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ASTM F1339-92(2016)

(Guide)

Standard Guide for Organization and Operation of Emergency Medical Services Systems

Standard Guide for Organization and Operation of Emergency Medical Services Systems

SIGNIFICANCE AND USE
3.1 This guide suggests methods for organizing and operating state, regional, and local EMS systems, in accordance with Guide F1086. It will assist state, regional, or local organizations in assessing, planning, documenting, and implementing their specific operations. The guide is general in nature and able to be adapted for existing EMS Systems. For organizations that are establishing EMS System operations, the guide is specific enough to form the basis of the operational manual.
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; (l) 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.  (A) If there are no regional organizations, within the state, the State EMS will need to accomplish, either directly or through delegation, regional tasks.

General Information

Status
Published
Publication Date
31-May-2016
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.03 - Organization/Management
Current Stage
Ref Project

Relations

Refers
ASTM F1086-94(2016) - Standard Guide for Structures and Responsibilities of Emergency Medical Services Systems Organizations
Effective Date
01-Jun-2016

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ASTM F1339-92(2016) - Standard Guide for Organization and Operation of Emergency Medical Services Systems
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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: F1339 − 92 (Reapproved 2016)
Standard Guide for
Organization and Operation of Emergency Medical Services
1
Systems
This standard is issued under the fixed designation F1339; 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 2. Referenced Documents
2
2.1 ASTM Standards:
1.1 Thisstandardestablishedguidelinesfortheorganization
F1086 Guide for Structures and Responsibilities of Emer-
and operation of Emergency Medical Services Systems
gency Medical Services Systems Organizations
(EMSS) at the state, regional and local levels. This guide will
F1149 Practice for Qualifications, Responsibilities, and Au-
identify methods of developing state standards, coordinating/
thority of Individuals and Institutions Providing Medical
managing regional EMS Systems, and delivering emergency
Direction of Emergency Medical Services
medical services through the local EMS System.
F1220 Guide for Emergency Medical Services System
1.1.1 At the state level this guide identifies scope, methods,
(EMSS) Telecommunications
procedures and participants in the following state structure
F1268 Guide for Establishing and Operating a Public
responsibilities: (a) establishment of EMS legislation; (b)
Information, Education, and Relations Program for Emer-
development of minimum standards; (c) enforcement of mini-
gency Medical Service Systems
mum standards; (d) designation of substate structure; (e)
F1285 Guide for Training the Emergency Medical Techni-
provision of technical assistance; (f) identification of funding
cian to Perform Patient Examination Techniques
and other resources for the development, maintenance, and
2.2 American Ambulance Association
enhancement of EMS systems; (g) development and imple-
3
Standards and Accreditation Document
mentation of training systems; (h) development and implemen-
tation of communication systems; (i) development and imple-
3. Significance and Use
mentation of record-keeping and evaluation systems; (j)
development and implementation of public information, public
3.1 This guide suggests methods for organizing and operat-
education, and public relations programs; (k) development and
ing state, regional, and local EMS systems, in accordance with
implementation of acute care center designation; (l) develop-
Guide F1086. It will assist state, regional, or local organiza-
ment and implementation of a disaster medical system; (m)
tions in assessing, planning, documenting, and implementing
overall coordination of EMS and related programs within the
their specific operations. The guide is general in nature and
state and in concert with other states or federal authorities.
able to be adapted for existing EMS Systems. For organiza-
tions that are establishing EMS System operations, the guide is
1.2 At the regional level, this guide identifies methods of
specific enough to form the basis of the operational manual.
planning, implementing, coordinating/managing, and evaluat-
ingtheemergencymedicalservicessystemwhichexistswithin
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—Thelegislativeprocessvar-
1.3 At the local level, this guide identifies a basic structure
ies 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
2
Medical Services and is the direct responsibility of Subcommittee F30.03 on For referenced ASTM standards, visit the ASTM website, www.astm.org, or
Organization/Management. contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Current edition approved June 1, 2016. Published June 2016. Originally Standards volume information, refer to the standard’s Document Summary page on
approved in 1992. Last previous edition approved in 2008 as F1339 – 92 (2008). the ASTM website.
3
DOI: 10.1520/F1339-92R16. Available from the American Ambulance Association.
Copyright © ASTM International,
...

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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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1.4 This guide does not include specific guidelines for the course administrator or the adjunct instructor. While the guide recognizes, by offering a definition of each category, that these types of individuals function in many EMT training programs, the limited instructional roles played by these individuals preclude the need for specific selection and utilization guidelines.  
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4.1 Since the quality of pre-hospital AEMT training depends, in large measure, on the instructional abilities and competencies of the AEMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.  
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1.1 This guide is intended to assist emergency medical services (EMS) agencies and institutions in selecting and utilizing individuals who teach in EMT (emergency medical technician) training programs that include instruction in advanced life support knowledge and skills.  
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1.3 This guide includes specific guidelines for qualifications, training, education, experience, scope of authority, responsibilities, continuing education, evaluation, and maintenance of competency when applicable.  
1.4 This guide does not include specific guidelines for the course administrator or the adjunct instructor. While the guide recognizes, by offering a definition of each category, that these types of individuals function in many AEMT training programs, the limited instructional roles played by these individuals preclude the need for specific selection and utilization guidelines.  
1.5 This guide is intended to apply to any individual who teaches in an AEMT training program regardless of the individual's present level of clinical practice.  
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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, health, and environmental practices and determine the applicability of regulatory limitations prior to use.
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ASTM F1287-90(2020)(Guide)
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.  
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

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

SIGNIFICANCE AND USE
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.  
4.5 The assessment process must be focused so as to identify those most at risk of early death who are likely to be salvaged by rapid medical intervention.  
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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SCOPE
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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.  
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