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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Published
Publication Date
31-Oct-2020
Current Stage
Ref Project

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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: F1654 − 95 (Reapproved 2020)
Standard Guide for
Training and Evaluation of Individuals Who Are Responsible
for or Perform Triage in a Prehospital Environment
This standard is issued under the fixed designation F1654; 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 F1031 Practice for Training the Emergency Medical Tech-
nician (Basic)
1.1 This guide covers minimum requirements for the train-
F1177 Terminology Relating to Emergency Medical Ser-
ing and evaluation of individuals who perform triage at an
vices (Withdrawn 2018)
emergency medical incident involving multiple casualties in a
F1219 Guide for Training the Emergency Medical Techni-
prehospital environment.
cian (Basic) to Perform Patient Initial and Detailed As-
1.2 All training will be in accordance with Guide F1653. 4
sessment (Withdrawn 2006)
F1253 Guide for Training the Emergency Medical Techni-
1.3 Included in this guide is a standard for knowledge and
skill evaluation. cian (Basic) to Perform Patient Secondary Assessment
(Withdrawn 1999)
1.4 Operating within the framework of this guide may
F1285 Guide for Training the Emergency Medical Techni-
expose personnel to hazardous materials, procedures, and
cian to Perform Patient Examination Techniques
equipment. For additional information see Practice F1031 and
F1288 Guide for Planning for and Response to a Multiple
Guides F1219, F1253, F1285, F1288, F1453, and F1489.
Casualty Incident (Withdrawn 2018)
1.5 This standard does not purport to address all of the
F1453 Guide for Training and Evaluation of First Respond-
safety concerns, if any, associated with its use. It is the
ers Who Provide Emergency Medical Care
responsibility of the user of this standard to establish appro-
F1489 Guide for Performance of Patient Assessment by the
priate safety, health, and environmental practices and deter-
Emergency Medical Technician (Paramedic) (Withdrawn
mine the applicability of regulatory limitations prior to use.
2003)
For specific precautionary statements, see the document cited
F1653 Guide for Scope of Performance of Triage in a
in Footnote 3.
Prehospital Environment
1.6 This international standard was developed in accor-
dance with internationally recognized principles on standard- 3. Terminology
ization established in the Decision on Principles for the
3.1 Definitions of Terms Specific to This Standard:
Development of International Standards, Guides and Recom-
3.1.1 first priority/immediate (RED)—those patients with
mendations issued by the World Trade Organization Technical
serious injuries that are life threatening but have a high
Barriers to Trade (TBT) Committee.
probability of survival.
3.1.2 fourth priority/dead/mortally wounded (BLACK)—
2. Referenced Documents
those patients who are obviously dead as determined by local
2,3
2.1 ASTM Standards:
medical protocol or those patients with severe injuries and a
low probability of survival, despite immediate care.
3.1.3 injured, adj—means both sick and injured patients.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.02 on
3.1.4 ongoing triage, n—the continuing process of patient
Personnel, Training and Education.
assessment and prioritization in a multiple casualty incident.
Current edition approved Nov. 1, 2020. Published November 2020. Originally
(Also known as secondary and tertiary.)
approved in 1995. Last previous edition approved in 2012 as F1654 – 95 (2012).
DOI: 10.1520/F1654-95R20.
3.1.5 primary triage, n—the initial process of rapid
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
assessment, provision of life-saving interventions, and assign-
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on ment of visual priority identification to each patient in a
the ASTM website.
multiple casualty incident.
Most recent “Standards and Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiac Care” as reprinted from the Journal of the American Medical
Association, available from American Heart Association, 7272 Greenville Ave., The last approved version of this historical standard is referenced on
Dallas, TX 75231. www.astm.org.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1654 − 95 (2020)
3.1.6 second priority/delayed (YELLOW)—those patients 5.1.3.1 Describe the concept of triage of doing the greatest
who are seriously injured and whose lives are not immediately good for the greatest number of casualties.
threatened.
5.1.3.2 Describe existing and potential incident conditions
and situations under which additional resources are needed but
3.1.7 third priority/minor (GREEN)—those patients who are
may or may not be available.
injured but do not require immediate medical attention and
those apparently not physically injured.
5.1.3.3 Describe methods for requesting needed resources.
3.1.8 triage, n—the process of sorting and prioritizing 5.1.4 Incident Management—Describe the methods for
emergency medical care of the sick and injured on the basis of implementation of the local emergency incident management
urgency and type of condition present as well as the number of
system as it relates to multi-casualty events.
patients and resources.
5.1.5 Medical Control—Describe the role and responsibili-
ties of medical control during an MCI, the application of
3.2 For definitions of other terms used in this guide, refer to
protocols, and the use of st
...

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