1、Designation: F1616 95 (Reapproved 2016)Standard Guide forScope of Performance of First Responders Who Practice inthe Wilderness or Delayed or Prolonged Transport Settings1This standard is issued under the fixed designation F1616; the number immediately following the designation indicates the year of
2、original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon () indicates an editorial change since the last revision or reapproval.1. Scope1.1 This guide covers minimum performance requirementsfor first
3、 responders who may initially provide care for sick orinjured persons in the specialized pre-hospital situations of thewilderness or delayed or prolonged transport settings, includ-ing catastrophic disasters.1.2 Individuals who will operate in the wilderness or de-layed or prolonged transport settin
4、gs need to be aware of thephysical requirements necessary to be able to perform allidentified objectives and necessary skills required for thesetting.1.3 This guide establishes supplemental or continuing edu-cation programs that will be taught to individuals trained to thefirst responder level by an
5、 appropriate authority.1.4 This guide does not establish performance standards foruse in the traditional emergency medical services (EMS) orambulance transportation environment.1.5 This guide does not establish medical protocols; nordoes it authorize invasive procedures without specific authori-zati
6、on and medical control.1.6 Successful completion of a course based on this guidedoes not constitute or imply certification or licensure.1.7 This standard does not purport to address all of thesafety concerns, if any, associated with its use. It is theresponsibility of the user of this standard to es
7、tablish appro-priate safety and health practices and determine the applica-bility of regulatory limitations prior to use.2. Referenced Documents2.1 ASTM Standards:2F1177 Terminology Relating to Emergency Medical Ser-vicesF1287 Guide for Scope of Performance of First RespondersWho Provide Emergency M
8、edical CareF1453 Guide for Training and Evaluation of First Respond-ers Who Provide Emergency Medical CareF1490 Terminology Relating to Search and Rescue (With-drawn 2011)32.2 Code of Federal Regulations:4Title 29, Part 1910.1030, Bloodborne Pathogens2.3 Department of Transportation Document:4U.S. D
9、OT HS 900-25, Course Guide, Emergency MedicalServices: First Responder Training Course, 19793. Terminology3.1 Definitions:3.1.1 accessthe process of reaching the patient/subjectand establishing physical contact.3.1.2 basic life support/cardiopulmonary resuscitation(BLS/CPR)a set of skills that inclu
10、des airway management,chest compressions, and others as defined by the AmericanHeart Association (AHA).3.1.3 definitive care (see Terminology F1177)a level oftherapeutic intervention capable of providing comprehensivehealth care services for a specific condition.3.1.4 evacuation (see Terminology F14
11、90)the processused between the time of extraction and transportation.3.1.5 extraction (see Terminology F1490)the process ofinitial assessment, treatment, stabilization, and packaging ofthe patient/subject as well as removal of the patient/subjectfrom the immediately hazardous environment.3.1.6 first
12、 responderan individual trained to meet therequirements of Guide F1287.3.1.7 transportationthe use of a specially designed ve-hicle to move a patient to a medical facility or definitive carefacility.1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the d
13、irect responsibility of Subcommittee F30.02 onPersonnel, Training and Education.Current edition approved June 1, 2016. Published June 2016. Originallyapproved in 1995. Last previous edition approved in 2009 as F1616 95(2009).DOI: 10.1520/F1616-95R16.2For referenced ASTM standards, visit the ASTM web
14、site, www.astm.org, orcontact ASTM Customer Service at serviceastm.org. For Annual Book of ASTMStandards volume information, refer to the standards Document Summary page onthe ASTM website.3The last approved version of this historical standard is referenced onwww.astm.org.4Available from Standardiza
15、tion Documents Order Desk, Bldg. 4 Section D, 700Robbins Ave., Philadelphia, PA 19111-5098, Attn: NPODS.Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States13.2 Definitions of Terms Specific to This Standard:3.2.1 delayed or prolonged tran
16、sport setting when thetime between patient injury and arrival at a definitive carefacility is greater than 60 min.3.2.2 nontraditional EMS environmentan environmentthat is not readily accessible to a ground ambulance.3.2.3 wilderness first responder (WFR)an individualtrained to meet the requirements
17、 of this guide.3.2.4 wilderness settingsituations in which the delivery ofpatient care by EMS providers is complicated by one or moreof the following factors: (1) remoteness with respect tologistics and access; (2) a significant delay in the delivery ofcare to the patient; (3) an environment that is
18、 physicallystressful to both patients and rescuers; and (4) lack ofequipment, supplies, and transportation.4. Significance and Use4.1 This guide is intended to expand the scope of thepractice of first responders and improve the emergency medicalcare delivered to patients in the wilderness or delayed
19、 orprolonged transport settings.4.2 This guide does not suggest a particular performancesequence.4.3 Individuals will be trained initially or concurrently inaccordance with the U.S. DOT HS 900-25, Course Guide, andGuide F1453.4.4 This guide may be used by individuals who developtraining programs for
20、 nontraditional EMS environments.4.5 This guide acknowledges the need for additional orspecific training required for the wilderness or delayed orprolonged transport settings.5. Required Objectives5.1 The WFRs shall be able to accomplish the following:5.1.1 Identify specific subjects included within
21、 the scope ofGuide F1287, where traditional patient care is not sufficient orappropriate, due to a patient being in the wilderness or delayedor prolonged transport settings; and manage such problems inan appropriate manner.5.1.2 Demonstrate a knowledge of anatomy and physiologysufficient to apply em
22、ergency care principles to the uniqueproblems found in the wilderness or prolonged or delayedtransport settings.5.1.3 Identify and manage the following medical problemsin the wilderness or delayed or prolonged transport settings:5.1.3.1 Abdominal pain,5.1.3.2 Vomiting,5.1.3.3 Diarrhea,5.1.3.4 Diabet
23、es,5.1.3.5 Seizure disorders,5.1.3.6 Respiratory distress (for example, asthma andaltitude),5.1.3.7 Allergies,5.1.3.8 Hypertension,5.1.3.9 Cardiac emergencies, and5.1.3.10 Dental emergencies.5.1.4 Identify and manage illness or injury related to orcaused by the environment in the wilderness or delay
24、ed orprolonged transport settings, including the following:5.1.4.1 Altitude illness (for example, acute mountainsickness, high-altitude pulmonary edema, and high-altitudecerebral edema);5.1.4.2 Barotrauma;5.1.4.3 Cold injury (for example, hypothermia and frost-bite);5.1.4.4 Heat illness (heat stroke
25、 and heat exhaustion);5.1.4.5 Electrical and lightning injuries;5.1.4.6 Exposure to plant or animal (for example, insect,reptile, arachnid, and marine) toxins;5.1.4.7 Drowning, near-drowning, and cold water immer-sion; and5.1.4.8 Dehydration.5.1.5 Understand the proper disinfection of water, andiden
26、tify and manage illnesses associated with improper waterdisinfection.5.1.6 Identify and manage open wounds in the wilderness ordelayed or prolonged transport settings.5.1.7 Identify and manage orthopedic problems in the wil-derness or delayed or prolonged transport settings, includingdislocations, f
27、ractures, and open fractures.5.1.8 Identify and manage spinal injuries and associatedproblems in the wilderness or delayed or prolonged transportsettings.5.1.9 Identify specific problems with managing cardiopul-monary arrest in the wilderness or delayed or prolongedtransport settings.5.1.10 Identify
28、 the uses, side effects, and administrationconcerns for nonprescription medications and prescriptionmedications in the wilderness or delayed or prolonged trans-port settings.5.1.11 Identify measures necessary to prevent illness orinjury in the wilderness or delayed or prolonged transportsettings, in
29、cluding the management of immediate stress reac-tions.5.1.12 Identify unique problems related to rendering care insevere weather, in environmental extremes, when equipment isnot readily available, access is limited, and there is little or noadditional assistance.5.1.13 Identify clothing, survival te
30、chniques, emergencycommunications, and bivouac considerations necessary tosurvive in environmental extremes.5.1.14 Understand patient packaging in the wilderness ordelayed or prolonged transport settings.5.1.15 Understand the need to document all care provided toany patient.5.1.16 Understand the EMS
31、 system and any unique legalaspects related to providing care in the wilderness or prolongedor delayed transport settings.5.1.17 Understand the role of medical control as it relates tothe WFRs practice, including patient care and quality im-provement.5.1.18 Understand and demonstrate familiarity wit
32、h theprinciples of disease transmission, body fluid isolation, and theuse of personal protective equipment.F1616 95 (2016)25.1.19 The order of these objectives does not suggest aperformance sequence.6. Keywords6.1 delayed; first responder; prolonged; nontraditional; pre-hospital; wildernessREFERENCE
33、S(1) Pre-Hospital Committee, Wilderness Medical Society, “WildernessPre-Hospital Emergency Care (WPHEC) Curriculum,” Journal ofWild Medicine, Vol 2, No. 2, 1991, pp. 8087.(2) Rural Affairs Committee, National Association of EMS Physicians,“Clinical Guidelines for Delayed/Prolonged Transport: I, Card
34、iopul-monary Arrest,” Prehospital and Disaster Medicine, Vol 6, No. 3,JulySeptember 1991.(3) Rural Affairs Committee, National Association of EMS Physicians,“Clinical Guidelines for Delayed/Prolonged Transport: II,Dislocations,” Prehospital and Disaster Medicine, Vol 8, No. 1,JanuaryMarch 1993.(4) R
35、ural Affairs Committee, National Association of EMS Physicians,“Clinical Guidelines for Delayed/Prolonged Transport: III, SpineInjury,” Prehospital and Disaster Medicine, Vol 8, No. 2, AprilJune1993.(5) Rural Affairs Committee, National Association of EMS Physicians,“Clinical Guidelines for Delayed/
36、Prolonged Transport: IV, Wounds,”Prehospital and Disaster Medicine, Vol 8, No. 3, JulySeptember1993.(6) Emergency Medical Services: First Responder Training Course, U.S.DOT HS 900-025, Course Guide, March 1979.(7) “Guidelines for Cardiopulmonary Resuscitation and Emergency Car-diac CareRecommendatio
37、ns of the 1992 National Conference,”Journal of the American Medical Association, Vol 268, No. 16, Oct.28, 1992, p. 2173.ASTM International takes no position respecting the validity of any patent rights asserted in connection with any item mentionedin this standard. Users of this standard are express
38、ly advised that determination of the validity of any such patent rights, and the riskof infringement of such rights, are entirely their own responsibility.This standard is subject to revision at any time by the responsible technical committee and must be reviewed every five years andif not revised,
39、either reapproved or withdrawn. Your comments are invited either for revision of this standard or for additional standardsand should be addressed to ASTM International Headquarters. Your comments will receive careful consideration at a meeting of theresponsible technical committee, which you may att
40、end. If you feel that your comments have not received a fair hearing you shouldmake your views known to the ASTM Committee on Standards, at the address shown below.This standard is copyrighted by ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959,United States.
41、Individual reprints (single or multiple copies) of this standard may be obtained by contacting ASTM at the aboveaddress or at 610-832-9585 (phone), 610-832-9555 (fax), or serviceastm.org (e-mail); or through the ASTM website(www.astm.org). Permission rights to photocopy the standard may also be secured from the Copyright Clearance Center, 222Rosewood Drive, Danvers, MA 01923, Tel: (978) 646-2600; http:/ 95 (2016)3
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