ASTM F1258-95(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: F1258 − 95 (Reapproved 2022)
Standard Practice for
Emergency Medical Dispatch
This standard is issued under the fixed designation F1258; 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 3. Terminology
1.1 This practice covers the definition of responsibilities, 3.1 Definitions of Terms Specific to This Standard:
knowledge, practices, and organizational support required to
3.1.1 emergency medical dispatcher (EMD)—a trained pub-
implement, perform, and effectively manage the emergency
lic safety telecommunicator with additional training and spe-
medical dispatch function.
cific emergency medical knowledge essential for the efficient
management of emergency medical communications.
1.2 This practice is useful for planning and evaluating the
training, implementation, and organizational support to satisfy 3.1.2 emergency medical dispatching—the reception and
the functional needs of emergency medical dispatching.
management of requests for emergency medical assistance.
1.3 This standard does not purport to address all of the
3.1.3 emergency medical dispatch priority reference system
safety concerns, if any, associated with its use. It is the
(EMDPRS)—a medically approved system used by a dispatch
responsibility of the user of this standard to establish appro-
agency to provide aid to medical emergencies that includes:
priate safety, health, and environmental practices and deter-
systematized caller interrogation questions, systematized pre-
mine the applicability of regulatory limitations prior to use.
arrival instructions, and protocols matching the dispatcher’s
1.4 This international standard was developed in accor-
evaluation of injury or illness severity with vehicle response
dance with internationally recognized principles on standard-
mode and configuration.
ization established in the Decision on Principles for the
3.1.4 medical direction—the management and accountabil-
Development of International Standards, Guides and Recom-
ity for the medical care aspects of an emergency medical
mendations issued by the World Trade Organization Technical
dispatch (EMD) program including: the medical monitoring
Barriers to Trade (TBT) Committee.
oversight of the training of the EMD personnel; approval and
medical control of the operational emergency medical dispatch
2. Referenced Documents
priority reference system (EMDPRS); evaluation of the medi-
2.1 ASTM Standards:
cal care and prearrival instructions rendered by the EMD
F1031 Practice for Training the Emergency Medical Tech- personnel; direct participation in the EMD system evaluation,
nician (Basic)
quality assurance, and quality improvement process and
F1381 Guide for Planning and Developing 9-1-1 Enhanced mechanisms; and responsibility for the medical decisions and
Telephone Systems (Withdrawn 2008) care rendered by the emergency medical dispatcher and emer-
F1552 Practice for Training Instructor Qualification and gency medical dispatch program.
Certification Eligibility of Emergency Medical Dispatch-
3.1.5 public safety telecommunicator—an individual trained
ers
to communicate remotely with persons seeking emergency
F1560 Practice for Emergency Medical Dispatch Manage-
assistance and with agencies and individuals providing such
ment
assistance.
3.1.6 telephone aid—consists of “ad-libbed” telephone in-
structions provided by either trained or untrained dispatchers
This practice is under the jurisdiction ofASTM Committee F30 on Emergency
and differs from DLS-based prearrival instructions in that the
Medical Services and is the direct responsibility of Subcommittee F30.04 on
instructions provided to the caller are based on the dispatcher’s
Communications.
Current edition approved Sept. 1, 2022. Published September 2022. Originally knowledge or previous training in a procedure or treatment
approved in 1990. Last previous edition approved in 2014 as F1258 – 95 (2014).
without following a scripted prearrival instruction protocol.
DOI: 10.1520/F1258-95R22.
They cannot be medically preapproved since they do not exist
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
in written form.
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
3.1.7 telephone treatment sequence protocols—specific
the ASTM website.
treatment strategies designed in a conversational script format
The last approved version of this historical standard is referenced on
www.astm.org. that direct the EMD step by step in giving critical prearrival
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1258 − 95 (2022)
instructions such as CPR, Heimlich maneuver, mouth-to- understanding of the medical condition, thorough
mouth breathing, and childbirth instruction. interrogation,callerintervention,saferesponses,andprearrival
instructions.
3.1.8 vehicleresponseconfiguration—thespecificvehicle(s)
of varied types, capabilities, and numbers responding to render
4.4 This practice establishes the EMD’s role and responsi-
assistance.
bilities in receiving, managing, and dispatching calls for
medical assistance and related agency coordination.
3.1.9 vehicle response mode—the use of emergency driving
techniques, such as warning lights and siren, versus a routine
4.5 An organizational structure as defined in Practice F1560
driving response.
must be in place before implementing the EMD program;
therefore, this practice establishes some general recommenda-
4. Summary of Practice
tions concerning the development of a supportive structure and
program content.
4.1 An emergency medical dispatcher is a trained public
safety telecommunicator with additional training and specific
4.6 Use of this practice is not intended to protect the EMD
emergency medical knowledge essential for assessment of
or dispatch organization from liability for negligent actions or
medical emergencies and limited remote treatment and appor-
failure to perform in accordance with established and approved
tionment of medical priorities. The EMD functions under the
medical practices and protocols.
medical authority of an off-line medical director to receive and
4.7 The EMD must be certified through either state govern-
manage calls for emergency medical assistance through the
ment processes or by professional medical dispatch standard-
systematic interrogation of callers, using procedures estab-
setting organizations.
lished by the off-line medical director who remains responsible
4.7.1 When certification is achieved by recognition of a
for the medical quality assurance of the EMD program.
professional medical dispatch standard-setting organization, it
4.1.1 The EMD’s role includes the ability to:
shall clearly demonstrate compliance with all criteria enumer-
4.1.1.1 Remotely evaluate the patient or incident,
ated in this practice and within Practice F1560 and Practice
4.1.1.2 Interpret the requirement and need for emergency
F1552.
medical resources,
4.1.1.3 Allocate the appropriate resources,
5. Significance and Use
4.1.1.4 Identify conditions requiring prearrival instructions
and provide them to the caller when necessary, possible, and
5.1 This practice is intended to promote the use of trained
appropriate,
telecommunicators in the role of emergency medical dis-
4.1.1.5 Coordinate the response of emergency medical and
patcher. It defines the basic skills and medical knowledge to
other public safety resources,
permit understanding and resolution of the problems that
4.1.1.6 Provide information to the responding units regard-
constitutetheirdailyroutine.Tousetrainedtelecommunicators
ing the emergency scene and patient, and
fully as functioning members of the emergency medical team,
4.1.1.7 Record and retrieve emergency medical response
it is deemed necessary to upgrade the telecommunicators’
records.
training by the addition of the concept of emergency medical
4.1.2 There must be continuity in the delivery of EMD care.
dispatch priorities.
To provide correct medical care safely and effectively, the
5.2 All agencies or individuals who routinely accept calls
EMD that is medically directing, evaluating, and coding must
for emergency medical assistance from the public and dispatch
maintain direct access to the calling party and must use a
emergency medical personnel shall have in effect an emer-
medically approved emergency medical dispatch priority ref-
gency medical dispatcher program in accordance with this
erencesystem.Thepersongivingthemedicalinstructiontothe
practice. The program shall include medical direction and
caller must be the same person that asks the systematic
oversight and an emergency medical dispatch priority refer-
interrogation questions.
ence system.
4.1.3 To accomplish the above safely and effectively, the
5.3 The successful use of the EMD concept depends on the
EMD must use a medically approved EMDPRS that includes:
medical community’s awareness of the “prearrival” state of
4.1.3.1 Systematized caller interrogation questions,
EMS affairs and their willingness to provide medical direction
4.1.3.2 Systematized prearrival instructions, and
in dispatch.
4.1.3.3 Protocols that determine vehicle response mode and
configuration based on the EMD’s evaluation of injury or
5.4 This practice may assist in overcoming some of the
illness severity.
misconceptions regarding emergency medical dispatching.
These include the uncontrollable nature of the caller’s hysteria,
4.2 This practice is intended to be used by agencies as a
lack of time of the dispatcher, potential danger and liability to
baseline for establishing a certifying emergency medical dis-
patch training program that includes the implementation of the the EMD, lack of recognition of the benefits of dispatch
prearrival instructions, and misconceptions that red lights,
emergency medical dispatch priority reference system, under
medical direction, and provides a means of evaluating the siren, and maximal response are always necessary.
EMD program.
5.5 TheEMDisthememberoftheEMSresponseteamwith
4.3 This practice will provide a common set of expectations the broadest view of the entire emergency system’s current
for training, performance, and preplanned response based on status and capabilities. The EMD has immediate lifesaving
F1258 − 95 (2022)
capability in converting the caller into an effective first tion.These protocols must reflect a given EMS system’s varied
responder. This practice recognizes the EMD’s role as includ- ability to respond, ranging from single-unit squads through
ing: multiple-level (tiered) response.
5.5.1 Interrogation techniques, 6.1.2.2 An established, medically approved, quantitative
5.5.2 Triage decisions, coding system for quality assurance/improvement and statisti-
cal analysis.
5.5.3 Information transmission,
5.5.4 Telephone medical intervention, and 6.1.3 Asetofsystematicprearrivalinstructionsthatinclude:
5.5.5 Logistics and resource coordination during the event. 6.1.3.1 ChiefcomplaintspecificcallerandEMDadvise,and
6.1.3.2 Scripted prearrival instructions.
5.6 For the EMD, this practice supersedes any other EMSS
6.1.4 In addition to the EMDPRS, an emergency medical
standards under which an individual may be qualified, such as
dispatch system should include:
Practice F1031. It is not the role of the EMD to generate a
6.1.4.1 A mass casualty plan for notification and operation
specific diagnosis but rather to elicit accurately a finite body of
in a disaster situation,
information, assign the appropriate response, and to commu-
6.1.4.2 A directory of emergency response resources and
nicate clearly among persons and units involved in the re-
information resources,
sponse. The protocols for inquiry, response, and resource
6.1.4.3 Awritten description of the communications system
coordination are essential and must not be modified based on
configuration for the service area, and
an individual’s possible experiences as a responder.
6.1.4.4 A record-keeping system, including report forms or
5.7 As an initial contact with the EMS system, the EMD is
a computer data management system to permit evaluation of
subject to questioning of actions as they relate to medical
EMD compliance with the EMDPRS, evaluation of protocol
practice.Thispracticemaybeusedbyagenciesasarecognized
effectiveness, and timeliness of interrogation and dispatch.
baseline for EMD training, practice, and organization and is
intendedtosupplant de factostandardsthatexistinsomeareas.
7. Functions of Emergency Medical Dispatch
This practice will assist in developing sound EMD programs
that will reduce the need and potential for legal action and 7.1 Receive and Process Calls for Assistance—The EMD
provide a common set of expectations for performance. mustreceiveandrecordcallsforemergencymedicalassistance
from various sources. This function includes the establishment
5.8 It will bring more accurate information into the dispatch
of effective communication with the person requesting
office by way of appropriate understanding of the medical
assistance, using the EMDPRS to evaluate the patient or
conditionandthereforebetterinterrogation,callerintervention,
situation,provideappropriateprearrivalinstructions,andselect
and decision-making. It allows for preplanned responses, safer
the most appropriate EMS system action in response to each
responses (fewer units responding with lights and siren), fuel
call.
and energy savings (smaller units and fewer units used when
possible), and may save advanced life-support resources for 7.2 Dispatch and Coordinate Appropriate, Available Re-
true advanced life-support emergencies when a tiered-level
sponse Resources—The EMD must select and dispatch the
response is available. necessary EMS vehicles and personnel to the scene of an
emergency in an appropriate time frame. The EMD functions
6. System Components incoordinatingthemovementsofEMSvehiclesenroutetothe
scene, en route to the medical facility, and back to the base of
6.1 Emergency Medical Dispatch Priority Reference System
operations. This requires that the EMD have current knowl-
(EMDPRS):
edge of the status of all EMS resources in the dispatch area and
6.1.1 This system is a written, reproducible document in a
the geographic constraints that will affect the EMS response.
uniform format based on medical and administrative protocols.
ThisalsorequiresthattheEMDhavedispatch-specificmedical
The emergency medical dispatch priority reference system
training and understands the use of systematized interrogation
directs the EMD to complete a full, programmed interrogation.
and response assignment protocols.
The information from the caller is paired with preset problem
groups to determine the appropriate response level. It shall 7.3 Provide Information and Prearrival Instructions:
include the following:
7.3.1 To the caller, the EMD is the contact with the
6.1.1.1 A set of systematized caller interrogation (key) emergency response agency and must be prepared to provide
questions.Thekeyquestionsmustobtaintheminimumamount emergency care instructions to callers waiting for an EMS
of information necessary to: response.These instructions should enable the caller to prevent
(1) Adequately establish the correct level of response, or reduce further injury to the victim and to do as much as
(2) Establish the need for prearrival instructions, and possible under the circumstances to intervene in any life-
(3) Provide responders with adequate patient and incident
threatening situation that exists. These instructions should also
information. include appropriate warnings and safety messages regarding
6.1.2 A set of systematized coding and response protocols potential dangers that can be reasonably foreseen through
that include: correct use of the EMDPRS.
6.1.2.1 Protocols that predetermine vehicle response mode 7.3.2 All dispatch life-support-based instructions and infor-
andconfigurationbasedontheEMD’sevaluationofinjuryand mation should be given directly from the EMDPRS rather than
illness severity as determined through key question interroga- ad lib. Federal Publication NIH No. 94-3287 on Emergency
F1258 − 95 (2022)
Medical Dispatching categorizes ad-lib instructions as “tele- 8. Medical Dispatch Practice
phone aid” which, further defined, “may only ensure that the
8.1 The role of the EMD is to obtain specific medical
dispatcher has attempted to provide some sort of care to the
information to prioritize accurately each medical response as
patient through the caller but does not ensure that such care is
listed in the emergency medical dispatch priority reference
correct, standard, and medically effective or even necessary in
system (EMDPRS). Using this system, the EMD asks key
the first place. Telephone aid, therefore, is usually considered
questions about patient condition and incident types, deter-
as inappropriate and an unreliable form of dispatcher-provided
mines the necessity for and gives prearrival instructions, and
medical care.”
selects predetermined response levels based on the medical
7.3.3 To the responding unit(s), the EMD must provide
significance of the information obtained. To accomplish this,
accurate information regarding the patient, conditions at the
the EMD must:
scene of response, other public safety unit responses, and other
8.1.1 Understand the basic philosophy of medical interro-
information regarding the situation. This information always
gation. Medical dispatch experts have shown that through the
includes the chief complaint, patient’s age, status of
use of proper techniques and interrogation protocols signifi-
consciousness, and status of breathing.
cantly more vital information can be obtained. While it may
seemtheemotional,andattimes,hystericalcaller’sbehavioris
7.4 Coordinate with Other Agencies and Emergency
random and unpredictable, there are some very predictable,
Services—The EMD must ensure the existence and mainte-
generic components present in most cases. Some of these are
nance of an effective communication link between and among
noted in Appendix X1.
all public safety services (that is, fire, police, rescue,
8.1.2 Understand the difference between key questions
aeromedical, hazardous materials, utility, and so forth) in-
asked in medical as opposed to trauma cases:
volved in the EMS response to facilitate mutual aid and to
coordinate services including such items as traffic control, fire 8.1.2.1 Medical case questions are generally based on
symptoms such as chest pain, breathing, level of
suppression, and extrication.
consciousness, and so forth. The caller usually is with the
7.5 Necessary Skills of the Emergency Medical Dispatcher:
victim or is personally familiar with the patient or their
7.5.1 Ability to read and write English proficiently and
problem.
other language or communications skills necessary to function
8.1.2.2 Trauma case questions are generally based on the
in given area,
type of incident rather than specific symptoms, since the caller
7.5.2 Ability to speak clearly and distinctly on r
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