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ASTM F1339-92(2003)

(Guide)

Standard Guide for Organization and Operation of Emergency Medical Services Systems

Standard Guide for Organization and Operation of Emergency Medical Services Systems

SCOPE
1.1 This standard established guidelines for the organization and operation of Emergency Medical Services Systems (EMSS) at the state, regional and local levels. This guide will identify methods of developing state standards, coordinating/managing regional EMS Systems, and delivering emergency medical services through the local EMS System.  
1.1.1 At the state level this guide identifies scope, methods, procedures and participants in the following state structure responsibilities: a) establishment of EMS legislation; b) development of minimum standards; c) enforcement of minimum standards; d) designation of substate structure; e) provision of technical assistance; f) identification of funding and other resources for the development, maintenance, and enhancement of EMS systems; g) development and implementation of training systems; h) development and implementation of communication systems; i) development and implementation of record-keeping and evaluation systems; j) development and implementation of public information, public education, and public relations programs; k) development and implementation of acute care center designation; 1) development and implementation of a disaster medical system; m) overall coordination of EMS and related programs within the state and in concert with other states or federal authorities.  
1.2 At the regional level, this guide identifies methods of planning, implementing, coordinating/managing, and evaluating the emergency medical services system which exists within a natural catchment area and provides guidance on the use of these methods.  
1.3 At the local level, this guide identifies a basic structure for the organization and management of a local EMS system and outlines the responsibilities that a local EMS should assume in the planning, development, implementation and evaluation of its EMS system.

General Information

Status
Historical
Publication Date
09-Sep-2003
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.03 - Organization/Management
Current Stage
Ref Project

Relations

Replaces
ASTM F1339-92(1998) - Standard Guide for Organization and Operation of Emergency Medical Services Systems
Effective Date
10-Sep-2003
Replaced By
ASTM F1339-92(2008) - Standard Guide for Organization and Operation of Emergency Medical Services Systems
Effective Date
01-Feb-2008

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ASTM F1339-92(2003) - Standard Guide for Organization and Operation of Emergency Medical Services SystemsASTM F1339-92(2003) - Standard Guide for Organization and Operation of Emergency Medical Services Systems
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ASTM F1339-92(2003) - Standard Guide for Organization and Operation of Emergency Medical Services Systems
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Standards Content (Sample)

NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation:F1339–92 (Reapproved 2003)
Standard Guide for
Organization and Operation of Emergency Medical Services
1
Systems
This standard is issued under the fixed designation F 1339; 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 2. Referenced Documents
1.1 Thisstandardestablishedguidelinesfortheorganization 2.1 ASTM Standards:
and operation of Emergency Medical Services Systems F 1086 Guide for Structures and Responsibilities of Emer-
2
(EMSS) at the state, regional and local levels. This guide will gency Medical Services Organizations
identify methods of developing state standards, coordinating/ F 1149 Practice for Qualifications, Responsibilities, and
managing regional EMS Systems, and delivering emergency Authority for Individuals and Institutions Providing Medi-
2
medical services through the local EMS System. cal Direction of Emergency Medical Services
1.1.1 At the state level this guide identifies scope, methods, F 1220 Guide for Emergency Medical Services System
2
procedures and participants in the following state structure (EMSS) Telecommunications
responsibilities: (a) establishment of EMS legislation; (b) F 1268 Guide for Establishing and Operating Public Infor-
development of minimum standards; (c) enforcement of mini- mation, Education and Relations Programs for Emergency
2
mum standards; (d) designation of substate structure; (e) Medical Services Systems
provision of technical assistance; (f) identification of funding F 1285 Guide for Training the Emergency Medical Techni-
2
and other resources for the development, maintenance, and cian (Basic) to Perform Patient Examination Techniques
enhancement of EMS systems; (g) development and imple- 2.2 American Ambulance Association
3
mentation of training systems; (h) development and implemen- Standards and Accreditation Document
tation of communication systems; (i) development and imple-
3. Significance and Use
mentation of record-keeping and evaluation systems; (j)
3.1 This guide suggests methods for organizing and operat-
development and implementation of public information, public
ing state, regional, and local EMS systems, in accordance with
education, and public relations programs; (k) development and
implementation of acute care center designation; (l) develop- Guide F 1086. It will assist state, regional, or local organiza-
tions in assessing, planning, documenting, and implementing
ment and implementation of a disaster medical system; (m)
overall coordination of EMS and related programs within the their specific operations. The guide is general in nature and
able to be adapted for existing EMS Systems. For organiza-
state and in concert with other states or federal authorities.
1.2 At the regional level, this guide identifies methods of tions that are establishing EMS System operations, the guide is
specific enough to form the basis of the operational manual.
planning, implementing, coordinating/managing, and evaluat-
ing the emergency medical services system which exists within
4. State Guide
a natural catchment area and provides guidance on the use of
4.1 Establishment of EMS Legislation:
these methods.
4.1.1 Methods and Procedures—The legislative process
1.3 At the local level, this guide identifies a basic structure
varies from state to state. The EMS lead agency should seek a
for the organization and management of a local EMS system
description of the process in its state from:
and outlines the responsibilities that a local EMS should
4.1.1.1 The legislature’s staff or clerk offices.
assume in the planning, development, implementation and
4.1.1.2 The legislative liaison, or other appropriate staff of
evaluation of its EMS system.
the governmental unit housing EMS (its “umbrella”).
4.1.1.3 The legal counsel assigned to EMS.
1
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.03 on
Organization/Management.
2
Current edition approved Sept. 10, 2003. Published October 2003. Originally Annual Book of ASTM Standards, Vol 13.02.
3
approved in 1992. Last previous edition approved in 1998 as F 1339 – 92 (1998). Available from the American Ambulance Association.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
1

---------------------- Page: 1 ----------------------
F1339–92 (2003)
TABLE 1 Levels of Organization
A
State Regional Local
Standard Setting Legislation Regional policies Employment standards
Regulations Regional protocols Operating policies
Guidelines/policies/proc
...

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5.1 The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. Many of these personnel still perform in this role without the benefits of dispatch specific medical training and medically sound protocols. The majority perform their duties without appropriate medical management provided through a structured quality assurance/improvement environment. Training only prepares a new EMD for correct use of the EMDPRS. It cannot ensure that the EMDPRS is used as intended. Since the EMD is clearly defined as a prehospital medical professional, it is necessary to establish sound medical management processes through a multi-component QA/QI program administered by the EMD's agency in conjunction with the physician medical director. Prompt, correct, and appropriate patient care can be enhanced through the use of a standardized approach to quality assurance, especially the component of EMD performance assessment. This practice is intended for use by agencies, organizations, and jurisdictions having the responsibility for providing such services and assurances to the public through the correct management of the nation's emergency medical dispatchers.
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1.1 This practice covers the function of the emergency medical dispatcher (EMD). This function is the prompt and accurate processing of calls for emergency medical assistance. The training and practice through the use of a written or automated medical dispatch protocol is not sufficient in itself to ensure continued medically correct functioning of the EMD. Their dispatch-specific medical training and focal role in EMS has developed to such a complexity that only through a correctly structured and appropriately managed quality assurance environment can the benefits of their practice be fully realized. The philosophies of emergency medical dispatch have established new duties to which the emergency medical dispatch agency must respond. It is important that their quality assurance/quality improvement (QA/QI) activities, including initial hiring, orientation, training and certification, continuing dispatch education, recertification, and performance evaluation be given appropriate managerial attention to help ensure the ongoing safety in the performance of the EMD. This practice establishes functional guidelines for these managerial, administrative, and supervisory functions.  
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4.1 This guide establishes the minimum national standard for training the Emergency Medical Technician to perform patient examination techniques on patients of all ages.  
4.2 This guide shall be used by those who wish to identify the minimum training standard for the Emergency Medical Technician as it relates to the performance of patient examination techniques.  
4.3 This guide shall be used as the basis to revise Practice F1031.  
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4.5 This guide does not stand alone and must be used in conjunction with the applicable documents cited in Section 2.
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1.1 This guide covers the minimum patient examination techniques that the Emergency Medical Technician shall be trained to use when assessing ill or injured patients of all ages.  
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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, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
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Standard Guide for Training and Evaluation of Individuals Who Are Responsible for or Perform Triage in a Prehospital Environment

SIGNIFICANCE AND USE
4.1 This guide is intended for use by those responsible for the development and implementation of training programs, that include competency evaluation, for triage in the prehospital environment.  
4.2 This guide is not intended to be used by itself, but as a component of Guide F1288.  
4.3 This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum training standard and encourages the addition of optional knowledge, skill, and attitudinal objectives.  
4.4 A vital role in the development and operational application of triage is that of medical control. This guide should be used by medical directors in the determination of operational and medical protocols for use during MCIs and coordinated with those who are responsible for training.  
4.5 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.
SCOPE
1.1 This guide covers minimum requirements for the training and evaluation of individuals who perform triage at an emergency medical incident involving multiple casualties in a prehospital environment.  
1.2 All training will be in accordance with Guide F1653.  
1.3 Included in this guide is a standard for knowledge and skill evaluation.  
1.4 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031 and Guides F1219, F1253, F1285, F1288, F1453, and F1489.  
1.5 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the document cited in Footnote 3.  
1.6 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.

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Standard Guide for Scope of Performance of Triage in a Prehospital Environment

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4.1 This guide is not intended to be used by itself, but as a component of Guide F1288. Merely conforming to the guidelines described herein will not ensure that adequate triage is carried out in a multiple casualty incident.  
4.2 The purpose of this guide is to establish a methodology for performing triage.  
4.3 Individuals responsible for performing triage must be proficient in triage methods and related life-saving techniques.  
4.4 A basic concept of triage is to do the greatest good for the greatest number of casualties.  
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4.6 Triage allows the most efficient use of available resources.  
4.7 This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum scope of performance and encourages the addition of optional knowledge, skills, and attitudinal objectives.  
4.8 A vital role in the development of and operational application of triage is that of medical control. This guide should be used by medical directors in the determination of operational and medical protocols for use during MCIs.  
4.9 This guide is intended to assist those who are responsible for defining the scope of performance of individuals who perform triage.  
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1.1 This guide covers minimum requirements for the scope of performance for individuals who perform triage at an emergency medical incident involving multiple casualties in a pre-hospital environment.  
1.2 This guide acknowledges objectives based on an individual's required knowledge of signs and symptoms, patient assessment, and basic life support.  
1.3 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031 and Guides F1219, F1253, F1285, F1287, F1288, F1489 and F1651.  
1.4 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, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see Footnote 2.2  
1.5 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.

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Standard Guide for Scope of Performance of First Responders Who Provide Emergency Medical Care

SIGNIFICANCE AND USE
4.1 The purpose of this guide is to improve the quality of initial emergency medical care provided to the sick and injured. As the first trained person at an emergency medical scene, it is critical that the first responder be proficient in providing patient care and minimizing further complications until more highly trained emergency medical service personnel intervene.  
4.2 In identifying these minima, the guide acknowledges many types of first responder emergency medical care courses of study. This guide allows and encourages the addition of optional knowledge, skill, and attitudinal objectives. Programs such as those for law enforcement, firefighters, and ski patrol are examples of this diversity meeting specific local community needs.  
4.3 This guide is intended to assist those who are responsible for defining the scope of performance for first responders.  
4.4 This guide is not  intended to be used as a scope of performance for emergency ambulance personnel (see Practice F1031).
SCOPE
1.1 This guide covers minimum requirements for the scope of performance of first responders who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.  
1.2 This guide includes objectives based on an individual's acquired knowledge, including signs and symptoms; patient assessment; basic life support/cardiopulmonary resuscitation (BLS/CPR); bleeding and shock; injuries to the skull, spine, chest, abdomen, and extremities; moving patients; medical and environmental emergencies; triage; gaining access; and hazardous situations that the first responder may encounter.  
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