1、Designation: F 1560 00 (Reapproved 2006)Standard Practice forEmergency Medical Dispatch Management1This standard is issued under the fixed designation F 1560; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revision, the year of last revisio
2、n. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon (e) indicates an editorial change since the last revision or reapproval.INTRODUCTIONThe emergency medical dispatcher (EMD) is the principal link between the public caller requestingemergency medical assistance and
3、 the emergency medical service (EMS) resource delivery system.Assuch, the EMD plays a fundamental role in the ability of the EMS system to respond to a perceivedmedical emergency. With proper training, program administration, supervision, and medical direction,the EMD can accurately query the caller
4、, select an appropriate method of response, provide pertinentinformation to responders, and give appropriate aid and direction for patients through the caller.Through careful application and reference to a written, medically approved, emergency medicaldispatch protocol, sound decisions concerning EM
5、S responses can be made in a safe, reproducible,and non-arbitrary manner. These benefits are realized by EMS systems when appropriate implemen-tation, sound medical management, and quality assurance/quality improvement (QA/QI) at dispatchare provided within the EMD/EMS system. This practice assists
6、in establishing these management andadministrative standards.1. Scope1.1 This practice covers the function of the emergencymedical dispatcher (EMD). This function is the prompt andaccurate processing of calls for emergency medical assistance.The training and practice through the use of a written ora
7、utomated medical dispatch protocol is not sufficient in itself toensure continued medically correct functioning of the EMD.Their dispatch-specific medical training and focal role in EMShas developed to such a complexity that only through acorrectly structured and appropriately managed quality assur-
8、ance environment can the benefits of their practice be fullyrealized. The philosophies of emergency medical dispatch haveestablished new duties to which the emergency medical dis-patch agency must respond. It is important that their qualityassurance/quality improvement (QA/QI) activities, includingi
9、nitial hiring, orientation, training and certification, continuingdispatch education, recertification, and performance evaluationbe given appropriate managerial attention to help ensure theongoing safety in the performance of the EMD. This practiceestablishes functional guidelines for these manageri
10、al, admin-istrative and supervisory functions.1.2 The scope of this practice includes:1.2.1 The entry level selection criteria for hiring emergencymedical dispatchers;1.2.2 The orientation of new emergency medical dispatch-ers;1.2.3 Development of QA/QI mechanisms, managementstrategies and organizat
11、ional structures for use within a com-prehensive emergency medical dispatch system;1.2.4 Performance evaluation as a component of a compre-hensive and ongoing quality assurance and risk managementprogram for an emergency medical dispatch system;1.2.5 Development and provision of continuing dispatche
12、ducation activities for the emergency medical dispatcher;1.2.6 Requirements for initial certification and recertifica-tion of the emergency medical dispatcher;1.2.7 Provision for comparative analysis between differentEMD program approaches available to the EMS communitythat conform to established EM
13、D practice standards prior toimplementation of an emergency medical dispatch program;and1.2.8 Guidelines for implementation of an emergency medi-cal dispatch program.1.3 This standard does not purport to address all of thesafety concerns, if any, associated with its use. It is theresponsibility of t
14、he user of this standard to establish appro-priate safety and health practices and determine the applica-bility of regulatory limitations prior to use.1This practice is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.04 o
15、nCommunications.Current edition approved March 1, 2006. Published March 2006. Originallyapproved in 1994. Last previous edition approved in 2000 as F 1560 00.1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.2. Referenced Documents2.1
16、ASTM Standards:2F 1258 Practice for Emergency Medical DispatchF 1552 Practice for Training Instructor Qualification andCertification Eligibility of Emergency Medical Dispatchers3. Terminology3.1 Definitions of Terms Specific to This Standard:3.1.1 case review templatea structured performanceevaluati
17、on document containing all necessary input and outputactions required of dispatchers that parallels the EMDs on-lineprotocols, policies, and procedures related to call-taking andprocessing. It contains check-off lists and compliance scoringmechanisms that objectively rate the EMDs performance on asi
18、ngle call.3.1.2 dispatch life supportthe knowledge, procedures,and skills used by trained EMDs in providing care throughpre-arrival instructions to callers. It consists of those BLS andALS principles that are appropriate to application by medicaldispatchers.3.1.3 emergency medical dispatch agencyany
19、 organiza-tion or a combination of organizations working cooperatively,that routinely accepts calls for emergency medical assistanceand facilitates the dispatch of prehospital emergency medicalresources/personnel and provides medically oriented pre-arrival instructions pursuant to such requests.3.1.
20、4 performance evaluationthe documented, objective,quantitative measure of an individual emergency medicaldispatchers performance based upon compliance with depart-mental protocols, policies and procedures.3.1.5 pre-arrival instructionstelephone-rendered, medi-cally approved written instructions prov
21、ided by trained EMDsthrough callers which help to provide aid to the victim andcontrol of the situation prior to arrival of prehospital personnel.3.1.6 quality assurance/quality improvement (QA/QI)thecomprehensive program of prospectively setting standards,concurrently monitoring the performance of
22、clinical, opera-tional and personnel components, and retrospectively improv-ing these components in the emergency medical dispatchagency when compared with these standards.3.1.7 risk managementa sub-component of the qualityassurance/quality improvement program designed to: identifyproblematic situat
23、ions and assist EMS medical directors, dis-patch supervisors, and EMDs in modifying practice behaviorsfound to be deficient by quality assurance procedures; protectthe public against incompetent practitioners; and modify struc-tural, resource, and protocol deficiencies that may exist in theemergency
24、 medical dispatch system.4. Summary of Practice4.1 A comprehensive plan for managing the quality of carein an emergency medical dispatch system must include carefulplanning, EMD program selection, proper system implemen-tation, employee selection, training, and certification, QA/QI,performance evalu
25、ation, continuing dispatch education, recer-tification, and risk management activities. These functionsmust be designed and implemented to assist the medicaldirector, dispatch supervisor, and emergency medical dis-patcher in monitoring and modifying EMD performance founddeficient by QA/QI to protect
26、 the public against incompetentpractitioners, as well as modify organizational structure, re-source, or protocol deficiencies that exist in the emergencymedical dispatch system.4.1.1 Entry Level SelectionThe selection and evaluationof new dispatchers must include clearly written objectivestandards t
27、o be adopted for qualifying candidates, interviewingapplicants and pre-employment aptitude and skill testing pur-suant to the hiring of dispatchers.4.1.2 OrientationA pre-planned process of events focus-ing on the development and acclimation of an employee whowill function within the organizations s
28、tandards, practices,policies, and procedures.4.1.3 Quality Assurance/Quality ImprovementWithin aphysician medically directed emergency medical dispatch sys-tem, the development and implementation of employee perfor-mance thresholds, concurrent evaluation of compliance tothese thresholds through on-l
29、ine supervision, retrospectiveevaluation of non-edited logged recordings of requests foremergency service measuring compliance with policy, practice,and procedure to validate that the practices are appropriate, andto correct the employee and practice if they are found to bedeficient.4.1.4 Performanc
30、e EvaluationEach EMD in an emer-gency medical dispatch agency must regularly and routinely beevaluated with respect to his or her adherence to policy,protocol, and procedure through the QA/QI process. Thisdetermines conformance to these elements and measures howthis performance affects the efficienc
31、y and effectiveness of theemergency medical dispatch agency. The evaluation must bequantitative and qualitative.4.1.5 Continuing EducationEach emergency medical dis-patch agency must provide for the development and implemen-tation of a continuing dispatch education program for thebenefit of that age
32、ncys EMD personnel. This program mustprovide the EMD with applicable educational topics designedto enhance their general knowledge and skill in the philosophyand application of the EMD program used within the emer-gency medical dispatch agency.4.1.6 Risk ManagementA written practice and proceduresha
33、ll be established for each agency that provides guidelinesfor physician medical directors, EMS system administrators,agency supervisors, and/or QA/QI personnel to follow when anEMD is identified as failing to meet or follow establishedprotocols. These may be acts of omission or commissionidentified
34、through concurrent or retrospective review. Thispractice and procedure shall provide guidelines for properinvestigative criteria relative to the medical or administrativenature of the perceived infraction, and the proper progressivedisciplinary procedure to be followed in order to provide theEMD due
35、 process.2For referenced ASTM standards, visit the ASTM website, 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.F 1560 00 (2006)24.1.7 Certification, Recertificatio
36、nAll EMDs working in amedical dispatch agency shall be certified as competent in theuse of the medically approved emergency medical dispatchpriority reference system (EMDPRS) used within the medicaldispatch center. Initial certification and recertification stan-dards shall be established by each cer
37、tifying entity associatedwith their EMDPRS protocols in accordance withASTM-EMDstandards that validate the individual EMDs knowledge andcompetency in their use.4.1.8 Reciprocal CertificationReciprocal certificationshall be established between certifying agencies and organiza-tions having programs th
38、at meet the standards contained in thispractice.4.1.9 Registration and Maintenance of CertificationRecordsAll certifying entities, agencies, or organizationsshall maintain records for all certified individuals and shallprovide documents and reports regarding testing and certifica-tion status as requ
39、ired by using agencies, states, or governmen-tal units. All records shall be maintained for a minimum periodof ten years from initial certification, recertification or testingof the individual.4.1.10 Revocation of CertificationThis practice shall setforth guidelines for assessing grounds for a possi
40、ble suspensionor termination of certification when questionable situationsarise in EMD conduct or performance.4.1.11 Program Selection and ImplementationThis is in-tended to assist the EMS administrator in the selection of theprogram that best suits the dispatch agencys needs from amedical, legal, a
41、nd operational perspective and provide forcomparative analysis between different EMD program ap-proaches available to the EMS community that conform toestablished EMD practice standards.4.1.12 Physician Medical DirectorEach emergency medi-cal dispatch agency shall have a physician medical director,w
42、ho shall assist in evaluation and review of the EMD programunder consideration. The physician medical director shallapprove the selected EMD program written protocol. Thephysician shall be responsible for all medical aspects of theEMD program. Additional responsibilities include the medicaloversight
43、 of the EMD training and certification program,continuing education requirements, recertification eligibility,QA/QI and risk management functions. These responsibilitiesinclude recommendations regarding the certification and em-ployment eligibility of individuals found to be unsafe practi-tioners th
44、rough employee evaluation and disciplinary dueprocess.5. Significance and Use5.1 The emergency medical dispatcher should be a speciallytrained telecommunicator with specific emergency medicalknowledge. Many of these personnel still perform in this rolewithout the benefits of dispatch specific medica
45、l training andmedically sound protocols. The majority perform their dutieswithout appropriate medical management provided through astructured quality assurance/improvement environment. Train-ing only prepares a new EMD for correct use of the EMDPRS.It cannot ensure that the EMDPRS is used as intende
46、d. Sincethe EMD is clearly defined as a pre-hospital medical profes-sional, it is necessary to establish sound medical managementprocesses through a multi-component QA/QI program admin-istered by the EMDs agency in conjunction with the physicianmedical director. Prompt, correct, and appropriate pati
47、ent carecan be enhanced through the use of a standardized approach toquality assurance, especially the component of EMD perfor-mance assessment. This practice is intended for use by agen-cies, organizations, and jurisdictions having the responsibilityfor providing such services and assurances to the
48、 publicthrough the correct management of the nations emergencymedical dispatchers.6. EMD Entry Level Selection Criteria6.1 Each emergency medical dispatch agency shall adopt aformal written policy delineating the selection procedures forindividuals to be employed as emergency medical dispatchers.It
49、must address the ability to:6.1.1 Read and write at a high school graduate or GEDlevel;6.1.2 Perform those clerical skills as delineated by theemploying agency;6.1.3 Perform verbal skills in a clear and understandablemanner, in the required language or languages established asnecessary to that emergency medical dispatch agency;6.1.4 Perform alphanumeric transcription skills necessary tocorrectly record addresses, locations, and telephone numbers;and6.1.5 Demonstrate competency in basic telecommunicationsskills as required by the employing or training agenc
