ASTM F1285-90(1998)
(Guide)Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Examination Techniques
Standard Guide for Training the Emergency Medical Technician (Basic) to Perform Patient Examination Techniques
SCOPE
1.1 This guide covers the minimum patient examination techniques that the emergency medical technician (basic) shall be trained to use when assessing ill or injured patients of all ages.
1.2 This guide is one of a series which together describe the minimum training standard for the emergency medical technician (basic).
1.3 This standard does not purport to address the safety problems 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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Designation: F 1285 – 90 (Reapproved 1998)
Standard Guide for
Training the Emergency Medical Technician (Basic) to
Perform Patient Examination Techniques
This standard is issued under the fixed designation F 1285; 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 4. Significance and Use
1.1 This guide covers the minimum patient examination 4.1 This guide establishes the minimum national standard
techniques that the emergency medical technician (basic) shall for training the emergency medical technician (basic) to
be trained to use when assessing ill or injured patients of all perform patient examination techniques on patients of all ages.
ages. 4.2 This guide shall be used by those who wish to identify
1.2 This guide is one of a series which together describe the the minimum training standard for the emergency medical
minimum training standard for the emergency medical techni- technician (basic) as it relates to the performance of patient
cian (basic). examination techniques.
1.3 This standard does not purport to address the safety 4.3 This guide shall be used as the basis to revise Practice
problems associated with its use. It is the responsibility of the F 1031.
user of this standard to establish appropriate safety and health 4.4 Every person who is identified as an emergency medical
practices and determine the applicability of regulatory limita- technician (basic) shall have been trained in accordance with
tions prior to use. this guide.
4.5 This guide does not stand alone and must be used in
2. Referenced Documents
conjunction with the applicable documents cited in Section 2.
2.1 ASTM Standards:
5. Examination Techniques
F 1031 Practice for Training the Emergency Medical Tech-
nician (Basic) 5.1 The emergency medical technician (basic) shall be
trained to perform the following examination techniques and to
3. Terminology
recognize the differences that exist because of age and sex:
3.1 Definitions of Terms Specific to This Standard:
5.1.1 Assess respirations for rate, rhythm, and quality,
3.1.1 auscultation—examination by listening with a stetho- 5.1.2 Auscultate for breath sounds,
scope.
...
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SIGNIFICANCE AND USE
5.1 This practice is intended to promote the use of trained telecommunicators in the role of emergency medical dispatcher. It defines the basic skills and medical knowledge to permit understanding and resolution of the problems that constitute their daily routine. To use trained telecommunicators fully as functioning members of the emergency medical team, it is deemed necessary to upgrade the telecommunicators' training by the addition of the concept of emergency medical dispatch priorities.
5.2 All agencies or individuals who routinely accept calls for emergency medical assistance from the public and dispatch emergency medical personnel shall have in effect an emergency medical dispatcher program in accordance with this practice. The program shall include medical direction and oversight and an emergency medical dispatch priority reference system.
5.3 The successful use of the EMD concept depends on the medical community's awareness of the “prearrival” state of EMS affairs and their willingness to provide medical direction in dispatch.
5.4 This practice may assist in overcoming some of the misconceptions regarding emergency medical dispatching. These include the uncontrollable nature of the caller's hysteria, lack of time of the dispatcher, potential danger and liability to the EMD, lack of recognition of the benefits of dispatch prearrival instructions, and misconceptions that red lights, siren, and maximal response are always necessary.
5.5 The EMD is the member of the EMS response team with the broadest view of the entire emergency system's current status and capabilities. The EMD has immediate lifesaving capability in converting the caller into an effective first responder. This practice recognizes the EMD's role as including:
5.5.1 Interrogation techniques,
5.5.2 Triage decisions,
5.5.3 Information transmission,
5.5.4 Telephone medical intervention, and
5.5.5 Logistics and resource coordination during the event.
5.6 For the EMD, th...
SCOPE
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.
1.2 This practice is useful for planning and evaluating the training, implementation, and organizational support to satisfy the functional needs of emergency medical dispatching.
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.
1.4 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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SIGNIFICANCE AND USE
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.
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, health, and environmental practices and determine the applicability of regulatory limitations prior to use.
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SIGNIFICANCE AND USE
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.
4.4 Every person who is identified as an Emergency Medical Technician shall have been trained in accordance with this guide.
4.5 This guide does not stand alone and must be used in conjunction with the applicable documents cited in Section 2.
SCOPE
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.
1.2 This guide is one of a series which together describe the minimum training standard for the Emergency Medical Technician.
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.
1.4 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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SIGNIFICANCE AND USE
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.
4.3 Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of ALS/EMT instructors for ALS/EMT training and education programs.
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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SIGNIFICANCE AND USE
4.1 The purpose of this practice is to provide standardized means of providing Emergency Medical Technician training. The practice should be used by all individuals and agencies that train such persons.
4.2 Successful completion of this course of training neither constitutes nor implies certification or licensure.
4.3 This practice adopts the knowledge and skill objectives contained in the NHSTA curriculum (latest version) as the standard practice for training those persons who provide emergency medical care at the basic life support level and are known as Emergency Medical Technicians. The actual lesson plans contained in the referenced document are recommended for use; however, each instructor may modify the order of presentation according to local needs.
4.4 This practice outlines a comprehensive course that covers most common emergencies encountered by the Emergency Medical Technician. Emergency Medicine Technician courses that do not include all of the knowledge and skill objectives of this practice may not be referred to as meeting this standard.
SCOPE
1.1 This practice covers a standard course for the training of the Emergency Medical Technician which will prepare a person to perform those skills commonly required to render lifesaving aid at the scene of an emergency and during transportation to a definitive care facility.
1.2 It is not the intent of this practice to require that the curriculum be used exactly as presented, but only that the knowledge and skill objectives that are part of the curriculum be included in any course purporting to train an Emergency Medical Technician. It is not the intent of this practice to limit the addition of knowledge and skill objectives as required by local conditions.
1.3 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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SIGNIFICANCE AND USE
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).
4.1.2 This practice is intended to describe and define responsibility for medical directions during transfers. It is not intended to determine the medical or legal, or both, appropriateness of transfers under the Consolidated Omnibus Budget Reconciliation Act and other similar federal or state laws, or both.
SCOPE
1.1 This practice covers the qualifications, responsibilities, and authority of individuals and institutions providing medical direction of emergency medical services.
1.2 This practice addresses the qualifications, authority, and responsibility of a Medical Director (off-line) and the relationship of the EMS (Emergency Medical Services) provider to this individual.
1.3 This practice also addresses components of on-line medical direction (direct medical control) including the qualifications and responsibilities of on-line medical physicians and the relationship of the pre-hospital provider to on-line medical direction.
1.4 This practice addresses the relationship of the on-line medical physician to the off-line Medical Director.
1.5 The authority for control of medical services at the scene of a medical emergency is addressed in this practice.
1.6 The requirements for a Communication Resource are also addressed within this practice.
1.7 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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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.
4.3 Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of EMT instructors for EMT training and education programs.
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 which include instruction in basic life support knowledge and skills.
1.2 This guide identifies six categories of instructor in an EMT (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 EMT 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 EMT training programs 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 basic life support training courses designed to prepare an individual for certification to practice above the level 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 EMT 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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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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SIGNIFICANCE AND USE
4.1 This guide is for those responsible for the development and implementation of training and evaluation programs for first responders (FRs).
4.2 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.
4.3 This guide is not intended for use as a training guide for emergency ambulance personnel.
SCOPE
1.1 This guide covers the minimum training standards for First Responders (FRs) who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.
1.2 The scope of training will be in accordance with Guide F1287.
1.3 Included in this guide is a standard for knowledge and skill evaluation.
1.4 This guide does not suggest a particular training sequence.
1.5 Operating within the framework of this guide may expose emergency medical service personnel to hazardous materials, procedures and equipment. 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 documents cited in 2.2.
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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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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