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ASTM F1560-00(2006)

(Practice)

Standard Practice for Emergency Medical Dispatch Management

Standard Practice for Emergency Medical Dispatch Management

SCOPE
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.
1.2 The scope of this practice includes:
1.2.1 The entry level selection criteria for hiring emergency medical dispatchers;
1.2.2 The orientation of new emergency medical dispatchers;
1.2.3 Development of QA/QI mechanisms, management strategies and organizational structures for use within a comprehensive emergency medical dispatch system;
1.2.4 Performance evaluation as a component of a comprehensive and ongoing quality assurance and risk management program for an emergency medical dispatch system;
1.2.5 Development and provision of continuing dispatch education activities for the emergency medical dispatcher;
1.2.6 Requirements for initial certification and recertification of the emergency medical dispatcher;
1.2.7 Provision for comparative analysis between different EMD program approaches available to the EMS community that conform to established EMD practice standards prior to implementation of an emergency medical dispatch program; and
1.2.8 Guidelines for implementation of an emergency medical dispatch program.
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 and health practices and determine the applicability of regulatory limitations prior to use.

General Information

Status
Historical
Publication Date
28-Feb-2006
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.04 - Communications
Current Stage
Ref Project

Relations

Replaces
ASTM F1560-00 - Standard Practice for Emergency Medical Dispatch Management
Effective Date
01-Mar-2006
Referred By
ASTM F1258-95(2022) - Standard Practice for Emergency Medical Dispatch
Effective Date
01-Mar-2006
Referred By
ASTM F1220-95(2022) - Standard Guide for Emergency Medical Services System (EMSS) Telecommunications
Effective Date
01-Mar-2006

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ASTM F1560-00(2006) - Standard Practice for Emergency Medical Dispatch Management
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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: F1560 − 00(Reapproved 2006)
Standard Practice for
Emergency Medical Dispatch Management
This standard is issued under the fixed designation F1560; 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.
INTRODUCTION
The emergency medical dispatcher (EMD) is the principal link between the public caller requesting
emergencymedicalassistanceandtheemergencymedicalservice(EMS)resourcedeliverysystem.As
such, the EMD plays a fundamental role in the ability of the EMS system to respond to a perceived
medical emergency.With proper training, program administration, supervision, and medical direction,
the EMD can accurately query the caller, select an appropriate method of response, provide pertinent
information to responders, and give appropriate aid and direction for patients through the caller.
Through careful application and reference to a written, medically approved, emergency medical
dispatch protocol, sound decisions concerning EMS responses can be made in a safe, reproducible,
and non-arbitrary manner. These benefits are realized by EMS systems when appropriate
implementation, sound medical management, and quality assurance/quality improvement (QA/QI) at
dispatch are provided within the EMD/EMS system. This practice assists in establishing these
management and administrative standards.
1. Scope 1.2 The scope of this practice includes:
1.2.1 The entry level selection criteria for hiring emergency
1.1 This practice covers the function of the emergency
medical dispatchers;
medical dispatcher (EMD). This function is the prompt and
1.2.2 The orientation of new emergency medical dispatch-
accurate processing of calls for emergency medical assistance.
ers;
The training and practice through the use of a written or
1.2.3 Development of QA/QI mechanisms, management
automatedmedicaldispatchprotocolisnotsufficientinitselfto
strategies and organizational structures for use within a com-
ensure continued medically correct functioning of the EMD.
prehensive emergency medical dispatch system;
Their dispatch-specific medical training and focal role in EMS
1.2.4 Performance evaluation as a component of a compre-
has developed to such a complexity that only through a
hensive and ongoing quality assurance and risk management
correctly structured and appropriately managed quality assur-
program for an emergency medical dispatch system;
ance environment can the benefits of their practice be fully
1.2.5 Development and provision of continuing dispatch
realized.Thephilosophiesofemergencymedicaldispatchhave
education activities for the emergency medical dispatcher;
established new duties to which the emergency medical dis-
1.2.6 Requirements for initial certification and recertifica-
patch agency must respond. It is important that their quality
tion of the emergency medical dispatcher;
assurance/quality improvement (QA/QI) activities, including
1.2.7 Provision for comparative analysis between different
initial hiring, orientation, training and certification, continuing
EMD program approaches available to the EMS community
dispatch education, recertification, and performance evaluation
that conform to established EMD practice standards prior to
be given appropriate managerial attention to help ensure the
implementation of an emergency medical dispatch program;
ongoing safety in the performance of the EMD. This practice
and
establishes functional guidelines for these managerial, admin-
1.2.8 Guidelines for implementation of an emergency medi-
istrative and supervisory functions.
cal dispatch program.
1.3 This standard does not purport to address all of the
This practice is under the jurisdiction ofASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.04 on
safety concerns, if any, associated with its use. It is the
Communications.
responsibility of the user of this standard to establish appro-
Current edition approved March 1, 2006. Published March 2006. Originally
priate safety and health practices and determine the applica-
approved in 1994. Last previous edition approved in 2000 as F1560 – 00. DOI:
10.1520/F1560-00R06. bility of regulatory limitations prior to use.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1560 − 00 (2006)
2. Referenced Documents planning, EMD program selection, proper system
implementation,employeeselection,training,andcertification,
2.1 ASTM Standards:
QA/QI, performance evaluation, continuing dispatch
F1258 Practice for Emergency Medical Dispatch
education, recertification, and risk management activities.
F1552 Practice for Training Instructor Qualification and
These functions must be designed and implemented to assist
Certification Eligibility of Emergency Medical Dispatch-
the medical director, dispatch supervisor, and emergency
ers
medical dispatcher in monitoring and modifying EMD perfor-
3. Terminology
mance found deficient by QA/QI to protect the public against
incompetent practitioners, as well as modify organizational
3.1 Definitions of Terms Specific to This Standard:
structure, resource, or protocol deficiencies that exist in the
3.1.1 case review template—a structured performance
emergency medical dispatch system.
evaluation document containing all necessary input and output
4.1.1 Entry Level Selection—The selection and evaluation
actionsrequiredofdispatchersthatparallelstheEMDs’on-line
protocols, policies, and procedures related to call-taking and of new dispatchers must include clearly written objective
standards to be adopted for qualifying candidates, interviewing
processing. It contains check-off lists and compliance scoring
mechanisms that objectively rate the EMDs’ performance on a applicants and pre-employment aptitude and skill testing pur-
suant to the hiring of dispatchers.
single call.
4.1.2 Orientation—A pre-planned process of events focus-
3.1.2 dispatch life support—the knowledge, procedures, and
ing on the development and acclimation of an employee who
skills used by trained EMDs in providing care through pre-
will function within the organization’s standards, practices,
arrival instructions to callers. It consists of those BLS andALS
policies, and procedures.
principles that are appropriate to application by medical
dispatchers. 4.1.3 Quality Assurance/Quality Improvement—Within a
physician medically directed emergency medical dispatch
3.1.3 emergency medical dispatch agency—any organiza-
system, the development and implementation of employee
tion or a combination of organizations working cooperatively,
performance thresholds, concurrent evaluation of compliance
that routinely accepts calls for emergency medical assistance
to these thresholds through on-line supervision, retrospective
and facilitates the dispatch of prehospital emergency medical
evaluation of non-edited logged recordings of requests for
resources/personnel and provides medically oriented pre-
emergencyservicemeasuringcompliancewithpolicy,practice,
arrival instructions pursuant to such requests.
andproceduretovalidatethatthepracticesareappropriate,and
3.1.4 performance evaluation—the documented, objective,
to correct the employee and practice if they are found to be
quantitative measure of an individual emergency medical
deficient.
dispatcher’s performance based upon compliance with depart-
4.1.4 Performance Evaluation—Each EMD in an emer-
mental protocols, policies and procedures.
gency medical dispatch agency must regularly and routinely be
3.1.5 pre-arrival instructions—telephone-rendered, medi-
evaluated with respect to his or her adherence to policy,
cally approved written instructions provided by trained EMDs
protocol, and procedure through the QA/QI process. This
through callers which help to provide aid to the victim and
determines conformance to these elements and measures how
controlofthesituationpriortoarrivalofprehospitalpersonnel.
this performance affects the efficiency and effectiveness of the
3.1.6 quality assurance/quality improvement (QA/QI)—the
emergency medical dispatch agency. The evaluation must be
comprehensive program of prospectively setting standards,
quantitative and qualitative.
concurrently monitoring the performance of clinical, opera-
4.1.5 Continuing Education—Each emergency medical dis-
tional and personnel components, and retrospectively improv-
patchagencymustprovideforthedevelopmentandimplemen-
ing these components in the emergency medical dispatch
tation of a continuing dispatch education program for the
agency when compared with these standards.
benefit of that agency’s EMD personnel. This program must
3.1.7 risk management—a sub-component of the quality provide the EMD with applicable educational topics designed
assurance/quality improvement program designed to: identify
to enhance their general knowledge and skill in the philosophy
problematic situations and assist EMS medical directors, dis- and application of the EMD program used within the emer-
patch supervisors, and EMDs in modifying practice behaviors
gency medical dispatch agency.
found to be deficient by quality assurance procedures; protect
4.1.6 Risk Management—A written practice and procedure
the public against incompetent practitioners; and modify
shall be established for each agency that provides guidelines
structural, resource, and protocol deficiencies that may exist in
for physician medical directors, EMS system administrators,
the emergency medical dispatch system.
agencysupervisors,and/orQA/QIpersonneltofollowwhenan
EMD is identified as failing to meet or follow established
4. Summary of Practice
protocols. These may be acts of omission or commission
4.1 A comprehensive plan for managing the quality of care
identified through concurrent or retrospective review. This
in an emergency medical dispatch system must include careful
practice and procedure shall provide guidelines for proper
investigative criteria relative to the medical or administrative
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
nature of the perceived infraction, and the proper progressive
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
disciplinary procedure to be followed in order to provide the
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. EMD due process.
F1560 − 00 (2006)
4.1.7 Certification, Recertification—All EMDs working in a professional, it is necessary to establish sound medical man-
medical dispatch agency shall be certified as competent in the agementprocessesthroughamulti-componentQA/QIprogram
use of the medically approved emergency medical dispatch administered by the EMD’s agency in conjunction with the
priority reference system (EMDPRS) used within the medical physician medical director. Prompt, correct, and appropriate
dispatch center. Initial certification and recertification stan- patient care can be enhanced through the use of a standardized
dards shall be established by each certifying entity associated approach to quality assurance, especially the component of
withtheirEMDPRSprotocolsinaccordancewithASTM-EMD EMD performance assessment. This practice is intended for
standards that validate the individual EMD’s knowledge and use by agencies, organizations, and jurisdictions having the
competency in their use. responsibility for providing such services and assurances to the
4.1.8 Reciprocal Certification—Reciprocal certification public through the correct management of the nation’s emer-
gency medical dispatchers.
shall be established between certifying agencies and organiza-
tions having programs that meet the standards contained in this
6. EMD Entry Level Selection Criteria
practice.
4.1.9 Registration and Maintenance of Certification
6.1 Each emergency medical dispatch agency shall adopt a
Records—All certifying entities, agencies, or organizations
formal written policy delineating the selection procedures for
shall maintain records for all certified individuals and shall
individuals to be employed as emergency medical dispatchers.
provide documents and reports regarding testing and certifica-
It must address the ability to:
tion status as required by using agencies, states, or governmen-
6.1.1 Read and write at a high school graduate or GED
tal units.All records shall be maintained for a minimum period
level;
of ten years from initial certification, recertification or testing
6.1.2 Perform those clerical skills as delineated by the
of the individual.
employing agency;
4.1.10 Revocation of Certification—This practice shall set 6.1.3 Perform verbal skills in a clear and understandable
forthguidelinesforassessinggroundsforapossiblesuspension
manner, in the required language or languages established as
or termination of certification when questionable situations necessary to that emergency medical dispatch agency;
arise in EMD conduct or performance.
6.1.4 Perform alphanumeric transcription skills necessary to
correctly record addresses, locations, and telephone numbers;
4.1.11 Program Selection and Implementation—This is in-
and
tended to assist the EMS administrator in the selection of the
6.1.5 Demonstratecompetencyinbasictelecommunications
program that best suits the dispatch agency’s needs from a
skills as required by the employing or training agency.
medical, legal, and operational perspective and provide for
comparative analysis between different EMD program ap-
6.2 Selection criteria should also include the following:
proaches available to the EMS community that conform to
6.2.1 A clear attribute of helpfulness and compassion to-
established EMD practice standards.
ward the sick or injured patient and the caller advocate;
4.1.12 Physician Medical Director—Each emergency medi-
6.2.2 The ability to clearly guide callers in crisis through
cal dispatch agency shall have a physician medical director,
application of necessary interrogation procedures and the
who shall assist in evaluation and review of the EMD program
provision of telephone pre-arrival instructions;
under consideration. The physician medical director shall
6.2.3 The ability to learn and master the skills, philosophy
approve the selected EMD program written protocol. The
and knowledge required to successfully complete the training
physician shall be responsible for all medical aspects of the
process;
EMD program.Additional responsibilities include the medical
6.2.4 The ability to efficiently and effectively organize
oversight of the EMD t
...

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1.1 This practice covers the definition of responsibilities, knowledge, practices, and organizational support required to implement, perform, and effectively manage the emergency medical dispatch function.  
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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.
SCOPE
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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1.2.8 Guidelines for implementation of an emergency medical dispatch program.  
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Standard Guide for Selection and Practice of Emergency Medical Services Instructor for Emergency Medical Technician (EMT) Training Programs

SIGNIFICANCE AND USE
4.1 Since the quality of EMT training depends, in large measure, on the instructional abilities and competencies of the EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.  
4.2 An EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of 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 which include instruction in basic life support knowledge and skills.  
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1.5 This guide is intended to apply to any individual who teaches in EMT training programs 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.
Note 1: Also see Practice F1031.  
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Standard Practice for Qualifications, Responsibilities, and Authority of Individuals and Institutions Providing Medical Direction of Emergency Medical Services

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4.1 Implementation of this practice will ensure that the EMS system has the authority commensurate with the responsibility to ensure adequate medical direction of all pre-hospital providers, as well as personnel and facilities that meet minimum criteria to implement medical direction of pre-hospital services.  
4.1.1 The state will develop, recommend, and encourage use of a plan that would ensure the standards outlined in this document can be implemented as appropriate at the local, regional, or state level (see Guide F1086).  
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1.1 This practice covers the qualifications, responsibilities, and authority of individuals and institutions providing medical direction of emergency medical services.  
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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.  
4.2 An AEMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of instruction.  
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SCOPE
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.  
1.2 This guide identifies six categories of instructor in an AEMT (advanced emergency medical technician) training program: adjunct instructor, clinical/field preceptor, practical skills instructor, associate instructor, course instructor/coordinator (I/C), and course administrator. The guide recognizes that an individual may, depending on his/her level of practice and the training program involved, function in any or all of these categories.  
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.  
1.6 This guide intentionally omits references to length of pre-hospital care experience, teaching experience, and continuing education requirements. This guide also omits reference to waiver or equivalency. These issues should be addressed by the appropriate agency.  
1.7 This guide applies only to instructors who teach in AEMT training courses designed to prepare an individual for certification to practice above the level of the EMT. It does not apply to instructors who teach in specialized courses that do not in themselves qualify the individual for a level of EMT certification.  
1.8 This guide does not establish certification requirements. Such requirements should be established by the certifying agency in the jurisdiction in which the AEMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.  
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.
Note 1: Also see Practice F1031.  
1.10 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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ASTM F1654-95(2020)(Guide)
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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ASTM F1268-90(2020)(Guide)
Standard Guide for Establishing and Operating a Public Information, Education, and Relations Program for Emergency Medical Service Systems

SIGNIFICANCE AND USE
4.1 It is essential to have the public's understanding and support for the EMS system to ensure its proper development and utilization.  
4.2 This guide encompasses those procedures, considerations, and resources that are necessary for a successful EMS public information, education, and relations program. Complex EMS systems may integrate or augment, or both, this guide in its entirety. Less complex systems may need to collaborate with other EMS organizations and related agencies. Responsibility for this guide will vary by level of authority, that is, state, regional, and local. (See Guide F1086.)  
4.3 The PIER tasks involve research, planning, production, distribution, and evaluation. Production requires significant resources and expertise and may be done most appropriately at the higher level, such as regional, state, and national levels.
SCOPE
1.1 The purpose of this guide is to provide national voluntary standards and recommendations to effectively provide emergency medical service system information and education to the public.  
1.2 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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ASTM F1653-95(2020)(Guide)
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.  
4.10 For the purpose of this guide the word “injured” includes both sick or injured patients, or both.
SCOPE
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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