ASTM F1220-95(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: F1220 − 95 (Reapproved 2022)
Standard Guide for
Emergency Medical Services System (EMSS)
Telecommunications
This standard is issued under the fixed designation F1220; 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
Operational Considerations 8.3
Goals and Objectives for EMSS Communications 9
1.1 This guide covers telecommunications practices and
Goal 1—State EMSS Communication Should Meet 10
performance standards required to support all of the functions Recognized Standards for Functional Performance
Goal 2—Local EMSS Communications Should Be 11
of community EMSS on a statewide basis. It defines state
Compatible with, and Should Not Interfere with, EMSS
planning goals and objectives for EMSS communications.
Communications in Neighboring Area
Goal 3—Local EMSS Communications Systems 12
1.2 Thisguideisforplanning,coordinating,integrating,and
Should Be Compatible with, and Should Not Interfere
evaluating telecommunications resources statewide to satisfy
with, Other Types of Communications Systems
Goal 4—EMSS Communications Systems Should 13
the functional needs of comprehensive community EMSS
Make Maximum Use of State and Common Resources
systems.
Where Appropriate, Cost Effective, and Authorized
Goal 5—The State Should Act as the Representative 14
1.3 To facilitate a two-tiered planning approach recom-
of Local EMSS in Dealing with Federal Agencies and
mended for EMSS communications, this guide identifies those
National Organizations
Goal 6—The State Should Have a Program for 15
communications system features that should be coordinated on
Positive Management of Its EMSS Communications
a statewide basis and defined in statewide (first tier) EMSS
Activities
communications planning guidelines. Local (second tier)
Emergency Medical Radio Services (EMRS) Radio Appendix X1
Frequencies (MHz)
EMSS communications plans prepared in accordance with the
Acronyms and Glossary for EMSS Communications Appendix X2
statewide guidelines should then be tailored to satisfy local
References
EMSS needs while providing compatibility and interoperabil-
1.5 This standard does not purport to address all of the
ity of communications with other EMSS.
safety concerns, if any, associated with its use. It is the
1.4 The sections in this guide appear in the following
responsibility of the user of this standard to establish appro-
sequence:
priate safety, health, and environmental practices and deter-
Section mine the applicability of regulatory limitations prior to use.
1.6 This international standard was developed in accor-
Scope 1
dance with internationally recognized principles on standard-
Referenced Documents 2
ization established in the Decision on Principles for the
Terminology 3
Summary of Guide 4
Development of International Standards, Guides and Recom-
Significance and Use 5
mendations issued by the World Trade Organization Technical
Functions and Categories of EMSS Communications 6
Telecommunications Functions 6.1 Barriers to Trade (TBT) Committee.
Telecommunications Categories 6.2
EMSS Functional Communications Requirements 7
2. Referenced Documents
General Information 7.1
Citizen Access 7.2
2.1 ASTM Standards:
EMSS Vehicle Dispatch and Coordination 7.3
F1031 Practice for Training the Emergency Medical Tech-
Medical Coordination/Direction 7.4
Interservice Communications 7.5 nician (Basic)
Radio Frequency Spectrum and Service Requirements 8
F1149 Practice for Qualifications, Responsibilities, and Au-
Radio Frequencies 8.1
thority of Individuals and Institutions Providing Medical
EMSS Radio Service Coverage 8.2
Direction of Emergency Medical Services
F1221 Guide for Interagency Information Exchange
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.04 on
Communications. For referenced ASTM standards, visit the ASTM website, www.astm.org, or
Current edition approved Sept. 1, 2022. Published September 2022. Originally contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
approved in 1989. Last previous edition approved in 2014 as F1220 – 95 (2014). Standards volume information, refer to the standard’s Document Summary page on
DOI: 10.1520/F1220-95R22. theASTM website.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1220 − 95 (2022)
F1229 Guide for Qualification and Training of EMS Air 5. Significance and Use
Medical Patient Care Providers
5.1 In situations in which the coordination of EMSS com-
F1254 Practice for Performance of Prehospital Manual De-
municationsamongpoliticalsubdivisionsaffectsthehealthand
fibrillation (Withdrawn 2007)
safety of the state’s population, it is appropriate for state
F1258 Practice for Emergency Medical Dispatch
government to take a coordinating role. Statewide planning for
F1287 Guide for Scope of Performance of First Responders
coordinated use of radio frequencies for EMSS communica-
Who Provide Emergency Medical Care
tions is specifically needed.
F1381 Guide for Planning and Developing 9-1-1 Enhanced
5.2 The state is the logical unit to formulate the statutory
Telephone Systems (Withdrawn 2008)
and regulatory framework for EMSS planning. State planning
F1418 Guide for Training the Emergency Medical Techni-
for area-wide EMSS communications provides authority to
cian (Basic) in Roles and Responsibilities (Withdrawn
accomplish coordination in the use of available radio
2007)
frequencies, thus promoting multiagency cooperation to best
F1453 Guide for Training and Evaluation of First Respond-
serve the public needs.
ers Who Provide Emergency Medical Care
F1517 GuideforScopeofPerformanceofEmergencyMedi-
5.3 With statewide planning, communities, counties, and
cal Services Ambulance Operators
multicounty EMSS regions are provided with guidance to
F1552 Practice for Training Instructor Qualification and
achieve the performance goals and objectives of their EMSS
Certification Eligibility of Emergency Medical Dispatch-
communications systems.
ers
5.4 The statewide EMSS communications performance
F1560 Practice for Emergency Medical Dispatch Manage-
goals and objectives in Sections10–15 address specific roles
ment
of state governments in EMSS communications systems plan-
2.2 Federal Standards:
ning. These performance goals and objectives should be
CommunicationsAct of 1934 (47 U.S.C. 405) (as amended)
considered by states for evaluating, planning, and implement-
Title47 UnitedStatesCodeofFederalRegulations(47CFR)
ing of acceptable EMSS communications statewide.
on Telecommunications
6. Functions and Categories of EMSS Communications
3. Terminology
6.1 Telecommunications Functions—Thereport“Communi-
3.1 Definitions of Terms Specific to This Standard:
cations in Support of Emergency Medical Services,” given in
3.1.1 goal—a statement of broad direction, general purpose,
Ref (1), defines the following EMSS functions that require
or intent. A goal is general and timeless and is not concerned
telecommunications:
with a specific achievement within a given time period.
6.1.1 Medical emergencies requiring EMSS response
3.1.2 objective—astatementofdesiredaccomplishmentthat
should be reported immediately to appropriate community
can be measured within a specified time frame and under
agencies that manage and control EMSS resources and ser-
determinable conditions.The attainment of an objective moves
vices.
the system toward a directly related goal.
6.1.2 Appropriate EMSS resources should respond to hu-
3.1.3 Communications terminology used in this guide and
man health emergencies at any time and place.
references are defined in Appendix X2, Acronyms and Glos-
6.1.3 Recognition of the need for and immediate response
sary for EMSS Communications.
by EMSS resources to life-threatening and serious injuries and
illness should be provided within a time period that will ensure
4. Summary of Guide
the greatest saving of lives and reduction of morbidity.
4.1 This guide identifies the functions and requirements of
6.1.4 EMSS and other health agencies and professionals
EMSS telecommunications. Observance of the state EMSS
should marshal their individual and collective resources (staff,
communications planning goals and objectives contained in
equipment, supplies, and facilities) and coordinate their re-
this guide permits planning and implementation of compatible,
sponses in the shortest effective time to meet individual and
interoperable, and reliable local EMSS communications which
mass medical emergency needs.
meet local needs while not interfering with the needs of
6.1.5 Emergency medical dispatchers should have special
adjoining EMSS.
training to provide guidance and direction to persons at the
scene of a medical emergency pending arrival of trained
4.2 EMSS communications should satisfy all of the perfor-
mance goals and objectives specified by those who use it and prehospital EMSS personnel.
those who are served by it. However, many constraints such as 6.1.6 EMSS must be coordinated with other community
costs, politics, demographic and social preferences, existing public safety emergency response services.
legislation, and time, limit what can be achieved.
6.1.7 The use of EMSS facilities (emergency departments,
intensive care, and coronary care units, burn and trauma
The last approved version of this historical standard is referenced on
www.astm.org.
4 5
AvailablefromU.S.GovernmentPrintingOfficeSuperintendentofDocuments, The boldface numbers in parentheses refer to the references at the end of this
732 N. Capitol St., NW, Mail Stop: SDE, Washington, DC 20401. guide.
F1220 − 95 (2022)
facilities, and so forth) should be coordinated so as to avoid 7.2.1 The EMSS communications system should have the
preventable delays in access to definitive emergency medical ability to receive and process any incoming calls that report
care.
emergencies and request emergency medical assistance. Per-
6.1.8 For life-threatening and serious medical emergencies sons should be able to summon help rapidly in an emergency
and in other instances requiring invasive prehospital emer- situation. They should be able to call for police, fire, rescue,
gency medical care, appropriate physiological data and patient and other emergency aid promptly, without confusion, and
assessment information should be collected and transmitted without familiarity with a particular community. Local,
from the site of the emergency to the EMSS facility providing statewide, and nationwide uniformity is needed to accomplish
on-line medical direction. this objective.
6.1.9 Telecommunications relating to EMSS should be
7.2.2 For several years, numerous governmental
recorded, documented, saved, and used by EMSS managers to
commissions, legislative bodies, private organizations, and
review, evaluate, revise, and reorganize EMSS as necessary to
citizen groups have recommended the establishment of a
meet changing conditions and needs.
single, universal “Nationwide 9-1-1 Emergency Telephone
6.1.10 Telecommunications should exist between EMSS
Number” to meet this need for improved emergency commu-
facilitiesandtransportvehiclesforsafeinterhospitaltransferof
nications. The achievement of this recommendation was stated
patients with life-threatening and serious medical emergencies.
as a matter of national policy in Bulletin No. 73-1 “National
6.1.11 Telecommunications should be used as needed, to
Policy for Emergency Telephone Number ‘911’” issued by the
improve utilization of all EMSS resources and to prevent or
Executive Office of the President on March 21, 1973. The
mitigate adverse effects of medical emergencies.
“nine-one-one” concept provides a single number that is easy
to use and remember. Moreover, implementation of the three-
6.2 Telecommunications Categories—Based on the above
digit emergency telephone number 9-1-1, encourages coordi-
EMSSneeds,thefollowingcategoriesofinformationexchange
natedeffortsbetweenthoseprovidingcommunicationsservices
requiring telecommunications are defined in Ref (1) as being
and emergency responses. The 9-1-1 concept should be in-
necessary to support of EMS operations.
cluded in EMSS communication planning with other methods
6.2.1 EMSS Access—Exchanges of information related to
of citizen access, primarily for its impact on response time and
public access for reporting emergency medical situations to
enhanced coordination among participants. Citizen access
appropriate EMSS response organizations.
communications primarily uses telephones, both public and
6.2.2 EMSS Dispatch and Control—Exchanges of informa-
private, to call 9-1-1 Public Safety Answering Points (PSAP).
tion related to reducing response time, such as alerting,
7.2.3 On the nation’s highways, citizen access to EMSS is
dispatching, and controlling the movement of EMS vehicles.
facilitated by use of mobile communications services that
6.2.3 Medical Coordination/Direction—Exchanges of infor-
enable drivers to rapidly report observed motor vehicle acci-
mation related to the emergency patient and his care, such as
dents and other emergency conditions to public safety service
transmission of physiological information and exchange of
providers. In areas having cellular telephone coverage, motor
patient assessment information and treatment information be-
vehicle occupants with cellular telephones may make direct
tween EMS personnel at the scene and physicians providing
calls to the local 9-1-1 PSAP. This use of cellular telephones
on-line medical direction.
for accessing public safety services is being facilitated through
6.2.4 EMSS Resource Coordination—Exchanges of infor-
rule changes initiated in 1994 by provisions of the Federal
mation necessary for the effective coordination of all EMS
Communications Commission Rules under RM-8143 Docket
resources.
No. 94-102, to ensure compatibility of cellular 9-1-1 calls with
6.2.5 Interservice Coordination—Exchanges of information
enhanced 911 emergency calling systems. Also, Citizen Band
for coordination of EMS activities with police, fire, govern-
(CB) mobile radio operators can report observed emergencies
ment agencies, and other resources, such as public utilities and
to volunteer CB base station radio monitors who in turn relay
private contractors.
the information to appropriate public safety response agencies
6.2.6 Disaster Coordination—Exchanges of information re-
via the 9-1-1 emergency telephone number or some other
lated to the coordination of EMS activities with those of local,
prearranged telephone number. Similarly, mobile equipped
state, and national disaster response authorities.
amateur radio operators can report observed emergencies to
appropriate public safety authorities via the 9-1-1 emergency
7. EMSS Functional Communications Requirements
telephone number using amateur radio/telephone interconnect
7.1 An EMSS communications system should provide the
services. Finally, motorists not equipped with mobile radio
means by which emergency resources can be accessed,
communications can report emergencies by stopping at the
mobilized, managed, and coordinated. To accomplish this, a
nearest roadside site having a public telephone and dialing
communications system must incorporate operational provi-
9-1-1. In some locations, a statewide toll-free 800 telephone
sionstousesufficientwire-lineandradiolinkagesandchannels
access number is available for calling state police. The avail-
among all EMSS participants over the service area of the
ability of such 800 service should be indicated by road signs.
EMSS (and for disaster response, between EMSS service
Such 800 calls may also be made via cellular radio. Calls
areas) to facilitate the EMSS functional needs described in 7.2
received by the state police may be transferred to the appro-
– 7.5 for communications.
priate 9-1-1 answering point or directly to the designated
7.2 Citizen Access: response agency. The use of these numbers should include
F1220 − 95 (2022)
provisions for ensuring caller identification and location and for mobilization, command, and control of all emergency
special screening by trained PSAP communicators. response units during a disaster situation.Although the various
services generally operate on different radio frequencies, in-
7.2.4 In areas in which the 9-1-1 system has not been
implemented, citizens may have to search through telephone terservice radio communications can be provided by use of
mobilerelays,cross-bandoperations,cross-frequencypatching
directories for one of several listed police, fire, ambulance, and
hospital emergency room numbers when a medical emergency at the radio consoles, interservice use of common radio
frequencies, trunked radio services, or other measures. Tele-
arises. Continuation of this practice delays the availability of
emergency medical assistance and, in life-threatening and phone lines between communications control centers for vari-
ous emergency response agencies can also be used for interser-
serious medical emergencies, can cost lives and limbs.There is
no technical reason why a basic or enhanced 9-1-1 emergency vice coordination. Provisions for such interservice radio
communications should be included in the system design.
telephone number cannot be planned and implemented by any
telephone company in the United States. The universal “Na-
8. Radio Frequency Spectrum and Service Requirements
tional 9-1-1 Emergency Telephone Number” should be imple-
mented without further delay as a matter of national public
8.1 Radio Frequencies—Allnonfederaltelecommunications
safety. systems in the United States are subject to the regulations of
7.2.5 Telephone calls for emergency services made by the Federal Communications Commission (FCC). There are
unattended automatic telephone calling devices should be radio frequencies nationally allocated primarily for dispatch of
received and screened by a private answering service and shall ground emergency medical vehicles, transport of patients, and
not be dialed in directly to the primary 9-1-1 or other general other EMS-related communications. Such radio communica-
public access number. tions are allowed under FCC Rules and Regulations (47 CFR,
Part 90) Private Land Mobile Radio Services, Subpart B,
7.3 EMSS Vehicle Dispatch and Coordination—When noti-
Public Safety Radio Services.These current FCC Rules clearly
fied of the need for an emergency medical response, the
distinguish between emergency medical service
communications system is used by trained emergency medical
communications, other types of medical communications, and
dispatchers:
other types of emergency communications. Section 90.27 of
7.3.1 To interrogate emergency callers to determine the
the FCC Rules defines the Emergency Medical Radio Services
nature and severity of the medical emergency,
(EMRS) and allocates radio frequencies exclusively for licens-
7.3.2 Toprovideon-sitecallerswithpre-arrivalinstructions,
ing eligible applicants to use for EMS communications. FCC
7.3.3 To dispatch the most appropriate EMS vehicles to the
Rules and Regulations also permit EMS use of radio frequen-
site of the emergency promptly,
cies allocated to other land mobile services such as the Special
7.3.4 To guide them directly to the site with minimum
Emergency Radio Service; Local Government Radio Service;
delays,
Law Enforcement Radio Service; Fire Radio Service; and
7.3.5 To direct them to an appropriate emergency medical
Business Radio Service.
facility, and
8.1.1 Radio Frequencies for EMSS Communications—
7.3.6 To ensure that they become available for further
Section 90.27 of the FCC Rules identifies users eligible for
assignment as soon as possible.
licensing on frequencies allocated for EMRS.
7.3.7 While EMS vehicles are enroute to a patient, the
8.1.2 Eligibility Criteria—As stated in the FCC Rules, the
communications system is used to keep them informed regard-
following are eligible for licensing to use the radio frequency
ing access to the patient and patient condition.
spectrum allocated by the FCC for the Emergency Medical
Radio Service: “Persons or entities engaged in the provision of
7.4 Medical Coordination/Direction—The EMSS commu-
basic or advanced life support services on an ongoing basis are
nications system should provide EMS field personnel with a
eligible . . . to operate stations for transmission of communi-
channel of communications that permits the exchange of
cations essential for the delivery or rendition of emergency
treatment information with an EMSS hospital, while at the
medical services for the provision of basic or advanced life
scene of the medical emergency, in an EMS ambulance and
support.”EMRSapplicantsarealsoeligibleforlicensingtouse
while enroute to an EMS hospital. Such communications also
frequencies in the Special Emergency Radio Service (SERS),
serve to alert the receiving medical facility before the patient’s
“in order to interface with other entities using SERS channels
arrival and to provide for coordination between medical
and to conduct necessary non-emergency communications.”
facilities. In areas in which the need frequently arises, consid-
eration should be given to equipping EMS ambulances with
8.2 EMSS Radio Service Coverage—This guide addresses
high-power portable radios or vehicular relay equipment and radio frequencies and radio service coverage currently autho-
handheld portables to permit the exchange of patient treatment rized and available under FCC Rules for use for land mobile
information while away from an EMS ambulance. Guidelines
communications for EMSS. In the Emergency Medical Radio
for medical coordination/direction are contained in Practice Service, there are seven high-band VHF frequencies, five
F1149.
220-MHz frequency pairs, and 35 UHF band frequency pairs.
Many of these frequencies are restricted for specific uses, such
7.5 Interservice Communications—Medical emergencies
often involve the response of other public safety and emer-
gency services. Interservice communications are needed to
Summary of FCC Report and Order, PR Docket No. 91-72, Federal Register,
support daily EMSS operations and mutual aid agreements and March 3, 1993.
F1220 − 95 (2022)
as paging, intersystem use, medical coordination, vehicle 8.2.3.1 Specific estimates of radio frequency requirements
coordination, or shared with other Public Safety Radio Ser- to support EMSS communications demands for large popula-
vices. Appendix X1 lists the frequencies and usage limitations. tions are contained in Ref (3). Guidelines for determining the
While there are no 800-MHz band frequencies specifically number of base station radio transmitter/receivers and radio
frequencies needed to ensure reliable EMSS communications
allocated to EMS, all EMRS eligible may license 800-MHz
frequencies allocated for Public Safety Radio Services. In in support of the EMS demands of various populations will be
set forth in a future ASTM standard guide.
addition, there are other land mobile communications services
such as cellular systems, citizen band radio, and prospective 8.2.3.2 In instances of mass casualty response, when the
need exists for an EMSS base station to communicate the same
satellite-relayed land mobile radio communications systems
information to several ambulances, the ambulances involved
that are available for public use. It is not intended that this
should all be directed to adjust their radio equipment for
guide exclude EMSS usage of such communications systems.
operationontheselectedbasestationfrequencyandtorespond
In 1987, The FCC Report on Docket No. 87-112 points out,
in sequence as required. Usage of radio frequencies can
however, that such public communications systems that are
thereby be expanded to satisfy mass casualty and disaster EMS
merely extensions of the public telephone net are not amenable
communications needs.
to planned usage for public safety services. The usage of any
8.2.4 Geographic coverage and control for EMSS radio
available radio spectrum for EMSS communications should be
communications can be provided by various communication
based on the capability of such systems of communications to
subsystem arrangements as illustrated in Figs. 1-4.
provide the necessary linkage to satisfy criteria with respect to
reliability of coverage of the EMSS operating area, grade of
8.3 Operational Considerations:
service (probability of blockage and delay), and accountability
8.3.1 Statewide communications planning, including
that apply to EMSS communications, as well as to other public
interstate, regional, and local planning, is essential to success-
safety communications such as fire and law enforcement
ful EMSS operation. EMSS operational control should be
communications.
carefully established and supported with communications op-
erational procedures.
8.2.1 RadiofrequencieslistedinAppendixX1andcurrently
available for EMSS communications are in the VHF “low 8.3.2 EMSS communications systems should be planned
and operated so as to be compatible and not interfere with the
band” (33 to 48 MHz), the VHF “high band” (150 to 173
MHz), the UHF band (453 to 468 MHz), and in the 800-MHz communications of adjacent EMSS. Compatibility means that
EMS vehicles from one community can communicate with
frequency range. The VHF high band and the UHF frequency
bands, which are most commonly used for EMS EMS vehicles and EMSS facilities in surrounding communi-
ties. Communications compatibility of EMS vehicles is needed
communications, and the 800-MHz frequencies are line of
for day-to-day EMSS activities and EMS response to disaster
sight, with communications range primarily a function of
situations. EMSS communications goals, objectives, and plan-
transmitter power output, antenna gain, antenna height, and
ning guidelines that follow are derived from Refs (4-6).
terrain.Forplanningpurposes,estimatesofthegeographicarea
over which intelligible voice radio reception can be achieved
between a specific radio base station site and a vehicle
equipped with mobile radio can be made using computerized
communications model services such as those described in Ref
(2).
8.2.2 Preinstallation estimates of radio geographic coverage
should be verified by postinstallation field tests using opera-
tionalcommunicationsequipment.Itisimportanttoensurethat
the transmitted signal strength from EMSS communications
base stations is adequate to provide good radio reception in
EMSS ambulances and other response vehicles over the entire
area services by an EMSS.
8.2.3 A single radio base station operating on a specific
radio frequency channel or channel pair permits separate
NOTE 1—FCC Definitions (47 C.F.R. Sec. 90.7):
two-way communications with a single radio-equipped EMSS
mobile station—a station in the mobile service intended to be used
ambulance operating on the same radio frequency channel or
while in motion or during halts at unspecified points. This includes hand
channel pair. If the need exists to communicate separately with
carried transmitters.
multiple EMSS mobile units simultaneously, then base station
base station—a station at a specified site authorized to communicate
sites must be equipped with multiple radio transmitter/
with mobile stations.
mobile service—a service of radiocommunication between mobile and
receivers, each equipped to operate on a separate radio fre-
base stations or between mobile stations.
quency. To communicate by radio in an area provided with
NOTE 2—EMTs in ambulances equipped as “mobile stations” conduct
multiple transmitter/receivers, an EMSS mobile unit must use
two-way radio communications directly with medical control personnel at
a radio transmitter/receiver that can be adjusted to operate on
EMSS resource hospitals equipped as “base stations.”
any base station frequency that may be available at a given
time. FIG. 1 An EMS Base/Mobile Communications System
F1220 − 95 (2022)
NOTE 1—FCC Definitions (47 C.F.R. Sec. 90.7):
mobile repeater station—a mobile station authorized to retransmit
automatically on a mobile service frequency, communications to or from
hand-carried transmitters.
hand-carried transmitters—See definition of mobile station under Fig.
1.
mobile service—See definition under Fig. 1.
NOTE 1—FCC Definition (47 C.F.R. Sec. 90.7):
portable radio—Syn. for hand-carried transmitter.
mobile relay station—a base station in the mobile service authorized to
NOTE 2—An EMT equipped with a “hand-carried” (portable) duplex
retransmit automatically on a mobile service frequency communications
radio, while located outside of an ambulance equipped as a duplex
which originate on the transmitting frequency of the mobile station.
“mobile repeater station” can conduct two-way radio communications via
NOTE 2—Mobile Relay:
the ambulance, with medical control personnel at EMSS resource hospi-
Transmit = F1.
tals equipped as “base stations.”This extends the range of on-line medical
Receive = F2.
control communications for patients outside of, but within portable radio
Base and Mobile:
communications range of, an ambulance.
Transmit = F2.
Receive = F1.
FIG. 2 Extending the Range of Communications for EMTs While
NOTE 3—A “mobile relay” located at a remote location can extend the
Outside of an Ambulance—Typical Both-Way Vehicular Repeater
area and range of coverage for both dispatch and medical control
communications.
9. Goals and Objectives for EMSS Communications
FIG. 3 Extending the Area and Range of Coverage for EMSS
9.1 Determination of state goals and objectives require a
Communications Between Ambulances, Hospitals, and a
Dispatch Center
definition of the specific role of state government in EMSS
communications in its jurisdiction and in boundary areas with
adjacent states. In general, state governments do not own or
9.4 The second level of interface is between a local EMS
operate EMSS communications systems and do not exercise
communications system and other EMSS communications
controloverlocalsystems.Instead,stategovernmentsactmore
systems in neighboring areas. There are two main concerns.
in the role of planners, coordinators, regulators, and facilita-
First, as a minimum, the various communications systems
tors.
should not interfere with each other. This requires consider-
9.2 A state can be thought of as divided into a number of ation of coverage boundaries, fixed allocation of unique
local EMS communications systems. The state’s primary frequencies, and real-time coordination and sharing of com-
concern is with the external interfaces and interactions of these mon frequencies. Second, systems should be able to cooperate
local EMS communications systems with each other and with constructivelywitheachotherinsuchmattersaspoint-to-point
their environments. The state government is not so much communications and communications within an area to mobile
concerned with the other details of the design and operation of units passing through from other regions. Items such as voice
the individual local systems. Following is a description and brevity codes and language must be standardized between
comments on some of the important interfaces and relation- regions.
ships.
9.5 A third level of interface is between a local EMS
9.3 The most important interface is the one between a local communications system and other types of emergency com-
EMS communications system and the population it serves. munications systems, such as law enforcement and emergency
Here, the concern of the state government should be that the management and fire services, within the same area and with
system serves its intended functions. The focus is on the end neighboring areas. The concerns are again the avoidance of
results: the character, quantity, and quality of service provided interference (such as at shared radio sites) and assurance of
to the population, rather than the mechanics of how the service compatibility for multiagency operations. With the creation of
is provided. Items of interest include the degree to which the the Emergency Medical Radio Service, EMS agencies main-
communications system supports the medical requirements for tain their eligibility in the Special Emergency Radio Service
basic life support or advanced life support, communications (SERS). For EMS communications using frequencies in the
parameters such as probability of place and time of coverage, SERS,thereisaconcernforinterferencefromschoolbusradio
communications practices, and operator training standards. communications and from hospital, veterinary, and physician
F1220 − 95 (2022)
and control of the program by means of information feedback,
analysis, evaluation, and corrective action.
9.9 In summary, therefore, the areas of concern for defini-
tion of statewide goals and objectives are as follows:
9.9.1 Functional performance standards,
9.9.2 Interface with other EMS systems,
9.9.3 Interface with other types of systems,
9.9.4 Utilization of state and common resources,
9.9.5 National representation, and
9.9.6 State-level management.
9.10 Each of these areas is addressed as a separate goal in
the remaining sections of this guide. Each goal is followed by
a listing of specific related objectives and a discussion of the
implications of each objective. Note that progress can be made
in many of these areas without substantial costs. In other cases,
the achievement of certain objectives will involve substantial
costs and therefore, given the national and state economies,
those objectives must be considered long term.
NOTE 1—FCC Definitions (47 C.F.R. Sec. 90.7):
land mobile radio system—a regularly interacting group of base,
10. Goal 1—State EMSS Communication Systems Should
mobile, and associated control and fixed relay stations intended to provide
Meet Recognized Standards for Functional
land mobile communications service over a single area of operation.
Performance
land mobile radio service—mobile service between base stations and
land mobile stations, or between land mobile stations.
10.1 State government should work to ensure that recog-
NOTE 2—Real-time centralized coordination/control of base station and
nized standards for functional performance (end result delivery
mobile relay frequencies and operations in an EMSS “land mobile radio”
of service to the public) are met. Specifically, EMS communi-
can be accomplished by use of dedicated telephone lines, microwave
links,orcombinationsofboth.Inthisillustration,theDispatchCenteralso
cations systems should conform at least to minimum perfor-
serves as the EMSS communications control center.
mance standards for public safety communications system
contained in “Report on Police” (7) and “Report on the
FIG. 4 Centralized Control of Radio Communications in an EMSS
Criminal Justice System” (8), which have been broadly ac-
Land Mobile Radio System
cepted by state and local public safety services and APCO as
the basis for public safety communications systems planning
and design. To the extent possible in view of local needs,
resources, and capabilities, the standards should be applied
business communications that are permitted by the FCC. A
uniformly throughout the state so that residents in rural areas
“frequencycoordination”processmustbecarriedoutaspartof
donotnecessarilyreceivelowerlevelsofservicethandourban
the statewide EMS communications system planning process
residents.
to lessen instances of this interference potential.
10.2 Objective—EMSS requirement should be explicitly
9.6 A fourth interface is from the local communications
considered in plans for improvement of citizen-access commu-
system to the state government. The primary concern of the
nications.
state is in ensuring that its population receives timely and
10.2.1 Citizen-access communication systems (such as
appropriate emergency medical care in accordance with state
9-1-1) handle all types of emergencies and are thus inherently
statutes and regulations and health care standards. Additional
broader in scope than EMSS. State EMSS authorities generally
concerns are efficient and effective use by the local systems of
do not have the lead role in the development of citizen-access
resources provided by the state or otherwise shared in common
systems. The statewide development of 9-1-1 in many states,
with multiple users. These might include radio sites, statewide
for example, has been assigned to the state emergency man-
microwave and telephone systems, and various services such
agement or law enforcement authorities. State EMSS authori-
as maintenance and purchasing. Complaints from adjoining
ties should, however, participate in the statewide planning for
states concerning radio communications interference in bound-
expanding the coverage and enhancing existing 9-1-1 systems
ary areas should also be the concern of state government.
to ensure that EMSS requirements are taken into account.
9.7 A fifth interface is from the state to the federal govern-
Guidelines for planning and developing 9-1-1 enhanced tele-
ment. The state acts as a representative of local EMSS in
phone systems are contained in Guide F1381. Additional
dealing with federal agencies and other national organizations.
information regarding Emergency Medical Dispatch (EMD) is
9.8 Finally, the state must be concerned with management contained in Practice F1258, Practice F1552, and Practice
F1560. Following is a summary of the requirements for 9-1-1
of the state-level program. The management functions include
ongoingplanning;stateandupper-levelregionalorganizations; enhanced telephone systems as set forth in Guide F1381:
personnel qualifications, standards, and training; direction of 10.2.1.1 In any given area, there should be only one
the program by laws, rules, funding incentives, other means; telephone number to call for requesting emergency assistance.
F1220 − 95 (2022)
It is a national goal that this number should be “9-1-1.” A nel at central locations such as malls, major intersections,
variety of supplemental and alternative arrangements exist in schools, and so forth. The plan should include provisions for
various areas of the United States, and new alternative provi- public safety announcements and alerts on local radio and
sions for citizen access are being introduced and evaluated in television advising the public of the situation and what should
areas in which 9-1-1 implementation is not operationally or be done to report emergencies.
economically feasible. These alternatives include roadway
10.3 Objective—EMSS resources should be coordinated.
telephone call boxes, cellular radio emergency telephone
10.3.1 EMSS communications in a local area should be
numbers, and area code 800 toll-free emergency numbers.
organized so as to guarantee for each caller that the nearest or
Such alternatives should include a single telephone number
mostappropriateEMSSresponseunit(s)willbeassignedtothe
other than 9-1-1 for all types of emergencies, or barring that, at
call. This objective may be met by the use of “staging or
least a single telephone number or other means of access for
move-up” plans to handle periods of peak EMS demand; by
reporting the existence of all medical emergencies. The single
dynamic positioning of ambulances to enhance area-wide
telephone number or means of access should be published on
response readiness; by use of resource allocation protocols to
the inside cover of telephone directories, displayed in public
ensure that the most appropriate response unit is used; and by
telephone booths, and otherwise prominently displayed to the
the development of an EMSS dispatch center usually in
public. Citizens should not have to look up EMSS ambulance
conjunctionwithacombinedpublicsafetydispatchcenter.The
companies in the telephone directories to request emergency
following requirements apply to an effective EMSS dispatch
medical assistance. They should not have to know their
center:
location in relation to jurisdictional boundaries to determine
10.3.1.1 The EMSS dispatch center should at all times
the proper number to call. Whatever means are provided,
monitor and be aware of the current location, status, and
citizen public telephone access to emergency services should
capability of all EMS response units in the area including
incorporate the following features:
private and public aeromedical units, ground ambulances, fire
10.2.1.2 There should be no financial barrier to requesting
department EMS units, first responders, and so forth.
emergency medical assistance. Coins should not be required
10.3.1.2 The EMSS dispatch center should be authorized
for EMS calls from public phones. (This “dial tone first”
andabletooptimizetheallocationofresourcesbypreassigning
feature is usually provided in 9-1-1 systems.) Long distance
specific units to particular locations in anticipation of need and
EMS calls should be toll-free.
relocating units as conditions change.
10.2.1.3 Sufficient lines should be provided to ensure that
10.3.1.3 The EMSS dispatch center should have written
no more than one call for emergency medical assistance in 100
policies and procedures for the assignment of specific combi-
attempts receives a busy signal during the average busy hour
nations of units to particular types of EMS incidents.
(P.01 grade of service).
10.3.2 Computer-aided dispatching, which includes provi-
10.2.1.4 Sufficientansweringpositionsandoperatorsshould
sions for dispatching EMSS and other public safety services,
be provided to ensure that at least 90 % of the calls for
can facilitate coordination of emergency medical responses.
emergency medical assistance are answered within 10 s during
10.4 Objective—EMSS dispatch should be as direct as
the average busy hour.
possible.
10.2.1.5 Call answerers should be provided with written
10.4.1 In the ideal case, the person who answers the call for
protocols for distinguishing calls for emergency medical assis-
emergency medical assistance is the radio dispatcher who can
tance from other types of emergencies and should have
make direct contact with the units to be assigned to the
adequate training to use the protocols effectively.
incident. More commonly, however, one or more call transfers
10.2.1.6 Call transfer or information relay, if used, should
or information relays are necessary before the emergency
be fast and reliable. Call referral (telling the caller to hang up
information gets out to the response units who can actually act
and call a different number) should never be used for calls for
upon it. In any case, the chain of communications should be as
emergency medical assistance.
short, simple, and direct as possible. The EMS caller should
10.2.1.7 If call transfer is used, the caller should never have
never have to talk to more than two people, for example, the
to talk to more than two people (for example, the 9-1-1 call
9-1-1 call answerer and the EMS dispatcher. Where the EMSS
answerer and the EMSS dispatcher).
dispatchermustcommunicatewithmultipleunitsandlocations
10.2.1.8 Where feasible and appropriate, the development
for a given incident, the communications to all should occur
of alternative and backup systems for citizen access to emer-
simultaneously (or as nearly so as possible) using common or
gency medical care should be encouraged. Such systems might
similar means of communications. There should also be some
include the use of citizen band radio and monitoring networks,
arrangement for positive feedback or an acknowledgment from
cellular telephone, and radio call boxes. Also, police stations,
each unit that the dispatch message has been received and
firestations,andgovernmentbuildingsequippedwithtwo-way
understood.
publicsafetyradioserviceshouldbepostedandmadeavailable
10.4.2 EMSS dispatch should be prompt. The delay be-
for walk-in access to emergency medical care.
tween the time of first notification of a medical emergency and
10.2.1.9 There should be a plan of action to maintain public the receipt of the dispatch message by the responding EMSS
access to emergency medical care when the primary telephone unit (ambulance or first responder) should nev
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