ASTM F1560-00(2022)

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: F1560 − 00 (Reapproved 2022)
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 1.2.1 The entry level selection criteria for hiring emergency
medical dispatchers;
1.1 This practice covers the function of the emergency
1.2.2 The orientation of new emergency medical dispatch-
medical dispatcher (EMD). This function is the prompt and
ers;
accurate processing of calls for emergency medical assistance.
1.2.3 Development of QA/QI mechanisms, management
The training and practice through the use of a written or
strategies, and organizational structures for use within a
automatedmedicaldispatchprotocolisnotsufficientinitselfto
comprehensive emergency medical dispatch system;
ensure continued medically correct functioning of the EMD.
1.2.4 Performance evaluation as a component of a compre-
Their dispatch-specific medical training and focal role in EMS
hensive and ongoing quality assurance and risk management
has developed to such a complexity that only through a
program for an emergency medical dispatch system;
correctly structured and appropriately managed quality assur-
1.2.5 Development and provision of continuing dispatch
ance environment can the benefits of their practice be fully
education activities for the emergency medical dispatcher;
realized.Thephilosophiesofemergencymedicaldispatchhave
1.2.6 Requirements for initial certification and recertifica-
established new duties to which the emergency medical dis-
tion of the emergency medical dispatcher;
patch agency must respond. It is important that their quality
1.2.7 Provision for comparative analysis between different
assurance/quality improvement (QA/QI) activities, including
EMD program approaches available to the EMS community
initial hiring, orientation, training and certification, continuing
that conform to established EMD practice standards prior to
dispatch education, recertification, and performance evaluation
implementation of an emergency medical dispatch program;
be given appropriate managerial attention to help ensure the
and
ongoing safety in the performance of the EMD. This practice
1.2.8 Guidelines for implementation of an emergency medi-
establishes functional guidelines for these managerial,
cal dispatch program.
administrative, and supervisory functions.
1.3 This standard does not purport to address all of the
1.2 The scope of this practice includes:
safety concerns, if any, associated with its use. It is the
responsibility of the user of this standard to establish appro-
priate safety, health, and environmental practices and deter-
This practice is under the jurisdiction ofASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.04 on
mine the applicability of regulatory limitations prior to use.
Communications.
1.4 This international standard was developed in accor-
Current edition approved Sept. 1, 2022. Published September 2022. Originally
dance with internationally recognized principles on standard-
approved in 1994. Last previous edition approved in 2014 as F1560 – 00 (2014).
DOI: 10.1520/F1560-00R22. ization established in the Decision on Principles for the
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1560 − 00 (2022)
Development of International Standards, Guides and Recom- structural, resource, and protocol deficiencies that may exist in
mendations issued by the World Trade Organization Technical the emergency medical dispatch system.
Barriers to Trade (TBT) Committee.
4. Summary of Practice
2. Referenced Documents
4.1 A comprehensive plan for managing the quality of care
2.1 ASTM Standards:
in an emergency medical dispatch system must include careful
F1258 Practice for Emergency Medical Dispatch
planning; EMD program selection; proper system implemen-
F1552 Practice for Training Instructor Qualification and
tation; employee selection, training, and certification; QA/QI;
Certification Eligibility of Emergency Medical Dispatch-
performance evaluation; continuing dispatch education; recer-
ers
tification; and risk management activities. These functions
must be designed and implemented to assist the medical
3. Terminology
director, dispatch supervisor, and emergency medical dis-
patcher in monitoring and modifying EMD performance found
3.1 Definitions of Terms Specific to This Standard:
deficient by QA/QI to protect the public against incompetent
3.1.1 case review template, n—a structured performance
practitioners, as well as modify organizational structure,
evaluation document containing all necessary input and output
resource, or protocol deficiencies that exist in the emergency
actions required of dispatchers that parallels the EMDs’on-line
medical dispatch system.
protocols, policies, and procedures related to call-taking and
4.1.1 Entry Level Selection—The selection and evaluation
processing. It contains check-off lists and compliance scoring
of new dispatchers must include clearly written objective
mechanisms that objectively rate the EMDs’ performance on a
standards to be adopted for qualifying candidates, interviewing
single call.
applicants, and pre-employment aptitude and skill testing
3.1.2 dispatch life support, n—the knowledge, procedures,
pursuant to the hiring of dispatchers.
and skills used by trained EMDs in providing care through
4.1.2 Orientation—A pre-planned process of events focus-
pre-arrival instructions to callers. It consists of those BLS and
ing on the development and acclimation of an employee who
ALS principles that are appropriate to application by medical
will function within the organization’s standards, practices,
dispatchers.
policies, and procedures.
3.1.3 emergency medical dispatch agency, n—any organiza-
4.1.3 Quality Assurance/Quality Improvement—Within a
tion or a combination of organizations working cooperatively,
physician medically directed emergency medical dispatch
that routinely accepts calls for emergency medical assistance
system, the development and implementation of employee
and facilitates the dispatch of prehospital emergency medical
performance thresholds, concurrent evaluation of compliance
resources/personnel and provides medically oriented pre-
to these thresholds through on-line supervision, retrospective
arrival instructions pursuant to such requests.
evaluation of non-edited logged recordings of requests for
3.1.4 performance evaluation, n—the documented,
emergencyservicemeasuringcompliancewithpolicy,practice,
objective, quantitative measure of an individual emergency
andproceduretovalidatethatthepracticesareappropriate,and
medical dispatcher’s performance based upon compliance with
to correct the employee and practice if they are found to be
departmental protocols, policies, and procedures.
deficient.
3.1.5 pre-arrival instructions, n—telephone-rendered,medi- 4.1.4 Performance Evaluation—Each EMD in an emer-
cally approved written instructions provided by trained EMDs gency medical dispatch agency must regularly and routinely be
through callers which help to provide aid to the victim and evaluated with respect to his or her adherence to policy,
control of the situation prior to arrival of prehospital personnel. protocol, and procedure through the QA/QI process. This
determines conformance to these elements and measures how
3.1.6 quality assurance/quality improvement (QA/QI),
this performance affects the efficiency and effectiveness of the
n—the comprehensive program of prospectively setting stan-
emergency medical dispatch agency. The evaluation must be
dards; concurrently monitoring the performance of clinical,
quantitative and qualitative.
operational, and personnel components; and retrospectively
4.1.5 Continuing Education—Each emergency medical dis-
improving these components in the emergency medical dis-
patch agency must provide for the development and implemen-
patch agency when compared with these standards.
tation of a continuing dispatch education program for the
3.1.7 risk management, n—a sub-component of the quality
benefit of that agency’s EMD personnel. This program must
assurance/quality improvement program designed to: identify
provide the EMD with applicable educational topics designed
problematic situations and assist EMS medical directors, dis-
to enhance their general knowledge and skill in the philosophy
patch supervisors, and EMDs in modifying practice behaviors
and application of the EMD program used within the emer-
found to be deficient by quality assurance procedures; protect
gency medical dispatch agency.
the public against incompetent practitioners; and modify
4.1.6 Risk Management—A written practice and procedure
shall be established for each agency that provides guidelines
for physician medical directors, EMS system administrators,
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
agencysupervisors,and/orQA/QIpersonneltofollowwhenan
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
EMD is identified as failing to meet or follow established
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. protocols. These may be acts of omission or commission
F1560 − 00 (2022)
identified through concurrent or retrospective review. This medically sound protocols. The majority perform their duties
practice and procedure shall provide guidelines for proper without appropriate medical management provided through a
investigative criteria relative to the medical or administrative
structured quality assurance/improvement environment. Train-
nature of the perceived infraction, and the proper progressive ing only prepares a new EMD for correct use of the EMDPRS.
disciplinary procedure to be followed in order to provide the
It cannot ensure that the EMDPRS is used as intended. Since
EMD due process.
the EMD is clearly defined as a prehospital medical
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-
shall be established between certifying agencies and organiza-
gency medical dispatchers.
tions having programs that meet the standards contained in this
practice.
6. EMD Entry Level Selection Criteria
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
of ten years from initial certification, recertification, or testing level;
of the individual.
6.1.2 Perform those clerical skills as delineated by the
4.1.10 Revocation of Certification—This practice shall set
employing agency;
forthguidelinesforassessinggroundsforapossiblesuspension
6.1.3 Perform verbal skills in a clear and understandable
or termination of certification when questionable situations
manner, in the required language or languages established as
arise in EMD conduct or performance.
necessary to that emergency medical dispatch agency;
4.1.11 Program Selection and Implementation—This is in-
6.1.4 Perform alphanumeric transcription skills necessary to
tended to assist the EMS administrator in the selection of the
correctly record addresses, locations, and telephone numbers;
program that best suits the dispatch agency’s needs from a
and
medical, legal, and operational perspective and provide for
6.1.5 Demonstratecompetencyinbasictelecommunications
comparative analysis between different EMD program ap-
skills as required by the employing or training agency.
proaches available to the EMS community that conform to
established EMD practice standards.
6.2 Selection criteria should also include the following:
4.1.12 Physician Medical Director—Each emergency medi-
6.2.1 A clear attribute of helpfulness and compassion to-
cal dispatch agency shall have a physician medical director,
ward the sick or injured patient and the caller advocate;
who shall assist in evaluation and review of the EMD program
6.2.2 The ability to clearly guide callers in crisis through
under consideration. The physician medical director shall
application of necessary interrogation procedures and the
approve the selected EMD program written protocol. The
provision of telephone pre-arrival instructions;
physician shall be responsible for all medical aspects of the
6.2.3 The ability to learn and master the skills, philosophy,
EMD program. Additional responsibilities include the medical
and knowledge required to successfully complete the training
oversight of the EMD training and certification program,
process;
continuing education requirements, recertification eligibility,
6.2.4 The ability to efficiently and effectively organize
QA/QI and risk management functions. These responsibilities
multiple tasks and complicated situations and activities;
include recommendations regarding the certification and em-
ployment eligibility of individuals found to be unsafe practi- 6.2.5 The ability to handle the levels of emotional stress
tioners through employee evaluation and disciplinary due present in caller/patient crisis intervention, death and dying
process.
situations, call prioritization and triage, and multiple tasking;
6.2.6 The ability to function within the team framework of
5. Significance and Use
public safety and EMS systems; and
6.2.7 The ability to elicit and assimilate caller information
5.1 The emergency medical dispatcher should be a specially
trained telecommunicator with specific emergency medical and then to prioritize and appropriately consolidate and sum-
marize this information in a format used to inform and direct
knowledge. Many of these personnel still perform in this role
without the benefits of dispatch specific medical training and public safety responders.
F1560 − 00 (2022)
7. Orientation Guidelines for Emergency Medical 8.3.5.2 Compliance to providing the systematized pre-
Dispatchers arrival instructions (when possible and appropriate to do so);
the record should show separate compliance for each type of
7.1 When an individual has successfully completed the
pre-arrival instructions found within the EMDPRS.
initialEMDtrainingandisemployedbyanemergencymedical
8.3.5.3 Compliance to correctly selecting the dispatch re-
dispatch agency, a comprehensive orientation program must be
sponse classification code.
in place to initiate this individual to the intense and demanding
8.3.6 Records should be kept showing cumulative compli-
conditions that exist in dispatch centers. It must include:
ance scores in the listed areas for the following groups:
7.1.1 An orientation manual for the new EMD;
8.3.6.1 Individual compliance averages,
7.1.2 Aformal orientation for the new EMD in the commu-
8.3.6.2 Shift compliance averages, and
nications and dispatch operation as well as the employing
8.3.6.3 Emergency medical dispatch agency compliance
agencyasawholeincludingallrelevantpolicies,practices,and
averages.
procedures.
8.3.7 Group compliance averages should be periodically
7.1.3 Orientation with a one-on-one preceptor concurrent
purged of older records allowing the EMD to reasonably
with the employee’s probationary period;
improve scores over time. All records should be maintained
7.1.4 Written evaluation of compliance through the agen-
and archived.
cy’s quality assessment practice as defined in this practice; and
8.3.8 The process of individual case review and the findings
7.1.5 Written evaluation of performance during orientation
and recommendations should be managed by a specially
and frequent feedback and critique from those individuals
trained diversified group of EMS and dispatch agency person-
responsible for training and evaluation of the new emergency
nel. Participants in the management of the case review process
medical dispatcher.
should represent a cross section of those individuals within the
system affected by the emergency medical dispatch program.
8. Performance Evaluation
These should include, but not be limited to: line dispatchers,
8.1 The EMD must function using a medically approved
managers, administrators, medical control physicians or their
EMDPRS to establish the template for performance and
representatives, or both, field personnel, and ancillary public
protocol compliance evaluation. The ongoing performance
safety groups such as 9-1-1, primary, and secondary public
appraisal must evaluate the EMD’s ability to follow and
safety answering points (PSAPs) that operate within the
comply with the established agency policies and procedures.
structure of an organized medical dispatch case review com-
mittee.
8.2 Established performance criteria should be shared with
new employees and measured on a regular basis. These should
8.3.9 The specific policies and procedures to be utilized for
include evaluation of performance in: performance appraisal activity must be carefully explained to
8.2.1 Conformance to established policies of the employing the EMDs whose performance will be measured and must be
objectively and impartially administered.
agency, and
8.2.2 Compliance with the EMDPRS of the employing 8.3.10 Regular feedback must be provided to the EMDs
based on the findings of their performance appraisal.
agency.
8.3.11 The goal of the case review process is to enhance the
8.3 Performance appraisal of the EMD through case review
performance of the EMD. This feedback should include both
should be accomplished by the f
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