ASTM F1655-95(2007)
(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
SIGNIFICANCE AND USE
Individuals will be initially or concurrently trained in accordance with U.S. D.O.T. Course Guide for First Responders3 and Guide F 1453.
This guide does not suggest a particular training sequence.
This guide may be used by individuals developing training programs for non-traditional EMS environments.
This guide acknowledges the need to provide additional specific training for first responders who will practice in the wilderness, delayed or prolonged transport settings.
Individuals responsible for training first responders should identify those who will practice in the wilderness, delayed or prolonged transport settings and must ensure that such personnel are competent in all skills needed for the unique 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.
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: F1655 − 95(Reapproved 2007)
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 (´) indicates an editorial change since the last revision or reapproval.
1. Scope 2. Referenced Documents
1.1 This guide covers minimum training standards for first 2.1 ASTM Standards:
responders who may care for sick or injured persons in the F1177Terminology Relating to Emergency Medical Ser-
specialized pre-hospital situations of the wilderness, delayed, vices
or prolonged transport settings, including catastrophic disas- F1453Guide for Training and Evaluation of First Respond-
ters. ers Who Provide Emergency Medical Care
F1490Terminology Relating to Search and Rescue (With-
1.2 This guide establishes supplemental or continuing edu-
drawn 2011)
cationprogramsthatwillbetaughttoindividualstrainedtothe
first responder level by an appropriate authority.
3. Terminology
1.3 This guide does not provide training to be used,
3.1 Definitions:
ordinarily, in the traditional EMS or ambulance transportation
3.1.1 access, n—the process of reaching the patient/subject
environments.
and establishing physical contact.
1.4 Included in this guide is a standard for the evaluation of
3.1.2 basic life support/cardiopulmonary resuscitation
the knowledge and skills defined within this guide.
(BLS/CPR), n—a set of skills that includes airway
management, chest compressions, and others as defined by the
1.5 Successful completion of a course based on this guide
American Heart Association.
neither constitutes nor implies certification or licensure.
3.1.3 definitive care, n—a level of therapeutic intervention
1.6 This guide does not establish medical protocols, nor
capable of providing comprehensive health care services for a
does it authorize invasive procedures without specific authori-
specific condition. (See Terminology F1177.)
zation and medical control.
3.1.4 evacuation, n—the process used between the time of
1.7 The values stated in inch-pound units are to be regarded
extraction and transportation. (See Terminology F1490.)
as the standard.
3.1.5 extraction, n—the process of initial assessment,
1.8 Operating within the framework of this guide may
treatment, stabilization, and packaging of the patient as well as
expose personnel to hazardous materials or environments,
the removal of the patient/subject from the immediately
procedures, and equipment or all of these.
hazardous environment. (See Terminology F1490.)
1.9 This standard does not purport to address all of the
3.1.6 first responder, n—an individual trained in accordance
safety concerns, if any, associated with its use. It is the
with Guide F1453.
responsibility of the user of this standard to establish appro-
3.1.7 transportation, n—the use of a dedicated vehicle for
priate safety and health practices and determine the applica-
theremovalofthepatienttoamedicalfacilityordefinitivecare
bility of regulatory limitations prior to use.
facility.
1 2
This guide is under the jurisdiction of ASTM Committee F30 on Emergency For referenced ASTM standards, visit the ASTM website, www.astm.org, or
Medical Services and is the direct responsibility of Subcommittee F30.02 on contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Personnel, Training and Education. Standards volume information, refer to the standard’s Document Summary page on
Current edition approved Feb. 1, 2007. Published February 2007. Originally the ASTM website.
approved in 1995. Last previous edition approved in 2002 as F1655–95(2002). The last approved version of this historical standard is referenced on
DOI: 10.1520/F1655-95R07. www.astm.org.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1655 − 95 (2007)
3.2 Definitions of Terms Specific to This Standard: 5.2 Rural (Delayed/Prolonged Settings)—A man was driv-
3.2.1 delayed or prolonged transport, n—when time be- ing along a gravel road in a remote rural area of Northern
tween patient injury and arrival to a definitive care facility is
Idaho. He stooped to clear a fallen tree from the road, and in
greater than 60 min. the attempt, he fell and dislocated his right shoulder. He
managed to call for help with his CB radio.About 2 h later, an
3.2.2 non-traditional EMS environment, n—environments
ambulance arrived. The EMTs on the ambulance checked the
not readily accessible to a ground ambulance.
pulse and sensation in his right arm, and found them to be
3.2.3 wilderness first responder (WFR), n—an individual
normal.Themanpleadedwiththemtopullonhisshoulderand
trained to meet the requirements of this guide.
relocate it; he had a similar dislocation of the left shoulder in
3.2.4 wilderness setting, n—situations in which EMS deliv-
thepast,andheknewthatitcouldbereducedwithalittlehelp.
eryiscomplicatedbyoneormoreofthefollowingfourfactors:
However the EMTs, mindful of their training, insisted on
(1) remoteness as far as logistics and access; (2) a significant
“splintingitinposition”anddrovehimsixhourstothenearest
delay in the delivery of care to the patient; (3) an environment
hospital,mostlyalongbumpysecondaryroads.Thepatientwas
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
4.1 Individuals will be initially or concurrently trained in 5.3 Disaster (Delayed/Prolonged Settings):
accordance with U.S. D.O.T. Course Guide for First Respond-
5.3.1 It was rush hour, and the freeways were crowded, but
ers and Guide F1453.
otherwisethedaywaslikeanyother.Suddenlytheearthshook,
and a freeway collapsed, entombing motorists in a mass of
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. Illustrative Examples
5.4.1 Severalyearsago,alightcivilaircraftcrashednearthe
5.1 Wilderness Settings:
top of Tinker Mountain in southwest Virginia. Atop Tinker
5.1.1 In May 1983, two climbers were at about 18000 ft,
Mountain’s rugged, cliff-strewn ridgeline is the Appalachian
near Denali Pass on Mount McKinley,Alaska. These climbers
Trail; the area is a favorite of hikers and climbers. The aircraft
took a tumbling 800 ft fall before coming to rest. One of the
was loc
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