F30 - Emergency Medical Services

SIGNIFICANCE AND USE
5.1 In situations in which the coordination of EMSS communications among political subdivisions affects the health and safety of the state’s population, it is appropriate for state government to take a coordinating role. Statewide planning for coordinated use of radio frequencies for EMSS communications is specifically needed.  
5.2 The state is the logical unit to formulate the statutory and regulatory framework for EMSS planning. State planning for area-wide EMSS communications provides authority to accomplish coordination in the use of available radio frequencies, thus promoting multiagency cooperation to best serve the public needs.  
5.3 With statewide planning, communities, counties, and multicounty EMSS regions are provided with guidance to achieve the performance goals and objectives of their EMSS communications systems.  
5.4 The statewide EMSS communications performance goals and objectives in Sections 10 – 15 address specific roles of state governments in EMSS communications systems planning. These performance goals and objectives should be considered by states for evaluating, planning, and implementing of acceptable EMSS communications statewide.
SCOPE
1.1 This guide covers telecommunications practices and performance standards required to support all of the functions of community EMSS on a statewide basis. It defines state planning goals and objectives for EMSS communications.  
1.2 This guide is for planning, coordinating, integrating, and evaluating telecommunications resources statewide to satisfy the functional needs of comprehensive community EMSS systems.  
1.3 To facilitate a two-tiered planning approach recommended for EMSS communications, this guide identifies those communications system features that should be coordinated on a statewide basis and defined in statewide (first tier) EMSS communications planning guidelines. Local (second tier) EMSS communications plans prepared in accordance with the statewide guidelines should then be tailored to satisfy local EMSS needs while providing compatibility and interoperability of communications with other EMSS.  
1.4 The sections in this guide appear in the following sequence:    
Section  
Scope  
1  
Referenced Documents  
2  
Terminology  
3  
Summary of Guide  
4  
Significance and Use  
5  
Functions and Categories of EMSS Communications  
6  
Telecommunications Functions  
6.1  
Telecommunications Categories  
6.2  
EMSS Functional Communications Requirements  
7  
General Information  
7.1  
Citizen Access  
7.2  
EMSS Vehicle Dispatch and Coordination  
7.3  
Medical Coordination/Direction  
7.4  
Interservice Communications  
7.5  
Radio Frequency Spectrum and Service Requirements  
8  
Radio Frequencies  
8.1  
EMSS Radio Service Coverage  
8.2  
Operational Considerations  
8.3  
Goals and Objectives for EMSS Communications  
9  
Goal 1—State EMSS Communication Should Meet Recognized Standards for Functional Performance  
10  
Goal 2—Local EMSS Communications Should Be Compatible with, and Should Not Interfere with, EMSS Communications in Neighboring Area  
11  
Goal 3—Local EMSS Communications Systems Should Be Compatible with, and Should Not Interfere with, Other Types of Communications Systems  
12  
Goal 4—EMSS Communications Systems Should Make Maximum Use of State and Common Resources Where Appropriate, Cost Effective, and Authorized  
13  
Goal 5—The State Should Act as the Representative of Local EMSS in Dealing with Federal Agencies and National Organizations  
14  
Goal 6—The State Should Have a Program for Positive Management of Its EMSS Communications Activities  
15  
Emergency Medical Radio Services (EMRS) Radio Frequencies (MHz)  
Appendix X1  
Acronyms and Glossary for EMSS Communications  
Appendix X2  
References  
1.5 This standard does not purport to address all of the safety co...

SIGNIFICANCE AND USE
5.1 The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. Many of these personnel still perform in this role without the benefits of dispatch specific medical training and medically sound protocols. The majority perform their duties without appropriate medical management provided through a structured quality assurance/improvement environment. Training only prepares a new EMD for correct use of the EMDPRS. It cannot ensure that the EMDPRS is used as intended. Since the EMD is clearly defined as a prehospital medical professional, it is necessary to establish sound medical management processes through a multi-component QA/QI program administered by the EMD's agency in conjunction with the physician medical director. Prompt, correct, and appropriate patient care can be enhanced through the use of a standardized approach to quality assurance, especially the component of EMD performance assessment. This practice is intended for use by agencies, organizations, and jurisdictions having the responsibility for providing such services and assurances to the public through the correct management of the nation's emergency medical dispatchers.
SCOPE
1.1 This practice covers the function of the emergency medical dispatcher (EMD). This function is the prompt and accurate processing of calls for emergency medical assistance. The training and practice through the use of a written or automated medical dispatch protocol is not sufficient in itself to ensure continued medically correct functioning of the EMD. Their dispatch-specific medical training and focal role in EMS has developed to such a complexity that only through a correctly structured and appropriately managed quality assurance environment can the benefits of their practice be fully realized. The philosophies of emergency medical dispatch have established new duties to which the emergency medical dispatch agency must respond. It is important that their quality assurance/quality improvement (QA/QI) activities, including initial hiring, orientation, training and certification, continuing dispatch education, recertification, and performance evaluation be given appropriate managerial attention to help ensure the ongoing safety in the performance of the EMD. This practice establishes functional guidelines for these managerial, administrative, and supervisory functions.  
1.2 The scope of this practice includes:  
1.2.1 The entry level selection criteria for hiring emergency medical dispatchers;  
1.2.2 The orientation of new emergency medical dispatchers;  
1.2.3 Development of QA/QI mechanisms, management strategies, and organizational structures for use within a comprehensive emergency medical dispatch system;  
1.2.4 Performance evaluation as a component of a comprehensive and ongoing quality assurance and risk management program for an emergency medical dispatch system;  
1.2.5 Development and provision of continuing dispatch education activities for the emergency medical dispatcher;  
1.2.6 Requirements for initial certification and recertification of the emergency medical dispatcher;  
1.2.7 Provision for comparative analysis between different EMD program approaches available to the EMS community that conform to established EMD practice standards prior to implementation of an emergency medical dispatch program; and  
1.2.8 Guidelines for implementation of an emergency medical dispatch program.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Developme...

SIGNIFICANCE AND USE
5.1 This practice is intended to promote the use of trained telecommunicators in the role of emergency medical dispatcher. It defines the basic skills and medical knowledge to permit understanding and resolution of the problems that constitute their daily routine. To use trained telecommunicators fully as functioning members of the emergency medical team, it is deemed necessary to upgrade the telecommunicators' training by the addition of the concept of emergency medical dispatch priorities.  
5.2 All agencies or individuals who routinely accept calls for emergency medical assistance from the public and dispatch emergency medical personnel shall have in effect an emergency medical dispatcher program in accordance with this practice. The program shall include medical direction and oversight and an emergency medical dispatch priority reference system.  
5.3 The successful use of the EMD concept depends on the medical community's awareness of the “prearrival” state of EMS affairs and their willingness to provide medical direction in dispatch.  
5.4 This practice may assist in overcoming some of the misconceptions regarding emergency medical dispatching. These include the uncontrollable nature of the caller's hysteria, lack of time of the dispatcher, potential danger and liability to the EMD, lack of recognition of the benefits of dispatch prearrival instructions, and misconceptions that red lights, siren, and maximal response are always necessary.  
5.5 The EMD is the member of the EMS response team with the broadest view of the entire emergency system's current status and capabilities. The EMD has immediate lifesaving capability in converting the caller into an effective first responder. This practice recognizes the EMD's role as including:  
5.5.1 Interrogation techniques,  
5.5.2 Triage decisions,  
5.5.3 Information transmission,  
5.5.4 Telephone medical intervention, and  
5.5.5 Logistics and resource coordination during the event.  
5.6 For the EMD, th...
SCOPE
1.1 This practice covers the definition of responsibilities, knowledge, practices, and organizational support required to implement, perform, and effectively manage the emergency medical dispatch function.  
1.2 This practice is useful for planning and evaluating the training, implementation, and organizational support to satisfy the functional needs of emergency medical dispatching.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

SIGNIFICANCE AND USE
4.1 This guide has been developed to facilitate communications between agencies involved in the delivery of emergency medical services. This guide is intended to be applied by agencies providing emergency medical services to improve their communications with EMS support agencies. It recommends necessary communication before, during, and after an EMS event.
SCOPE
1.1 This guide covers the planning, operations, and evaluation phases of interagency communications as part of a comprehensive EMS system.  
1.2 This is a guide for interagency communications within an EMS system. Interagency communications involves the EMS responder and support agencies whose primary mission is not  to deliver prehospital emergency medical care.  
1.3 The primary focus of this guide is to address interagency communications necessary for ongoing EMS responses.  
1.4 The guide also addresses interagency communications in any major EMS incident, including man-made or natural disasters.  
1.5 The recommendations for drills/exercises for the evaluation of interagency communications during an EMS event are also incorporated into this guide.  
1.6 Additional information can be found in Guide F1220 and Refs (1-5).2  
1.7 The sections in this guide appear in the following sequence:    
Section  
Introduction  
Scope  
1  
Referenced Documents  
2  
Terminology  
3  
Significance and Use  
4  
Procedure  
5  
Rationale  
Appendix X1  
Keywords  
6  
References  
1.8 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.9 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.

SIGNIFICANCE AND USE
4.1 This practice establishes the national standard for training the EMT in communicating pertinent patient information to the receiving medical facility.  
4.2 Appropriate physiological data and patient assessment information should be collected from the scene or while en route to the receiving medical facility or medical command site.  
4.3 This practice is based on the information needs of a receiving medical facility to assist them in medical triage, ED resource management, and the provision of medical direction.  
4.4 This practice should be used by those who develop curricula, provide continuing medical education, or desire a needs-based reporting approach.  
4.5 This practice should be used to develop documentation aids such as EMS notepads and medical command documentation sheets.  
4.6 The communication format in each PISA subsection in this practice are not necessarily in sequential order. The report may vary dependent upon patient presentation.
SCOPE
1.1 This practice establishes the EMS standard for communications entailing a patient radio (phone) report to a receiving medical facility.  
1.1.1 This report is based on receiving facility needs and is generic for medical, traumatic (ALS), and (BLS) patients.  
1.1.2 This report standard is based on the hierarchical information needs of an average medical receiving facility.  
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.

ABSTRACT
This specification covers minimum requirements for primary medical oxygen delivery systems for EMS ground vehicles used in the following applications: (1) the transportation of the sick and injured to or from an appropriate medical facility while basic, advanced, or specialized life support services are being provided, (2) the delivery of interhospital critical transport care, (3) the delivery of nonemergency, medically required, transport services, and (4) the transportation and delivery of personnel and supplies essential for proper care of an emergent patient. This standard establishes criteria to be considered in the performance, specification, purchase, and acceptance testing of EMS ground vehicles. The oxygen delivery system may be either a gaseous oxygen (GOX) system, or a liquid oxygen (LOX) system. Design and installation of the oxygen delivery system shall meet the requirements specified for: (1) capacity, (2) components such as oxygen piping system, flow control device, oxygen outlet, shutoff device, and secondary oxygen outlet, and (3) oxygen compartment. The oxygen system shall conform to the specified performance requirements including: (1) delivery flowrate, (2) delivery pressure, (3) delivery temperature, (4) temperature conditions such as storage temperature, cold soak, and heat soak, (5) electromagnetic interference, and (6) structural integrity against vibration, acceleration load, and shock load (basic design and crash worthiness). Installation requirements for oxygen piping routing and mounting, as well as flaring and bending, are specified. Design, installation, and pressure test requirements for GOX and LOX systems are detailed.
SCOPE
1.1 This standard covers minimum requirements for primary medical oxygen delivery systems for EMS ground vehicles used in the following applications:  
1.1.1 The transportation of the sick and injured to or from an appropriate medical facility while basic, advanced, or specialized life support services are being provided,  
1.1.2 The delivery of interhospital critical transport care,  
1.1.3 The delivery of nonemergency, medically required transport services, and  
1.1.4 The transportation and delivery of personnel and supplies essential for proper care of an emergent patient.  
1.2 This standard establishes criteria to be considered in the performance, specification, purchase, and acceptance testing of ground vehicles for EMS use.  
1.3 This entire standard should be read before ordering an ambulance in order to be knowledgeable of the types of equipment that are available and their performance requirements. Due to the variety of ambulance equipment or features, some options may be incompatible with all chassis manufacturers' models. Detailed technical information is available from the chassis manufacturers.  
1.4 The sections in this standard appear in the following sequence:    
Section  
Scope  
1  
Referenced Documents  
2  
Terminology  
3  
Significance and Use  
4  
Design Requirements  
5  
Performance Requirements  
6  
Installation Requirements  
7  
GOX System Design Requirements  
8  
GOX System Installation Requirements  
9  
GOX System Test Requirements  
10    
LOX System Design Requirements  
11    
LOX System Installation Requirements  
12    
LOX System Test Requirements  
13    
Keywords  
14  
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.

SIGNIFICANCE AND USE
4.1 The purpose of this practice is to provide standardized means of providing Emergency Medical Technician training. The practice should be used by all individuals and agencies that train such persons.  
4.2 Successful completion of this course of training neither constitutes nor implies certification or licensure.  
4.3 This practice adopts the knowledge and skill objectives contained in the NHSTA curriculum (latest version) as the standard practice for training those persons who provide emergency medical care at the basic life support level and are known as Emergency Medical Technicians. The actual lesson plans contained in the referenced document are recommended for use; however, each instructor may modify the order of presentation according to local needs.  
4.4 This practice outlines a comprehensive course that covers most common emergencies encountered by the Emergency Medical Technician. Emergency Medicine Technician courses that do not include all of the knowledge and skill objectives of this practice may not be referred to as meeting this standard.
SCOPE
1.1 This practice covers a standard course for the training of the Emergency Medical Technician which will prepare a person to perform those skills commonly required to render lifesaving aid at the scene of an emergency and during transportation to a definitive care facility.  
1.2 It is not the intent of this practice to require that the curriculum be used exactly as presented, but only that the knowledge and skill objectives that are part of the curriculum be included in any course purporting to train an Emergency Medical Technician. It is not the intent of this practice to limit the addition of knowledge and skill objectives as required by local conditions.  
1.3 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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.

SIGNIFICANCE AND USE
4.1 Since the quality of EMT training depends, in large measure, on the instructional abilities and competencies of the EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.  
4.2 An EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of instruction.  
4.3 Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of EMT instructors for EMT training and education programs.
SCOPE
1.1 This guide is intended to assist emergency medical services (EMS) agencies and institutions in selecting and utilizing individuals who teach in EMT (emergency medical technician) training programs which include instruction in basic life support knowledge and skills.  
1.2 This guide identifies six categories of instructor in an EMT (emergency medical technician) training program: adjunct instructor, clinical/field preceptor, practical skills instructor, associate instructor, course instructor/coordinator (I/C), and course administrator. The guide recognizes that an individual may, depending on his/her level of practice and the training program involved, function in any or all of these categories.  
1.3 This guide includes specific guidelines for qualifications, training, education, experience, scope of authority, responsibilities, continuing education, evaluation, and maintenance of competency when applicable.  
1.4 This guide does not include specific guidelines for the course administrator or the adjunct instructor. While the guide recognizes, by offering a definition of each category, that these types of individuals function in many EMT training programs, the limited instructional roles played by these individuals preclude the need for specific selection and utilization guidelines.  
1.5 This guide is intended to apply to any individual who teaches in EMT training programs regardless of the individual's present level of clinical practice.  
1.6 This guide intentionally omits references to length of pre-hospital care experience, teaching experience, and continuing education requirements. This guide also omits reference to waiver or equivalency. These issues should be addressed by the appropriate agency.  
1.7 This guide applies only to instructors who teach in basic life support training courses designed to prepare an individual for certification to practice above the level EMT. It does not apply to instructors who teach in specialized courses that do not in themselves qualify the individual for a level of EMT certification.  
1.8 This guide does not establish certification requirements. Such requirements should be established by the certifying agency in the jurisdiction in which the EMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.  
1.9 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.
Note 1: Also see Practice F1031.  
1.10 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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.

SIGNIFICANCE AND USE
4.1 This guide establishes the minimum national standard for training the Emergency Medical Technician to perform patient examination techniques on patients of all ages.  
4.2 This guide shall be used by those who wish to identify the minimum training standard for the Emergency Medical Technician as it relates to the performance of patient examination techniques.  
4.3 This guide shall be used as the basis to revise Practice F1031.  
4.4 Every person who is identified as an Emergency Medical Technician shall have been trained in accordance with this guide.  
4.5 This guide does not stand alone and must be used in conjunction with the applicable documents cited in Section 2.
SCOPE
1.1 This guide covers the minimum patient examination techniques that the Emergency Medical Technician shall be trained to use when assessing ill or injured patients of all ages.  
1.2 This guide is one of a series which together describe the minimum training standard for the Emergency Medical Technician.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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.

SIGNIFICANCE AND USE
4.1 This guide is for those responsible for the development and implementation of training and evaluation programs for first responders (FRs).  
4.2 At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.  
4.3 This guide is not intended for use as a training guide for emergency ambulance personnel.
SCOPE
1.1 This guide covers the minimum training standards for First Responders (FRs) who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.  
1.2 The scope of training will be in accordance with Guide F1287.  
1.3 Included in this guide is a standard for knowledge and skill evaluation.  
1.4 This guide does not suggest a particular training sequence.  
1.5 Operating within the framework of this guide may expose emergency medical service personnel to hazardous materials, procedures and equipment. This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the documents cited in 2.2.  
1.6 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

SIGNIFICANCE AND USE
4.1 The purpose of this guide is to improve the quality of initial emergency medical care provided to the sick and injured. As the first trained person at an emergency medical scene, it is critical that the first responder be proficient in providing patient care and minimizing further complications until more highly trained emergency medical service personnel intervene.  
4.2 In identifying these minima, the guide acknowledges many types of first responder emergency medical care courses of study. This guide allows and encourages the addition of optional knowledge, skill, and attitudinal objectives. Programs such as those for law enforcement, firefighters, and ski patrol are examples of this diversity meeting specific local community needs.  
4.3 This guide is intended to assist those who are responsible for defining the scope of performance for first responders.  
4.4 This guide is not  intended to be used as a scope of performance for emergency ambulance personnel (see Practice F1031).
SCOPE
1.1 This guide covers minimum requirements for the scope of performance of first responders who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.  
1.2 This guide includes objectives based on an individual's acquired knowledge, including signs and symptoms; patient assessment; basic life support/cardiopulmonary resuscitation (BLS/CPR); bleeding and shock; injuries to the skull, spine, chest, abdomen, and extremities; moving patients; medical and environmental emergencies; triage; gaining access; and hazardous situations that the first responder may encounter.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

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.

SIGNIFICANCE AND USE
4.1 This guide provides minimum training guidelines for safe and efficient ambulance operations.  
4.2 Ambulance providers and educators should follow this guide for the development of educational and training programs.  
4.3 This guide is intended to promote safe and efficient ambulance operations and to reduce morbidity, mortality, and property loss associated with ambulance operations.  
4.4 This guide is intended to assist those who are responsible for the development and implementation of policies and procedures for ambulance operations.  
4.5 Topics or concepts listed in this guide are intended to serve as an outline of materials to be covered in the training of ambulance operators.
SCOPE
1.1 This guide provides minimum training standards for Emergency Medical Services (EMS) Ambulance Operators including legal aspects, operator qualifications and testing, history of EMS vehicle operations, vehicle types/equipment, safety, physical forces, mechanics, pre-run, operations, post-run, and special circumstances.  
1.2 This guide promotes 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 the driving of other EMS vehicles that do not necessarily provide patient transportation.  
1.3 This guide shall be used as the basis for all programs relevant to the training of the emergency medical services operators.  
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.  
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.

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.

SIGNIFICANCE AND USE
3.1 This guide suggests methods for organizing and operating state, regional, and local EMS systems, in accordance with Guide F1086. It will assist state, regional, or local organizations in assessing, planning, documenting, and implementing their specific operations. The guide is general in nature and able to be adapted for existing EMS Systems. For organizations that are establishing EMS System operations, the guide is specific enough to form the basis of the operational manual.
SCOPE
1.1 This standard established guidelines for the organization and operation of Emergency Medical Services Systems (EMSS) at the state, regional and local levels. This guide will identify methods of developing state standards, coordinating/managing regional EMS Systems, and delivering emergency medical services through the local EMS System.  
1.1.1 At the state level this guide identifies scope, methods, procedures and participants in the following state structure responsibilities: (a) establishment of EMS legislation; (b) development of minimum standards; (c) enforcement of minimum standards; (d) designation of substate structure; (e) provision of technical assistance; (f) identification of funding and other resources for the development, maintenance, and enhancement of EMS systems; (g) development and implementation of training systems; (h) development and implementation of communication systems; (i) development and implementation of record-keeping and evaluation systems; (j) development and implementation of public information, public education, and public relations programs; (k) development and implementation of acute care center designation; (l) development and implementation of a disaster medical system; (m) overall coordination of EMS and related programs within the state and in concert with other states or federal authorities.  
1.2 At the regional level, this guide identifies methods of planning, implementing, coordinating/managing, and evaluating the emergency medical services system which exists within a natural catchment area and provides guidance on the use of these methods.  
1.3 At the local level, this guide identifies a basic structure for the organization and management of a local EMS system and outlines the responsibilities that a local EMS should assume in the planning, development, implementation and evaluation of its EMS system.  (A) If there are no regional organizations, within the state, the State EMS will need to accomplish, either directly or through delegation, regional tasks.

SIGNIFICANCE AND USE
4.1 This guide is intended to expand the scope of the practice of first responders and improve the emergency medical care delivered to patients in the wilderness or delayed or prolonged transport settings.  
4.2 This guide does not suggest a particular performance sequence.  
4.3 Individuals will be trained initially or concurrently in accordance with the U.S. DOT HS 900-25, Course Guide, and Guide F1453.  
4.4 This guide may be used by individuals who develop training programs for nontraditional EMS environments.  
4.5 This guide acknowledges the need for additional or specific training required for the wilderness or delayed or prolonged transport settings.
SCOPE
1.1 This guide covers minimum performance requirements for first responders who may initially provide care for sick or injured persons in the specialized pre-hospital situations of the wilderness or delayed or prolonged transport settings, including catastrophic disasters.  
1.2 Individuals who will operate in the wilderness or delayed or prolonged transport settings need to be aware of the physical requirements necessary to be able to perform all identified objectives and necessary skills required for the setting.  
1.3 This guide establishes supplemental or continuing education programs that will be taught to individuals trained to the first responder level by an appropriate authority.  
1.4 This guide does not establish performance standards for use in the traditional emergency medical services (EMS) or ambulance transportation environment.  
1.5 This guide does not establish medical protocols; nor does it authorize invasive procedures without specific authorization and medical control.  
1.6 Successful completion of a course based on this guide does not constitute or imply certification or licensure.  
1.7 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.

SIGNIFICANCE AND USE
4.1 This guide provides minimum guidance for the development of air medical training programs.  
4.2 This guide identifies additional subject areas of training necessary to become an air medical patient care provider.
SCOPE
1.1 This guide applies to patient care providers onboard medical flights involved in the provision of patient care during air medical transport. It does not necessarily address the qualifications and training of additional specialty care providers or other allied health professionals during air medical transport.  
1.2 This guide establishes air medical nomenclature.  
1.3 This guide establishes minimum qualifications and training requirements for the air medical patient care provider(s) and the air medical director.  
1.4 This guide identifies the general content of the curricula for air medical training.  
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 and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
4.1 The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. These EMS personnel have traditionally performed this role without the benefits of dispatch specific medical training and medically sound protocols. Prompt, correct, and appropriate patient care can be enhanced with the use of a standardized approach to selection, training and performance assessment. This standard guide is intended for use by agencies, organizations and jurisdictions having the responsibility for providing the training, practice, and evaluation of emergency medical dispatchers.
SCOPE
1.1 This practice covers the training structure and primary function of emergency medical dispatchers. The primary function of the emergency medical dispatcher is the management of calls for emergency medical assistance as outlined in Practice F1258 and NAEMSP Position Paper on emergency medical dispatch. Training as an emergency medical technician, paramedic, nurse, physician, or basic telecommunicator does not prepare a person to function as an EMD. The emergency medical dispatching functions have become so specialized that only an individual with dispatch specific medical training can perform the required tasks. This practice will delineate the training structure for the essential role of emergency medical dispatcher.  
1.2 This practice is intended to outline the basic areas of knowledge required for an EMD, and to standardize the expectations and training between the various educational settings that are available to deliver the EMD training. This practice is not intended to serve as a curriculum for a training agency. All curricula developed or selected shall include the key components outlined in this practice.  
1.3 It is understood that each agency may possess special and unique needs related to the training of EMDs. However, those specialty training areas that lie outside the scope of this standard shall not be included in selected 24 h minimum curriculum delineated by this practice. Additional training as desired may be annexed but may not supplant the learning goals required by this practice.  
1.4 The scope of this standard includes:  
1.4.1 EMD instructor qualifications,  
1.4.2 Student selection criteria for emergency medical dispatcher candidates,  
1.4.3 Emergency medical dispatcher training curriculum guideline,  
1.4.4 Guidelines for EMD course goals and minimum time allocations,  
1.4.5 Testing and evaluation of the student utilizing the stated course goals as basis for certification or certification eligibility as an emergency medical dispatcher,  
1.4.6 Recommended equipment, materials, and facilities for training,  
1.4.7 Guidelines for training course administration and record maintenance, and  
1.4.8 Guidelines for an optional EMD preceptorship.  
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 and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
2.1 This guide is not meant to mandate a specific structure or responsibility at the various levels but rather to suggest a means or method that will allow for the creation or further development of a state, regional, or local EMS system.  
2.2 This guide will assist state, regional, or local organizations in establishing EMS systems or refining existing EMS systems.
SCOPE
1.1 This guide establishes optimum guidelines for the structures and responsibilities that will facilitate development, delivery, and assessment of Emergency Medical Services (EMS) on state, regional, and local levels.  
1.1.1 State Level—At the state level, this guide sets forth a basic structure for the organization and management of a state emergency medical services program and outlines the responsibilities of the state in the planning, development, coordination, and regulation of emergency medical services throughout the state.  
1.1.2 Regional Level—At the regional level, this guide addresses the planning, development, and coordination of a functional and comprehensive EMS system which consists of all personnel, equipment, and facilities necessary for the response to the emergently ill or injured patient, according to national and state lead agency standards.  
1.1.3 Local Level—At the local level, this guide sets forth a basic structure for the organization and management of a local EMS system and outlines the responsibilities that a local EMS should assume in the planning, development, implementation, and evaluating of its EMS system.

SIGNIFICANCE AND USE
4.1 This practice establishes the national standard for training the EMT in communicating pertinent patient information to the receiving medical facility.  
4.2 Appropriate physiological data and patient assessment information should be collected from the scene or while en route to the receiving medical facility or medical command site.  
4.3 This practice is based on the information needs of a receiving medical facility to assist them in medical triage, ED resource management, and the provision of medical direction.  
4.4 This practice should be used by those who develop curricula, provide continuing medical education, or desire a needs-based reporting approach.  
4.5 This practice should be used to develop documentation aids such as EMS note pads and medical command documentation sheets.  
4.6 The communication format in each PISA subsection in the practice are not necessary in sequential order. The report may vary dependent upon patient presentation.
SCOPE
1.1 This practice establishes the EMS standard for communications entailing a patient radio (phone) report to a receiving medical facility.  
1.1.1 This report is based on receiving facility needs and is generic for medical, traumatic, (ALS), and (BLS) patients.  
1.1.2 This report standard is based on the hierarchical information needs of an average medical receiving facility.

SIGNIFICANCE AND USE
5.1 In situations in which the coordination of EMSS communications among political subdivisions affects the health and safety of the state’s population, it is appropriate for state government to take a coordinating role. Statewide planning for coordinated use of radio frequencies for EMSS communications is specifically needed.  
5.2 The state is the logical unit to formulate the statutory and regulatory framework for EMSS planning. State planning for area-wide EMSS communications provides authority to accomplish coordination in the use of available radio frequencies, thus promoting multiagency cooperation to best serve the public needs.  
5.3 With statewide planning, communities, counties, and multicounty EMSS regions are provided with guidance to achieve the performance goals and objectives of their EMSS communications systems.  
5.4 The statewide EMSS communications performance goals and objectives in Sections 10 – 15 address specific roles of state governments in EMSS communications systems planning. These performance goals and objectives should be considered by states for evaluating, planning, and implementing of acceptable EMSS communications statewide.
SCOPE
1.1 This guide covers telecommunications practices and performance standards required to support all of the functions of community EMSS on a statewide basis. It defines state planning goals and objectives for EMSS communications.  
1.2 This guide is for planning, coordinating, integrating, and evaluating telecommunications resources statewide to satisfy the functional needs of comprehensive community EMSS systems.  
1.3 To facilitate a two-tiered planning approach recommended for EMSS communications, this guide identifies those communications system features that should be coordinated on a statewide basis and defined in statewide (first tier) EMSS communications planning guidelines. Local (second tier) EMSS communications plans prepared in accordance with the statewide guidelines should then be tailored to satisfy local EMSS needs while providing compatibility and interoperability of communications with other EMSS.  
1.4 The sections in this guide appear in the following sequence:    
Section  
Scope  
1  
Referenced Documents  
2  
Terminology  
3  
Summary of Guide  
4  
Significance and Use  
5  
Functions and Categories of EMSS Communications  
6  
Telecommunications Functions  
6.1  
Telecommunications Categories  
6.2  
EMSS Functional Communications Requirements  
7  
General Information  
7.1  
Citizen Access  
7.2  
EMSS Vehicle Dispatch and Coordination  
7.3  
Medical Coordination/Direction  
7.4  
Interservice Communications  
7.5  
Radio Frequency Spectrum and Service Requirements  
8  
Radio Frequencies  
8.1  
EMSS Radio Service Coverage  
8.2  
Operational Considerations  
8.3  
Goals and Objectives for EMSS Communications  
9  
Goal 1—State EMSS Communication Should Meet Recognized Standards for Functional Performance  
10  
Goal 2—Local EMSS Communications Should be Compatible with, and Should Not Interfere with, EMSS Communications in Neighboring Area  
11  
Goal 3—Local EMSS Communications Systems Should be Compatible with, and Should Not Interfere with, Other Types of Communications Systems  
12  
Goal 4—EMSS Communications Systems Should Make Maximum Use of State and Common Resources Where Appropriate, Cost Effective, and Authorized  
13  
Goal 5—The State Should Act as the Representative of Local EMSS in Dealing with Federal Agencies and National Organizations  
14  
Goal 6—The State Should Have a Program for Positive Management of Its EMSS Communications Activities  
15  
Emergency Medical Radio Services (EMRS) Radio Frequencies (MHz)  
Appendix X1  
Acronyms and Glossary for EMSS Communications  
Appendix X2  
References  
1.5 This standard does not purport to address all of ...

SIGNIFICANCE AND USE
4.1 This guide has been developed to facilitate communications between agencies involved in the delivery of emergency medical services. This guide is intended to be applied by agencies providing emergency medical services to improve their communications with EMS support agencies. It recommends necessary communication before, during, and after an EMS event.
SCOPE
1.1 This guide covers the planning, operations, and evaluation phases of interagency communications as part of a comprehensive EMS system.  
1.2 This is a guide for interagency communications within an EMS system. Interagency communications involves the EMS responder and support agencies whose primary mission is not  to deliver prehospital emergency medical care.  
1.3 The primary focus of this guide is to address interagency communications necessary for ongoing EMS responses.  
1.4 The guide also addresses interagency communications in any major EMS incident, including man-made or natural disasters.  
1.5 The recommendations for drills/exercises for the evaluation of interagency communications during an EMS event are also incorporated into this guide.  
1.6 Additional information can be found in Guide F1220 and Refs 1-5.2  
1.7 The sections in this guide appear in the following sequence:    
Section  
Introduction  
Scope  
1  
Referenced Document  
2  
Terminology  
3  
Significance and Use  
4  
Procedure  
5  
Rationale  
Appendix X1  
Keywords  
6  
References  
1.8 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.

SIGNIFICANCE AND USE
5.1 The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. Many of these personnel still perform in this role without the benefits of dispatch specific medical training and medically sound protocols. The majority perform their duties without appropriate medical management provided through a structured quality assurance/improvement environment. Training only prepares a new EMD for correct use of the EMDPRS. It cannot ensure that the EMDPRS is used as intended. Since the EMD is clearly defined as a pre-hospital medical professional, it is necessary to establish sound medical management processes through a multi-component QA/QI program administered by the EMD's agency in conjunction with the physician medical director. Prompt, correct, and appropriate patient care can be enhanced through the use of a standardized approach to quality assurance, especially the component of EMD performance assessment. This practice is intended for use by agencies, organizations, and jurisdictions having the responsibility for providing such services and assurances to the public through the correct management of the nation's emergency medical dispatchers.
SCOPE
1.1 This practice covers the function of the emergency medical dispatcher (EMD). This function is the prompt and accurate processing of calls for emergency medical assistance. The training and practice through the use of a written or automated medical dispatch protocol is not sufficient in itself to ensure continued medically correct functioning of the EMD. Their dispatch-specific medical training and focal role in EMS has developed to such a complexity that only through a correctly structured and appropriately managed quality assurance environment can the benefits of their practice be fully realized. The philosophies of emergency medical dispatch have established new duties to which the emergency medical dispatch agency must respond. It is important that their quality assurance/quality improvement (QA/QI) activities, including initial hiring, orientation, training and certification, continuing dispatch education, recertification, and performance evaluation be given appropriate managerial attention to help ensure the ongoing safety in the performance of the EMD. This practice establishes functional guidelines for these managerial, administrative and supervisory functions.  
1.2 The scope of this practice includes:  
1.2.1 The entry level selection criteria for hiring emergency medical dispatchers;  
1.2.2 The orientation of new emergency medical dispatchers;  
1.2.3 Development of QA/QI mechanisms, management strategies and organizational structures for use within a comprehensive emergency medical dispatch system;  
1.2.4 Performance evaluation as a component of a comprehensive and ongoing quality assurance and risk management program for an emergency medical dispatch system;  
1.2.5 Development and provision of continuing dispatch education activities for the emergency medical dispatcher;  
1.2.6 Requirements for initial certification and recertification of the emergency medical dispatcher;  
1.2.7 Provision for comparative analysis between different EMD program approaches available to the EMS community that conform to established EMD practice standards prior to implementation of an emergency medical dispatch program; and  
1.2.8 Guidelines for implementation of an emergency medical dispatch program.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
5.1 This practice is intended to promote the use of trained telecommunicators in the role of emergency medical dispatcher. It defines the basic skills and medical knowledge to permit understanding and resolution of the problems that constitute their daily routine. To use trained telecommunicators fully as functioning members of the emergency medical team, it is deemed necessary to upgrade the telecommunicators' training by the addition of the concept of emergency medical dispatch priorities.  
5.2 All agencies or individuals who routinely accept calls for emergency medical assistance from the public and dispatch emergency medical personnel shall have in effect an emergency medical dispatcher program in accordance with this practice. The program shall include medical direction and oversight and an emergency medical dispatch priority reference system.  
5.3 The successful use of the EMD concept depends on the medical community's awareness of the “prearrival” state of EMS affairs and their willingness to provide medical direction in dispatch.  
5.4 This practice may assist in overcoming some of the misconceptions regarding emergency medical dispatching. These include the uncontrollable nature of the caller's hysteria, lack of time of the dispatcher, potential danger and liability to the EMD, lack of recognition of the benefits of dispatch prearrival instructions, and misconceptions that red lights, siren, and maximal response are always necessary.  
5.5 The EMD is the member of the EMS response team with the broadest view of the entire emergency system's current status and capabilities. The EMD has immediate lifesaving capability in converting the caller into an effective first responder. This practice recognizes the EMD's role as including:  
5.5.1 Interrogation techniques,  
5.5.2 Triage decisions,  
5.5.3 Information transmission,  
5.5.4 Telephone medical intervention, and  
5.5.5 Logistics and resource coordination during the event.  
5.6 For the EMD, ...
SCOPE
1.1 This practice covers the definition of responsibilities, knowledge, practices, and organizational support required to implement, perform, and manage effectively the emergency medical dispatch function.  
1.2 This practice is useful for planning and evaluating the training, implementation, and organizational support to satisfy the functional needs of emergency medical dispatching.  
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
4.1 The purpose of this practice is to provide standardized means of providing Emergency Medical Technician training. The practice should be used by all individuals and agencies that train such persons.  
4.2 Successful completion of this course of training neither constitutes nor implies certification or licensure.  
4.3 This practice adopts the knowledge and skill objectives contained in the NHSTA curriculum (latest version) as the standard practice for training those persons who provide emergency medical care at the basic life support level and are known as emergency medical technicians . The actual lesson plans contained in the referenced document are recommended for use; however, each instructor may modify the order of presentation according to local needs.  
4.4 This practice outlines a comprehensive course that covers most common emergencies encountered by the emergency medical technician. Emergency Medicine Technician courses that do not include all of the knowledge and skill objectives of this practice may not be referred to as meeting this standard.
SCOPE
1.1 This practice covers a standard course for the training of the emergency medical technician which will prepare a person to perform those skills commonly required to render lifesaving aid at the scene of an emergency and during transportation to a definitive care facility.  
1.2 It is not the intent of this practice to require that the curriculum be used exactly as presented, but only that the knowledge and skill objectives that are part of the curriculum be included in any course purporting to train an emergency medical technician. It is not the intent of this practice to limit the addition of knowledge and skill objectives as required by local conditions.

SIGNIFICANCE AND USE
4.1 Since the quality of EMT training depends, in large measure, on the instructional abilities and competencies of the EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.  
4.2 An EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of instruction.  
4.3 Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of EMT instructors for EMT training and education programs. BASIC LIFE SUPPORT INSTRUCTOR GUIDELINES
SCOPE
1.1 This guide is intended to assist emergency medical services (EMS) agencies and institutions in selecting and utilizing individuals who teach in EMT (emergency medical technician) training programs which include instruction in basic life support knowledge and skills.  
1.2 This guide identifies six categories of instructor in an EMT (emergency medical technician) training program: adjunct instructor, clinical/field preceptor, practical skills instructor, associate instructor, course instructor/coordinator (I/C), and course administrator. The guide recognizes that an individual may, depending on his/her level of practice and the training program involved, function in any or all of these categories.  
1.3 This guide includes specific guidelines for qualifications, training, education, experience, scope of authority, responsibilities, continuing education, evaluation, and maintenance of competency when applicable.  
1.4 This guide does not include specific guidelines for the course administrator or the adjunct instructor. While the guide recognizes, by offering a definition of each category, that these types of individuals function in many EMT training programs, the limited instructional roles played by these individuals preclude the need for specific selection and utilization guidelines.  
1.5 This guide is intended to apply to any individual who teaches in EMT training programs regardless of the individual's present level of clinical practice.  
1.6 This guide intentionally omits references to length of prehospital care experience, teaching experience, and continuing education requirements. This guide also omits reference to waiver or equivalency. These issues should be addressed by the appropriate agency.  
1.7 This guide applies only to instructors who teach in basic life support training courses designed to prepare an individual for certification to practice above the level EMT. It does not apply to instructors who teach in specialized courses that do not in themselves qualify the individual for a level of EMT certification.  
1.8 This guide does not establish certification requirements. Such requirements should be established by the certifying agency in the jurisdiction in which the EMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.  
1.9 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use. Note 1—Also see Practice F1031.

SIGNIFICANCE AND USE
4.1 Since the quality of prehospital 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. ADVANCED LIFE SUPPORT INSTRUCTOR GUIDELINES
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 programs regardless of the individual's present level of clinical practice.  
1.6 This guide intentionally omits references to length of prehospital 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 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.Note 1—Also see Practice F1031.

SIGNIFICANCE AND USE
4.1 This guide establishes the minimum national standard for training the emergency medical technician to perform patient examination techniques on patients of all ages.  
4.2 This guide shall be used by those who wish to identify the minimum training standard for the emergency medical technician as it relates to the performance of patient examination techniques.  
4.3 This guide shall be used as the basis to revise Practice F1031.  
4.4 Every person who is identified as an emergency medical technician shall have been trained in accordance with this guide.  
4.5 This guide does not stand alone and must be used in conjunction with the applicable documents cited in Section 2.
SCOPE
1.1 This guide covers the minimum patient examination techniques that the emergency medical technician shall be trained to use when assessing ill or injured patients of all ages.  
1.2 This guide is one of a series which together describe the minimum training standard for the emergency medical technician.  
1.3 This standard does not purport to address the safety concerns 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.

ABSTRACT
This specification covers minimum requirements for primary medical oxygen delivery systems for EMS ground vehicles used in the following applications: (1) the transportation of the sick and injured to or from an appropriate medical facility while basic, advanced, or specialized life support services are being provided, (2) the delivery of interhospital critical transport care, (3) the delivery of nonemergency, medically required, transport services, and (4) the transportation and delivery of personnel and supplies essential for proper care of an emergent patient. This standard establishes criteria to be considered in the performance, specification, purchase, and acceptance testing of EMS ground vehicles. The oxygen delivery system may be either a gaseous oxygen (GOX) system, or a liquid oxygen (LOX) system. Design and installation of the oxygen delivery system shall meet the requirements specified for: (1) capacity, (2) components such as oxygen piping system, flow control device, oxygen outlet, shutoff device, and secondary oxygen outlet, and (3) oxygen compartment. The oxygen system shall conform to the specified performance requirements including: (1) delivery flowrate, (2) delivery pressure, (3) delivery temperature, (4) temperature conditions such as storage temperature, cold soak, and heat soak, (5) electromagnetic interference, and (6) structural integrity against vibration, acceleration load, and shock load (basic design and crash worthiness). Installation requirements for oxygen piping routing and mounting, as well as flaring and bending, are specified. Design, installation, and pressure test requirements for GOX and LOX systems are detailed.
SCOPE
1.1 This standard covers minimum requirements for primary medical oxygen delivery systems for EMS ground vehicles used in the following applications:  
1.1.1 The transportation of the sick and injured to or from an appropriate medical facility while basic, advanced, or specialized life support services are being provided,  
1.1.2 The delivery of interhospital critical transport care,  
1.1.3 The delivery of nonemergency, medically required, transport services, and  
1.1.4 The transportation and delivery of personnel and supplies essential for proper care of an emergent patient.  
1.2 This standard establishes criteria to be considered in the performance, specification, purchase, and acceptance testing of ground vehicles for EMS use.  
1.3 This entire standard should be read before ordering an ambulance in order to be knowledgeable of the types of equipment that are available and their performance requirements. Due to the variety of ambulance equipment or features, some options may be incompatible with all chassis manufacturers' models. Detailed technical information is available from the chassis manufacturers.  
1.4 The sections in this standard appear in the following sequence:    
Section  
Scope  
1  
Referenced Documents  
2  
Terminology  
3  
Significance and Use  
4  
Design Requirements  
5  
Performance Requirements  
6  
Installation Requirements  
7  
GOX System Design Requirements  
8  
GOX System Installation Requirements  
9  
GOX System Test Requirements  
10    
LOX System Design Requirements  
11    
LOX System Installation Requirements  
12    
LOX System Test Requirements  
13    
Keywords  
14

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 prehospital providers, as well as personnel and facilities that meet minimum criteria to implement medical direction of prehospital services.  
4.1.1 The state will develop, recommend, and encourage use of a plan that would assure 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 prehospital 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.

ABSTRACT
This specification covers rotary wing aircraft involved in patient prehospital emergency medical care and transportation. It outlines the minimum requirements, including personnel, and patient care equipment and supplies, that must be met before the aircraft can be classified as a rotary wing air ambulance unit. This specification describes a suitable rotary wing aircraft, which together with the specified personnel, equipment, and supplies, will provide patient care, at least to national standards for basic life support, throughout the medical mission. It applies to all the medical activities that involve rotary wing air ambulance operation at the basic life support level, including on-scene work and interhospital transfer. Application of this specification will ensure that the air ambulance will be able to provide a well-established level of patient care. The rotary wing basic life support air ambulance shall consist of three components: the rotary wing medical transport vehicle, transport personnel, and patient care equipment and supplies in accordance with this specification. The minimum personnel requirement for the rotary wing basic life support air ambulance shall be the FAA flight crew requirement for the aircraft and for each patient, one qualified air-medical crewmember. All pieces of medical equipment and supplies used in rotary wing operations shall be maintained in accordance with the specified requirements.
SCOPE
1.1 This specification covers rotary wing aircraft involved in patient prehospital emergency medical care and transportation. It outlines the minimum requirements, including personnel, and patient care equipment and supplies, that must be met before the aircraft can be classified as a rotary wing air ambulance unit.
1.2 The first part of this specification (Sections through ) describes the minimum aircraft configuration and capability, the minimum number of seats for personnel, and the provisions for the minimum medical equipment and supplies for rotary wing basic life support air ambulances.
1.3 The provisions of this specification plus the provisions of the Advanced Life Support (ALS) Annex comprise the specification for rotary wing advanced life support air ambulances.(See Section 1 and 1.1 of the Advanced Life Support (ALS) Annex for the scope for rotary wing advanced life support air ambulances.)
1.4 The provisions of this specification plus the provisions of the Advanced Life Support Annex, plus the provisions in the Specialized Medical Support (SMS) Annex comprise the specification for rotary wing specialized medical support air ambulances. (See Sections 1 through 1.3 of the Specialized Medical Support (SMS) Annex for the scope for rotary wing specialized medical support air ambulances.)
WITHDRAWN RATIONALE
This specification covers rotary wing aircraft involved in patient prehospital emergency medical care and transportation. It outlines the minimum requirements, including personnel, and patient care equipment and supplies, that must be met before the aircraft can be classified as a rotary wing air ambulance unit.
Formerly under the jurisdiction of Committee F30 on Emergency Medical Services, this specification was withdrawn in January 2013 in accordance with section 10.5.3.1 of the Regulations Governing ASTM Technical Committees, which requires that standards shall be updated by the end of the eighth year since the last approval date.

SIGNIFICANCE AND USE
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.
This guide is not intended to be used by itself, but as a component of Guide F1288.
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.
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.
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 and health practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the document cited in Footnote 3.

SIGNIFICANCE AND USE
This guide provides minimum training guidelines for safe and efficient ambulance operations.
Ambulance providers and educators 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.
Topics or concepts listed in this guide are intended to serve as an outline of materials to be covered in the training of ambulance operators.
SCOPE
1.1 This guide provides minimum training standards for Emergency Medical Services (EMS) Ambulance Operators including legal aspects, operator qualifications and testing, history of EMS vehicle operations, vehicle types/equipment, safety, physical forces, mechanics, pre-run, operations, post-run, and special circumstances.
1.2 This guide promotes 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 the driving of other EMS vehicles that do not necessarily provide patient transportation.
1.3 This guide shall be used as the basis for all programs relevant to the training of the emergency medical services operators.
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 and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
This guide is for those responsible for the development and implementation of training and evaluation programs for first responders (FRs).
At the beginning of the program, students shall be informed of the course objectives and requirements for successful completion.
This guide is not intended for use as a training guide for emergency ambulance personnel.
SCOPE
1.1 This guide covers the minimum training standards for First Responders (FRs) who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.
1.2 The scope of training will be in accordance with Guide F1287.
1.3 Included in this guide is a standard for knowledge and skill evaluation.
1.4 This guide does not suggest a particular training sequence.
1.5 Operating within the framework of this guide may expose emergency medical service personnel to hazardous materials, procedures and equipment. This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see the documents cited in 2.2.

SIGNIFICANCE AND USE
This guide provides minimum guidance for the development of air medical training programs.
This guide identifies additional subject areas of training necessary to become an air medical patient care provider.
SCOPE
1.1 This guide applies to patient care providers onboard medical flights involved in the provision of patient care during air medical transport. It does not necessarily address the qualifications and training of additional specialty care providers or other allied health professionals during air medical transport.
1.2 This guide establishes air medical nomenclature.
1.3 This guide establishes minimum qualifications and training requirements for the air medical patient care provider(s) and the air medical director.
1.4 This guide identifies the general content of the curricula for air medical training.
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 and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
The purpose of this practice is to provide a standard means of providing Emergency Medical Technician (Basic) training. The practice should be used by all individuals and agencies that train such persons.
Successful completion of this course of training neither constitutes nor implies certification or licensure.
This practice adopts the knowledge and skill objectives contained in the DOT curriculum (latest version) as the standard practice for training those persons who provide emergency medical care at the basic life support level and are known as emergency medical technicians (basic). The actual lesson plans contained in the referenced document are recommended for use; however, each instructor may modify the order of presentation according to local needs.  
This practice outlines a comprehensive course that covers most common emergencies encountered by the emergency medical technician. EMT-basic courses that do not include all of the knowledge and skill objectives of this practice may not be referred to as meeting this standard.
SCOPE
1.1 This practice covers a standard course for the training of the emergency medical technician (basic) which will prepare a person to perform those skills commonly required to render lifesaving aid at the scene of an emergency and during transportation to a definitive care facility.
1.2 It is not the intent of this practice to require that the curriculum be used exactly as presented, but only that the knowledge and skill objectives that are part of the curriculum be included in any course purporting to train the emergency medical technician (basic). It is not the intent of this practice to limit the addition of knowledge and skill objectives as required by local conditions.

SIGNIFICANCE AND USE
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.
The purpose of this guide is to establish a methodology for performing triage.
Individuals responsible for performing triage must be proficient in triage methods and related life-saving techniques.
A basic concept of triage is to do the greatest good for the greatest number of casualties.
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.
Triage allows the most efficient use of available resources.
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.
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 MCI's.
This guide is intended to assist those who are responsible for defining the scope of performance of individuals who perform triage.
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, 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 and health practices and determine the applicability of regulatory limitations prior to use. For specific precautionary statements, see Footnote 3.

SIGNIFICANCE AND USE
The purpose of this guide is to improve the quality of initial emergency medical care provided to the sick and injured. As the first trained person at an emergency medical scene, it is critical that the first responder be proficient in providing patient care and minimizing further complications until more highly trained emergency medical service personnel intervene.
In identifying these minima, the guide acknowledges many types of first responder emergency medical care courses of study. This guide allows and encourages the addition of optional knowledge, skill, and attitudinal objectives. Programs such as those for law enforcement, firefighters, and ski patrol are examples of this diversity meeting specific local community needs.
This guide is intended to assist those who are responsible for defining the scope of performance for first responders.
This guide is not  intended to be used as a scope of performance for emergency ambulance personnel (see Practice F1031).
SCOPE
1.1 This guide covers minimum requirements for the scope of performance of first responders who may be responsible for the initial care of sick and injured persons of all ages in the prehospital environment.
1.2 This guide includes objectives based on an individual's acquired knowledge, including signs and symptoms; patient assessment; basic life support/cardiopulmonary resuscitation (BLS/CPR); bleeding and shock; injuries to the skull, spine, chest, abdomen, and extremities; moving patients; medical and environmental emergencies; triage; gaining access; and hazardous situations that the first responder may encounter.
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.le:normal;">22
1.3 The values stated in SI units are to be regarded as the standard.  
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 and health practices and determine the applicability of regulatory limitations prior to use. For specific hazard and precautionary statements, see Section 5 and Practices E50.

SIGNIFICANCE AND USE
It is essential to have the public's understanding and support for the EMS system to ensure its proper development and utilization.
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.)
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.

SIGNIFICANCE AND USE
This guide is intended to expand the scope of the practice of first responders and improve the emergency medical care delivered to patients in the wilderness or delayed or prolonged transport settings.
This guide does not suggest a particular performance sequence.
Individuals will be trained initially or concurrently in accordance with the U.S. DOT HS 900-25, Course Guide, and Guide F 1453.
This guide may be used by individuals who develop training programs for nontraditional EMS environments.
This guide acknowledges the need for additional or specific training required for the wilderness or delayed or prolonged transport settings.
SCOPE
1.1 This guide covers minimum performance requirements for first responders who may initially provide care for sick or injured persons in the specialized pre-hospital situations of the wilderness or delayed or prolonged transport settings, including catastrophic disasters.
1.2 Individuals who will operate in the wilderness or delayed or prolonged transport settings need to be aware of the physical requirements necessary to be able to perform all identified objectives and necessary skills required for the setting.
1.3 This guide establishes supplemental or continuing education programs that will be taught to individuals trained to the first responder level by an appropriate authority.
1.4 This guide does not establish performance standards for use in the traditional emergency medical services (EMS) or ambulance transportation environment.
1.5 This guide does not establish medical protocols; nor does it authorize invasive procedures without specific authorization and medical control.
1.6 Successful completion of a course based on this guide does not constitute or imply certification or licensure.
1.7 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.

SIGNIFICANCE AND USE
The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. These EMS personnel have traditionally performed this role without the benefits of dispatch specific medical training and medically sound protocols. Prompt, correct, and appropriate patient care can be enhanced with the use of a standardized approach to selection, training and performance assessment. This standard guide is intended for use by agencies, organizations and jurisdictions having the responsibility for providing the training, practice, and evaluation of emergency medical dispatchers.
SCOPE
1.1 This practice covers the training structure and primary function of emergency medical dispatchers. The primary function of the emergency medical dispatcher is the management of calls for emergency medical assistance as outlined in Practice F 1258 and NAEMSP Position Paper on emergency medical dispatch. Training as an emergency medical technician, paramedic, nurse, physician, or basic telecommunicator does not prepare a person to function as an EMD. The emergency medical dispatching functions have become so specialized that only an individual with dispatch specific medical training can perform the required tasks. This practice will delineate the training structure for the essential role of emergency medical dispatcher.
1.2 This practice is intended to outline the basic areas of knowledge required for an EMD, and to standardize the expectations and training between the various educational settings that are available to deliver the EMD training. This practice is not intended to serve as a curriculum for a training agency. All curricula developed or selected shall include the key components outlined in this practice.
1.3 It is understood that each agency may possess special and unique needs related to the training of EMDs. However, those specialty training areas that lie outside the scope of this standard shall not be included in selected 24 h minimum curriculum delineated by this practice. Additional training as desired may be annexed but may not supplant the learning goals required by this practice.
1.4 The scope of this standard includes:
1.4.1 EMD instructor qualifications,
1.4.2 Student selection criteria for emergency medical dispatcher candidates,
1.4.3 Emergency medical dispatcher training curriculum guideline,
1.4.4 Guidelines for EMD course goals and minimum time allocations,
1.4.5 Testing and evaluation of the student utilizing the stated course goals as basis for certification or certification eligibility as an emergency medical dispatcher,
1.4.6 Recommended equipment, materials, and facilities for training,
1.4.7 Guidelines for training course administration and record maintenance, and
1.4.8 Guidelines for an optional EMD preceptorship.
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 and health practices and determine the applicability of regulatory limitations prior to use.

SIGNIFICANCE AND USE
This guide is not meant to mandate a specific structure or responsibility at the various levels but rather to suggest a means or method that will allow for the creation or further development of a state, regional, or local EMS system.
This guide will assist state, regional, or local organizations in establishing EMS systems or refining existing EMS systems.
SCOPE
1.1 This guide establishes optimum guidelines for the structures and responsibilities that will facilitate development, delivery, and assessment of Emergency Medical Services (EMS) on state, regional, and local levels.
1.1.1 State Level—At the state level, this guide sets forth a basic structure for the organization and management of a state emergency medical services program and outlines the responsibilities of the state in the planning, development, coordination, and regulation of emergency medical services throughout the state.
1.1.2 Regional Level—At the regional level, this guide addresses the planning, development, and coordination of a functional and comprehensive EMS system which consists of all personnel, equipment, and facilities necessary for the response to the emergently ill or injured patient, according to national and state lead agency standards.
1.1.3 Local Level—At the local level, this guide sets forth a basic structure for the organization and management of a local EMS system and outlines the responsibilities that a local EMS should assume in the planning, development, implementation, and evaluating of its EMS system.

SIGNIFICANCE AND USE
Since the quality of prehospital ALS/EMT training depends, in large measure, on the instructional abilities and competencies of the ALS/EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.
An ALS/EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs and meet other specific requirements pertinent to the level of instruction.
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. ADVANCED LIFE SUPPORT INSTRUCTOR GUIDELINES   Top
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 ALS/EMT (advanced life support/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 ALS/EMT training programs, the limited instructional roles played by these individuals precludes the need for specific selection and utilization guidelines.
1.5 This guide is intended to apply to any individual who teaches in ALS/EMT training programs regardless of the individual's present level of clinical practice.
1.6 This guide intentionally omits references to length of prehospital 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 advanced life support training courses designed to prepare an individual for certification to practice as an EMT above the level of the EMT (basic). 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 ALS/EMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.
1.9 This standard does not purport to address all of the safety concerns 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.
Note 1—Also see Practice F 1031.

SIGNIFICANCE AND USE
Since the quality of prehospital BLS/EMT training depends, in large measure, on the instructional abilities and competencies of the BLS/EMT instructor, it is imperative that the individual selected and used in this capacity possess the qualifications and capabilities necessary to provide effective instruction.
A BLS/EMT instructor must possess clearly defined knowledge and skills competencies, have clearly defined responsibilities and scope of authority related to instructional programs, and meet other specific requirements pertinent to the level of instruction.
Using this guide, EMS institutions and organizations should be able to develop requirements for selection and utilization of BLS/EMT instructors for BLS/EMT training and education programs. BASIC LIFE SUPPORT INSTRUCTOR GUIDELINES   Top
SCOPE
1.1 This guide is intended to assist emergency medical services (EMS) agencies and institutions in selecting and utilizing individuals who teach in EMT (emergency medical technician) training programs which include instruction in basic life support knowledge and skills.
1.2 This guide identifies six categories of instructor in a BLS/EMT (basic life support/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 BLS/EMT training programs, the limited instructional roles played by these individuals precludes the need for specific selection and utilization guidelines.
1.5 This guide is intended to apply to any individual who teaches in BLS/EMT training programs regardless of the individual's present level of clinical practice.
1.6 This guide intentionally omits references to length of prehospital care experience, teaching experience, and continuing education requirements. This guide also omits reference to waiver or equivalency. These issues should be addressed by the appropriate agency.
1.7 This guide applies only to instructors who teach in basic life support training courses designed to prepare an individual for certification to practice as an EMT (basic) or first responder. 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 BLS/EMT instructor will function. This guide may be used to provide considerable guidance to the jurisdiction responsible for establishing certification standards.
1.9 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
Note 1—Also see Practice F 1031.

SIGNIFICANCE AND USE
Implementation of this practice will ensure that the EMS system has the authority, commensurate with the responsibility, to ensure adequate medical direction of all prehospital providers, as well as personnel and facilities that meet minimum criteria to implement medical direction of prehospital services.
The state will develop, recommend, and encourage use of a plan that would assure the standards outlined in this document can be implemented as appropriate at the local, regional, or state level (see Guide F 1086).
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 and/or state laws.
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 prehospital 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.

SIGNIFICANCE AND USE
It is essential to have the public’understanding and support for the EMS system to ensure its proper development and utilization.
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 F 1086.)
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.

SIGNIFICANCE AND USE
This guide establishes the minimum national standard for training the emergency medical technician (basic) to perform patient examination techniques on patients of all ages.
This guide shall be used by those who wish to identify the minimum training standard for the emergency medical technician (basic) as it relates to the performance of patient examination techniques.
This guide shall be used as the basis to revise Practice F 1031.
Every person who is identified as an emergency medical technician (basic) shall have been trained in accordance with this guide.
This guide does not stand alone and must be used in conjunction with the applicable documents cited in Section 2.
SCOPE
1.1 This guide covers the minimum patient examination techniques that the emergency medical technician (basic) shall be trained to use when assessing ill or injured patients of all ages.
1.2 This guide is one of a series which together describe the minimum training standard for the emergency medical technician (basic).
1.3 This standard does not purport to address the safety concerns 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.