responders Who Provide Emergency Medical Care
• ASTM F1177: Terminology Relating to Emergency Medical Services
• U.S. DOT HS 900-25: Emergency Medical Services: First Responder Training Course
• OSHA 29 CFR 1910.1030: Bloodborne Pathogens Standard

Summary

ASTM F1616-95(2016) serves as a foundational guideline for first responders working outside traditional EMS systems, especially in the wilderness or where transport delays are common. It helps organizations, trainers, and responders address unique challenges, ensuring that high standards are maintained for emergency medical care, even in the most difficult and remote environments. For those tasked with developing, implementing, or evaluating emergency response protocols in nontraditional settings, this standard is a critical reference for achieving preparedness and resilience.

Keywords: wilderness first responder, delayed transport, prolonged transport, emergency medical care, remote medical response, nontraditional EMS, ASTM F1616

Standards Content (Sample)

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: F1616 − 95 (Reapproved 2016)
Standard Guide for
Scope of Performance of First Responders Who Practice in
the Wilderness or Delayed or Prolonged Transport Settings
This standard is issued under the fixed designation F1616; 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 F1177 Terminology Relating to Emergency Medical Ser-
vices
1.1 This guide covers minimum performance requirements
F1287 Guide for Scope of Performance of First Responders
for first responders who may initially provide care for sick or
Who Provide Emergency Medical Care
injured persons in the specialized pre-hospital situations of the
F1453 Guide for Training and Evaluation of First Respond-
wilderness or delayed or prolonged transport settings, includ-
ers Who Provide Emergency Medical Care
ing catastrophic disasters.
F1490 Terminology Relating to Search and Rescue (With-
1.2 Individuals who will operate in the wilderness or de-
drawn 2011)
layed or prolonged transport settings need to be aware of the
2.2 Code of Federal Regulations:
physical requirements necessary to be able to perform all
Title 29, Part 1910.1030, Bloodborne Pathogens
identified objectives and necessary skills required for the
2.3 Department of Transportation Document:
setting.
U.S. DOT HS 900-25, Course Guide, Emergency Medical
1.3 This guide establishes supplemental or continuing edu-
Services: First Responder Training Course, 1979
cation programs that will be taught to individuals trained to the
first responder level by an appropriate authority. 3. Terminology
3.1 Definitions:
1.4 This guide does not establish performance standards for
use in the traditional emergency medical services (EMS) or 3.1.1 access—the process of reaching the patient/subject
and establishing physical contact.
ambulance transportation environment.
3.1.2 basic life support/cardiopulmonary resuscitation
1.5 This guide does not establish medical protocols; nor
(BLS/CPR)—a set of skills that includes airway management,
does it authorize invasive procedures without specific authori-
chest compressions, and others as defined by the American
zation and medical control.
Heart Association (AHA).
1.6 Successful completion of a course based on this guide
3.1.3 definitive care (see Terminology F1177)—a level of
does not constitute or imply certification or licensure.
therapeutic intervention capable of providing comprehensive
1.7 This standard does not purport to address all of the
health care services for a specific condition.
safety concerns, if any, associated with its use. It is the
3.1.4 evacuation (see Terminology F1490)—the process
responsibility of the user of this standard to establish appro-
used between the time of extraction and transportation.
priate safety and health practices and determine the applica-
bility of regulatory limitations prior to use.
3.1.5 extraction (see Terminology F1490)—the process of
initial assessment, treatment, stabilization, and packaging of
2. Referenced Documents
the patient/subject as well as removal of the patient/subject
from the immediately hazardous environment.
2.1 ASTM Standards:
3.1.6 first responder—an individual trained to meet the
requirements of Guide F1287.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.1.7 transportation—the use of a specially designed ve-
Medical Services and is the direct responsibility of Subcommittee F30.02 on
hicle to move a patient to a medical facility or definitive care
Personnel, Training and Education.
facility.
Current edition approved June 1, 2016. Published June 2016. Originally
approved in 1995. Last previous edition approved in 2009 as F1616 – 95(2009).
DOI: 10.1520/F1616-95R16.
2 3
For referenced ASTM standards, visit the ASTM website, www.astm.org, or The last approved version of this historical standard is referenced on
contact ASTM Customer Service at [e-mail]. For Annual Book of ASTM www.astm.org.
Standards volume information, refer to the standard’s Document Summary page on AvailablefromStandardizationDocumentsOrderDesk,Bldg.4SectionD,700
the ASTM website. Robbins Ave., Philadelphia, PA 19111-5098, Attn: NPODS.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1616 − 95 (2016)
3.2 Definitions of Terms Specific to This Standard: 5.1.4 Identify and manage illness or injury related to or
3.2.1 delayed or prolonged transport setting— when the caused by the environment in the wilderness or delayed or
time between patient injury and arrival at a definitive care prolonged transport settings, including the following:
facility is greater than 60 min. 5.1.4.1 Altitude illness (for example, acute mountain
sickness, high-altitude pulmonary edema, and high-altitude
3.2.2 nontraditional EMS environment—an environment
cerebral edema);
that is not readily accessible to a ground ambulance.
5.1.4.2 Barotrauma;
3.2.3 wilderness first responder (WFR)—an individual
5.1.4.3 Cold injury (for example, hypothermia and frost-
trained to meet the requirements of this guide.
bite);
3.2.4 wilderness setting—situations in which the delivery of
5.1.4.4 Heat illness (heat stroke and heat exhaustion);
patient care by EMS providers is complicated by one or more
5.1.4.5 Electrical and lightning injuries;
of the following factors: (1) remoteness with respect to
5.1.4.6 Exposure to plant or animal (for example, insect,
logistics and access; (2) a significant delay in the delivery of
reptile, arachnid, and marine) toxins;
care to the patient; (3) an environment that is physically
5.1.4.7 Drowning, near-drowning, and cold water immer-
stressful to both patients and rescuers; and (4) lack of
sion; and
equipment, supplies, and transportation.
5.1.4.8 Dehydration.
5.1.5 Understand the proper disinfection of water, and
4. Significance and Use
identify and manage illnesses associated with improper water
4.1 This guide is intended to expand the scope of the
...