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ASTM F1517-94(2007)

(Guide)

Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations

Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations

SIGNIFICANCE AND USE
This guide provides minimum guidelines for safe and efficient ambulance operation.
All ambulance operations and operators should follow this guide for the development of educational and training programs.
This guide is intended to promote safe and efficient ambulance operations and to reduce morbidity, mortality, and property loss associated with ambulance operations.
This guide is intended to assist those who are responsible for the development and implementation of policies and procedures for ambulance operations.
SCOPE
1.1 This guide covers minimum standards for the performance of emergency medical services (EMS) ambulance operators, including: operator qualifications, pre-run operation, and post-run aspects.
1.2 This guide shall promote the safe and efficient delivery of the ambulance, equipment, crew, passengers and patients, during all phases of the delivery of EMS involving the ambulance; at all times exercising the highest degree of care for the safety of the public. This guide may be applied to other EMS vehicles that do not necessarily provide patient transport.
1.3 This guide shall be used as the basis for training guides of the emergency medical services ambulance operator.
1.4 The values stated in SI units are to be regarded as the standard. The SI units given in parentheses are for information only.
This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

General Information

Status
Historical
Publication Date
31-Jan-2007
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.02 - Personnel, Training and Education
Current Stage
Ref Project

Relations

Replaces
ASTM F1517-94(2002) - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
Effective Date
01-Feb-2007
Referred By
ASTM F1705-96(2020) - Standard Guide for Training Emergency Medical Services Ambulance Operations
Effective Date
01-Feb-2007
Referred By
ASTM F1220-95(2022) - Standard Guide for Emergency Medical Services System (EMSS) Telecommunications
Effective Date
01-Feb-2007

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ASTM F1517-94(2007) - Standard Guide for Scope of Performance of Emergency Medical Services Ambulance Operations
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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: F1517 − 94(Reapproved 2007)
Standard Guide for
Scope of Performance of Emergency Medical Services
Ambulance Operations
This standard is issued under the fixed designation F1517; 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 3.1.2 ambulance—See Terminology F1177.
1.1 This guide covers minimum standards for the perfor- 3.2 Definitions of Terms Specific to This Standard:
mance of emergency medical services (EMS) ambulance 3.2.1 ambulance operations—the efficient delivery of the
operators, including: operator qualifications, pre-run operation,
ambulance, equipment, crew, passengers and patients, during
and post-run aspects. all phases of the delivery of EMS involving the ambulance at
all times exercising the highest degree of care for the safety of
1.2 This guide shall promote the safe and efficient delivery
the public.
of the ambulance, equipment, crew, passengers and patients,
during all phases of the delivery of EMS involving the 3.2.2 ambulance service provider—as outlined in this guide,
ambulance; at all times exercising the highest degree of care a person, company, corporation or political entity responsible
for the safety of the public. This guide may be applied to other for operation, maintenance, or policy making, or combination
EMS vehicles that do not necessarily provide patient transport. thereof, regarding emergency medical vehicle operations.
1.3 This guide shall be used as the basis for training guides 3.2.3 bona fide occupational qualification (BFOQ)—the
skills and knowledge relevant to the performance of a specific
of the emergency medical services ambulance operator.
task.
1.4 The values stated in SI units are to be regarded as the
3.2.4 departure check—the visual check of the vehicle and
standard. The SI units given in parentheses are for information
surrounding area ensuring that equipment and supplies have
only.
been retrieved and properly stored and that all compartment
1.5 This standard does not purport to address all of the
doors are secured.
safety concerns, if any, associated with its use. It is the
3.2.5 egress check—the visual check of the vehicle and
responsibility of the user of this standard to establish appro-
priate safety and health practices and determine the applica- surrounding area prior to operating the ambulance.
bility of regulatory limitations prior to use.
3.2.6 emergency mode—as defined by individual state stat-
ues that refer to emergency vehicles, equipment, and opera-
2. Referenced Documents
tions.
2.1 ASTM Standards:
3.2.7 full check—a comprehensive and systematic evalua-
F1177 Terminology Relating to Emergency Medical Ser-
tion of the ambulance at specified intervals, including docu-
vices
mentation of the inspection, any deficiencies found and their
F1258 Practice for Emergency Medical Dispatch
corrective actions.
3. Terminology
3.2.8 operator—a person who operates or assists with the
operation of an ambulance.
3.1 Definitions:
3.1.1 The definitions given in Terminology F1177 are ap-
3.2.9 post-run—the managed return of the ambulance and
plicable to this guide.
operators to optimal pre-run readiness.
3.2.10 pre-run—all aspects of assuring response readiness.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
3.2.11 quick check—an abbreviated version of the full
Medical Services and is the direct responsibility of Subcommittee F30.02 on
Personnel, Training and Education.
check, focusing on the major operational functions of the
Current edition approved Feb. 1, 2007. Published February 2007. Originally
vehicle.
approved in 1994. Last previous edition approved in 2002 as F1517 – 94(2002).
DOI: 10.1520/F1517-94R07.
For referenced ASTM standards, visit the ASTM website, www.astm.org, or 4. Significance and Use
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
4.1 This guide provides minimum guidelines for safe and
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. efficient ambulance operation.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1517 − 94 (Reapproved 2007)
4.2 All ambulance operations and operators should follow precautions, turning, backing, and parking techniques during
this guide for the development of educational and training emergency and non-emergency modes.
programs.
6.3 A review of the state motor vehicle record for the
4.3 This guide is intended to promote safe and efficient previous three years with specific attention to traffic convic-
ambulance operations and to reduce morbidity, mortality, and tions concerning:
property loss associated with ambulance operations. 6.3.1 Speed,
6.3.2 Careless and imprudent driving,
4.4 This guide is intended to assist those who are respon-
6.3.3 Driving under the influence of alcohol or other mind-
sible for the development and implementation of policies and
altering substances, and
procedures for ambulance operations.
6.3.4 Moving violations.
5. Medical Fitness to Drive
6.4 A review of motor vehicle accidents for the previous
five years.
5.1 Because of the complex relationship of certain medical
and mental impairments, a medical screening program shall be
6.5 The operator shall possess a valid motor vehicle opera-
established by all EMS entities bestowing the privilege of
tors license, and any other certification required by state or
ambulance driving.
local laws or regulations.
5.2 The authorization of ambulance drivers must always be
7. Pre-Run
based on bona fide occupational qualifications (BFOQ) pursu-
7.1 The operator shall have knowledge of and shall comply
ant to the task of ambulance operation. The following consid-
with all applicable federal, state statues, local ordinances, and
erations must be evaluated:
regulations.
5.2.1 Amedical exam of the applicant by a licensed M.D. or
D.O. attesting that the history and physical reveals no evidence
7.2 The operator shall have knowledge of the provider’s
of any medical or physical condition which would prove
policies and procedures.
detrimental to operating an ambulance.
7.3 The operator shall have knowledge of roads, highways,
5.2.2 Eye exam by a licensed ophthalmologist/optometrist
and the locations of and accesses to major public facilities
to include:
within the service area.
5.2.2.1 Visual acuity,
7.4 The provider shall have a process by which the operator
5.2.2.2 Depth perception,
is made aware of conditions that may affect traffic flow within
5.2.2.3 Peripheral vision,
the service area (street closures, construction, special events,
5.2.2.4 Night blindness,
and so forth).
5.2.2.5 Color blindness, and
5.2.2.6 Amblyopia.
7.5 The provider shall have a process by which the operator
5.2.3 An examination of the medical history of the
is made aware of present or forecasted environmental condi-
individual, designed to identify drivers who may be impaired
tions affecting traffic flow within the service area (ice, snow,
by:
rain, and so forth).
5.2.3.1 Loss of consciousness,
7.6 Uponunitavailability,theoperatorshallvisuallyinspect
5.2.3.2 Cardiovascular disease,
the ambulance, and document the inspection in accordance
5.2.3.3 Neurological/neurovascular disorder,
with one of the methods as shown in Table 1. The vehicle shall
5.2.3.4 Mental illness,
be inspected for the following:
5.2.3.5 Substance abuse/dependency,
7.6.1 Apparent body or glass damage,
5.2.3.6 Insulin-dependent diabetes, and
7.6.2 Proper function of emergency lights:
5.2.3.7 Rheumatic, arthritic, orthopedic, muscular,
7.6.2.1 Beacons or strobe,
neuromuscular, or vascular disease that interferes with the
7.6.2.2 Light bar,
ability to control and operate a motor vehicle safely.
7.6.2.3 Tunnel lights/flashers, and
5.2.4 The presence of a medical condition by itself may not
7.6.2.4 Other warning lights.
constitute an impaired operator, but shall identify an area for
7.6.3 Vehicle operating lights:
consideration by the physician in making a determination of
7.6.3.1 Headlights (high/low),
the medical fitness to operating an ambulance.
7.6.3.2 Emergency flashers,
7.6.3.3 Parking/running lights,
6. Qualifications to Drive
6.1 Authorization shall be based upon cognitive evaluation
TABLE 1 Emergency Medical Services Ambulance Maintenance
of the operator regarding laws, guidelines, and policies relating
Guidelines for Checklist Completion
to ambulance operation during emergency and non-emergency
Runs per Week Full Check, h Quick Check, h
modes.
0 to 1 every 96 every 24
6.1.1 The provider shall have a policy that addresses opera-
2 to 3 every 72 every 24
tor fatigue.
4 to 7 every 48 every 24
8 to 50 every 24 every 12
6.2 An ambulance driving evaluation by the provider cov-
50 + every 24 every 8
ering warning device operation, passing, intersection approach
F1517 − 94 (Reapproved 2007)
7.6.3.4 Interior and exterior turn signal, 7.7.3.3 Power steering,
7.6.3.5 Brake lights, 7.7.3.4 Water/coolant level,
7.6.3.6 Back up lights,
7.7.3.5 Brake fluid,
7.6.3.7 Flood or scene lights,
7.7.3.6 Transmission fluid,
7.6.3.8 Dome lights: cab and patient compartment, and 7.7.3.7 Windshield washer fluid, and
7.6.3.9 Spotlights.
7.7.3.8 Battery water level.
7.6.4 Damage, wear, and pressure in tires,
7.7.4 Wear and tension of belts,
7.6.5 Damage, loose, or missing lugs on wheels,
7.7.5 Wear and pressure of tires,
7.6.6 Proper opening, closing, locking, and seals of entry
7.7.6 Emergency lights,
and compartment doors,
7.7.7 Function of lighting systems:
7.6.7 Fluid levels:
7.7.7.1 Emergency lights,
7.6.7.1 Automatic transmission,
7.7.7.2 Running lights,
7.6.7.2 Battery,
7.7.7.3 Vehicle exterior, and
7.6.7.3 Brakes,
7.7.7.4 Vehicle interior.
7.6.7.4 Engine oil,
7.7.8 Proper function of horn and each siren position,
7.6.7.5 Engine coolant,
7.7.9 Vehicle cleanliness, and
7.6.7.6 Power steering, and
7.7.10 Proper function of two-way radio and other commu-
7.6.7.7 Windshield washer.
nications equipment.
7.6.8 Fluid leakage on, around, or under the vehicle,
7.6.9 Wear, abrasion, rigidity or sponginess of radiator, fuel,
8. Operations
heater, and other hoses,
8.1 Response Mode Management:
7.6.10 Wear, abraded, or cracked engine drive or accessory
8.1.1 The response mode of the ambulance shall be deter-
belts,
mined by dispatch protocol based on dispatch determinants as
7.6.11 Cleanliness of exterior, crew cab, and patient
approved by the medical director. These determinants shall be
compartments,
consistent with Practice F1258.
7.6.12 Wear, abrasion, and proper function of operator,
passenger, and patient restraint,
8.2 The operator shall, on the basis of known information,
7.6.13 Indications and function of gages:
determine the best route to the scene and end destination.
7.6.13.1 Electrical charging system,
8.3 Before beginning the response, the operator shall con-
7.6.13.2 Emergency brake,
duct a brief egress check consisting of the following:
7.6.13.3 Fuel,
8.3.1 Vehicle doors are securely closed and latched,
7.6.13.4 Oil pressure,
8.3.2 Vehicle hood is closed and securely latched,
7.6.13.5 Tachometer, and
8.3.3 Vehicle shore line is disconnected,
7.6.13.6 Temperature.
8.3.4 All equipment is secured,
7.6.14 Wear, abrasion, and proper function of windshield
8.3.5 Egress door is open, and
wipers,
8.3.6 Patient stretcher is in place and secured.
7.6.15 Proper function and aim of windshield washer,
7.6.16 Proper function and clarity of two-way radio and 8.4 Operational Check Sequence:
other communication devices,
8.4.1 Ensure crew is on board and properly restrained,
7.6.17 Damage, stability, and adjustment of outside and
8.4.2 Adjust the operator’s seat,
inside mirrors,
8.4.3 Adjust mirrors,
7.6.18 Proper function and clarity of emergency siren,
8.4.4 Turn on battery(s),
public address, and other warning devices,
8.4.5 Start the engine,
7.6.19 Proper adjustment of all seats,
8.4.6 Review all gages,
7.6.20 Proper adjustment and function of steering wheel,
8.4.7 Adjust environmental controls consistent with appli-
7.6.21 Charged and properly stored fire extinguishers,
cable needs,
7.6.22 Proper function of heating and air conditioning
8.4.8 Turn radio on and contact dispatch,
systems,
8.4.9 Adjust the tilt wheel,
7.6.23 Proper inventory and condition of medical equip-
8.4.10 Turn the headlights on,
ment and supplies, and
8.4.11 Activate the emergency warning lights (if
7.6.24 Level and alignment of chassis.
applicable),
8.4.12 Turn on power to siren/public address control system
7.7 The quick check shall be constituted by:
(if applicable),
7.7.1 Visually checking for any fluid leakage on or around
the ambulance, 8.4.13 Partially open the driver side window,
8.4.14 Evaluate brake pedal resistance,
7.7.2 Conducting vehicle warm-up,
8.4.15 Place the vehicle in gear,
7.7.3 Checking fluid levels:
7.7.3.1 Fuel, 8.4.16 Activate the siren (if applicable), and
7.7.3.2 Engine oil, 8.4.17 Activate the turn signal (if applicable).
F1517 − 94 (Reapproved 2007)
8.5 Crew Roles—The operator/crew member is responsible slow the vehicle enabling the operator to start to apply the
for: brake to bring the ambulance to a complete stop at the
8.5.1 Operating the ambulance in a safe and efficient crosswalk line.
manner, exercising the highest degree of care, 8.6.4 If the ambulance has an air-driven audible airhorn,
8.5.2 Safely passing other vehicles, give two short blasts on the airhorn.
8.5.3 Utilizing eye sweep,
8.6.5 Look to the left, look to the immediate front, look to
8.5.4 Maintaininga3to4-s following distance, and the right, and then again to the left. The operator may then
8.5.5 Maintaining the vehicle at a speed that is safe for proceed through the intersection under ten miles per hour if
conditions. traffic is stopped in all lanes to the left, in front of, and to the
8.5.5.1 Under emergency response conditions the speed rightoftheambulance.Aftertheoperatorhasmadeeyecontact
shall not exceed that which is safe for road or environmental with all stopped vehicle drivers, the ambulance may proceed
conditions; in no case shall the speed exceed ten miles per hour through the intersection exercising the highest degree of care.
over the posted speed limit.
8.6.6 Continue the siren yelp mode activation and proceed
8.5.5.2 Under non-emergency operations the operator shall through the intersection exercising the highest degree of care.
comply with all local and state traffic laws.
8.6.7 When there are vacant lanes to t
...

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ASTM
ASTM F1149-22(Practice)
Standard Practice for Qualifications, Responsibilities, and Authority of Individuals and Institutions Providing Medical Direction of Emergency Medical Services

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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ASTM
ASTM F1257-22(Guide)
Standard Guide for Selection and Practice of Emergency Medical Services Instructor for Advanced Emergency Medical Technician

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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ASTM
ASTM F1654-95(2020)(Guide)
Standard Guide for Training and Evaluation of Individuals Who Are Responsible for or Perform Triage in a Prehospital Environment

SIGNIFICANCE AND USE
4.1 This guide is intended for use by those responsible for the development and implementation of training programs, that include competency evaluation, for triage in the prehospital environment.  
4.2 This guide is not intended to be used by itself, but as a component of Guide F1288.  
4.3 This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum training standard and encourages the addition of optional knowledge, skill, and attitudinal objectives.  
4.4 A vital role in the development and operational application of triage is that of medical control. This guide should be used by medical directors in the determination of operational and medical protocols for use during MCIs and coordinated with those who are responsible for training.  
4.5 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.
SCOPE
1.1 This guide covers minimum requirements for the training and evaluation of individuals who perform triage at an emergency medical incident involving multiple casualties in a prehospital environment.  
1.2 All training will be in accordance with Guide F1653.  
1.3 Included in this guide is a standard for knowledge and skill evaluation.  
1.4 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031 and Guides F1219, F1253, F1285, F1288, F1453, and F1489.  
1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the document cited in Footnote 3.  
1.6 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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ASTM F1268-90(2020)(Guide)
Standard Guide for Establishing and Operating a Public Information, Education, and Relations Program for Emergency Medical Service Systems

SIGNIFICANCE AND USE
4.1 It is essential to have the public's understanding and support for the EMS system to ensure its proper development and utilization.  
4.2 This guide encompasses those procedures, considerations, and resources that are necessary for a successful EMS public information, education, and relations program. Complex EMS systems may integrate or augment, or both, this guide in its entirety. Less complex systems may need to collaborate with other EMS organizations and related agencies. Responsibility for this guide will vary by level of authority, that is, state, regional, and local. (See Guide F1086.)  
4.3 The PIER tasks involve research, planning, production, distribution, and evaluation. Production requires significant resources and expertise and may be done most appropriately at the higher level, such as regional, state, and national levels.
SCOPE
1.1 The purpose of this guide is to provide national voluntary standards and recommendations to effectively provide emergency medical service system information and education to the public.  
1.2 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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ASTM
ASTM F1653-95(2020)(Guide)
Standard Guide for Scope of Performance of Triage in a Prehospital Environment

SIGNIFICANCE AND USE
4.1 This guide is not intended to be used by itself, but as a component of Guide F1288. Merely conforming to the guidelines described herein will not ensure that adequate triage is carried out in a multiple casualty incident.  
4.2 The purpose of this guide is to establish a methodology for performing triage.  
4.3 Individuals responsible for performing triage must be proficient in triage methods and related life-saving techniques.  
4.4 A basic concept of triage is to do the greatest good for the greatest number of casualties.  
4.5 The assessment process must be focused so as to identify those most at risk of early death who are likely to be salvaged by rapid medical intervention.  
4.6 Triage allows the most efficient use of available resources.  
4.7 This guide acknowledges many types of individuals with varying levels of emergency medical training. It also establishes a minimum scope of performance and encourages the addition of optional knowledge, skills, and attitudinal objectives.  
4.8 A vital role in the development of and operational application of triage is that of medical control. This guide should be used by medical directors in the determination of operational and medical protocols for use during MCIs.  
4.9 This guide is intended to assist those who are responsible for defining the scope of performance of individuals who perform triage.  
4.10 For the purpose of this guide the word “injured” includes both sick or injured patients, or both.
SCOPE
1.1 This guide covers minimum requirements for the scope of performance for individuals who perform triage at an emergency medical incident involving multiple casualties in a pre-hospital environment.  
1.2 This guide acknowledges objectives based on an individual's required knowledge of signs and symptoms, patient assessment, and basic life support.  
1.3 Operating within the framework of this guide may expose personnel to hazardous materials, procedures, and equipment. For additional information see Practice F1031 and Guides F1219, F1253, F1285, F1287, F1288, F1489 and F1651.  
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see Footnote 2.2  
1.5 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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