ASTM F1655-95(2002)
(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:F1655–95 (Reapproved 2002)
Standard Guide for
Training First Responders Who Practice in Wilderness,
Delayed, or Prolonged Transport Settings
This standard is issued under the fixed designation F1655; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision.Anumber in parentheses indicates the year of last reapproval.A
superscript epsilon (e) indicates an editorial change since the last revision or reapproval.
1. Scope F1287 GuideforScopeofPerformanceofFirstResponders
Who Provide Medical Care
1.1 This guide covers minimum training standards for first
F1453 Guide for the Training and Evaluation of First
responders who may care for sick or injured persons in the
Responders Who Provide Medical Care
specialized pre-hospital situations of the wilderness, delayed,
F1490 Terminology Relating to Search and Rescue
or prolonged transport settings, including catastrophic disas-
ters.
3. Terminology
1.2 This guide establishes supplemental or continuing edu-
3.1 Definitions:
cationprogramsthatwillbetaughttoindividualstrainedtothe
3.1.1 access, n—the process of reaching the patient/subject
first responder level by an appropriate authority.
and establishing physical contact.
1.3 This guide does not provide training to be used, ordi-
3.1.2 basic life support/cardiopulmonary resuscitation
narily, in the traditional EMS or ambulance transportation
(BLS/CPR), n—a set of skills that includes airway manage-
environments.
ment, chest compressions, and others as defined by the
1.4 Included in this guide is a standard for the evaluation of
American Heart Association.
the knowledge and skills defined within this guide.
3.1.3 definitive care, n—a level of therapeutic intervention
1.5 Successful completion of a course based on this guide
capable of providing comprehensive health care services for a
neither constitutes nor implies certification or licensure.
specific condition. (See Terminology F1177.)
1.6 This guide does not establish medical protocols, nor
3.1.4 evacuation, n—the process used between the time of
does it authorize invasive procedures without specific authori-
extraction and transportation. (See Terminology F1490.)
zation and medical control.
3.1.5 extraction, n—the process of initial assessment, treat-
1.7 The values stated in inch-pound units are to be regarded
ment, stabilization, and packaging of the patient as well as the
as the standard.
removal of the patient/subject from the immediately hazardous
1.8 Operating within the framework of this guide may
environment. (See Terminology F1490.)
expose personnel to hazardous materials or environments,
3.1.6 first responder, n—anindividualtrainedinaccordance
procedures, and equipment or all of these.
with Guide F1453.
1.9 This standard does not purport to address all of the
3.1.7 transportation, n—the use of a dedicated vehicle for
safety concerns, if any, associated with its use. It is the
theremovalofthepatienttoamedicalfacilityordefinitivecare
responsibility of the user of this standard to establish appro-
facility.
priate safety and health practices and determine the applica-
3.2 Definitions of Terms Specific to This Standard:
bility of regulatory limitations prior to use.
3.2.1 delayed or prolonged transport, n—when time be-
2. Referenced Documents tween patient injury and arrival to a definitive care facility is
greater than 60 min.
2.1 ASTM Standards:
3.2.2 non-traditional EMS environment, n—environments
F1177 Terminology Relating to Emergency Medical Ser-
not readily accessible to a ground ambulance.
vices
3.2.3 wilderness first responder (WFR), n—an individual
trained to meet the requirements of this guide.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.2.4 wilderness setting, n—situations in which EMS deliv-
Medical Services and is the direct responsibility of Subcommittee F30.02 on
eryiscomplicatedbyoneormoreofthefollowingfourfactors:
Personnel, Training, and Education.
(1) remoteness as far as logistics and access; (2) a significant
Current edition approved Oct. 10, 1995. Published December 1995.
delay in the delivery of care to the patient; (3) an environment
Annual Book of ASTM Standards, Vol 13.02.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
F1655–95 (2002)
that is stressful to both patients and rescuers; and (4) a lack of moaningandintermittentlyscreamingtheentiretime,insevere
equipment and supplies. pain. Later he wrote to various authorities criticizing the care
provided to him.
4. Significance and Use
5.3 Disaster (Delayed/Prolonged Settings):
5.3.1 It was rush hour, and the freeways were crowded, but
4.1 Individuals will be initially or concurrently trained in
accordance with U.S. D.O.T. Course Guide for First Respond- otherwisethedaywaslikeanyother.Suddenlytheearthshook,
and a freeway collapsed, entombing motorists in a mass of
ers and Guide F1453.
4.2 This guide does not suggest a particular training se- concrete and twisted metal.
quence. 5.3.2 For four days, rescuers attacked the mass of rubble
4.3 This guide may be used by individuals developing with every tool available from pliers to massive construction
training programs for non-traditional EMS environments. equipment. They had given up hope of finding any one else
4.4 This guide acknowledges the need to provide additional alive when they found a 57 year old construction worker alive,
specific training for first responders who will practice in the his lower extremities being trapped and crushed.
wilderness, delayed or prolonged transport settings. 5.3.3 No medical personnel were available to render care
4.5 Individuals responsible for training first responders
such as IVhydration, so the construction workers immediately
should identify those who will practice in the wilderness, extricated him. Despite later attempts at hydration, he later
delayed or prolonged transport settings and must ensure that
developed kidney failure and then sepsis; he died a few days
suchpersonnelarecompetentinallskillsneededfortheunique later.
settings.
5.4 Borderline Wilderness Settings:
5.4.1 Severalyearsago,alightcivilaircraftcrashednearthe
5. Illustrative Examples
top of Tinker Mountain in southwest Virginia. Atop Tinker
5.1 Wilderness Settings: Mountain’s rugged, cliff-strewn ridgeline is the Appalachian
5.1.1 In May 1983, two climbers were at about 18000 ft, Trail; the area is a favorite of hikers and climbers. The aircraft
near Denali Pass on Mount McKinley,Alaska. These climbers was located from the air, and a team responded to the site.The
took a tumbling 800 ft fall before coming to rest. One of the quickest way to reach the site was from a road near the bottom
climberswasonlyresponsivetopain,withalaceratedfaceand of the ridge. Those responding to the site fell into two groups:
thepickendofhisiceaxeimpaledintherightsideofhischest, mountain rescue team members and “regular” fire/EMS per-
just below the nipple line.Anearby climbing party responded. sonnel. Protocols for the fire/EMS personnel required them,
They first attempted to stabilize the ice axe in place as per when responding to an air crash, to wear full turnout gear and
standard EMS protocols. They improvised a rescue toboggan self-contained breathing apparatus, and to carry fire suppres-
using two plastic sleds, but moving the patient was very sion equipment. The standard practice for the mountain
...
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