ASTM F1560-2000(2014) Standard Practice for Emergency Medical Dispatch Management《应急医疗调度管理的标准实施规程》.pdf

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1、Designation: F1560 00 (Reapproved 2014)Standard Practice forEmergency Medical Dispatch Management1This standard is issued under the fixed designation F1560; the number immediately following the designation indicates the year oforiginal adoption or, in the case of revision, the year of last revision.

2、 A number in parentheses indicates the year of last reapproval. Asuperscript epsilon () 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 th

3、e 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, s

4、elect 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 EMS r

5、esponses can be made in a safe, reproducible,and non-arbitrary manner. These benefits are realized by EMS systems when appropriateimplementation, sound medical management, and quality assurance/quality improvement (QA/QI) atdispatch are provided within the EMD/EMS system. This practice assists in es

6、tablishing thesemanagement and administrative 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 orautoma

7、ted 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-ance

8、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, includinginitia

9、l 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 managerial, a

10、dmin-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 organizational

11、 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 dispatcheducat

12、ion 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 EMD pra

13、ctice 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 the us

14、er 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 onComm

15、unications.Current edition approved June 1, 2014. Published June 2014. Originallyapproved in 1994. Last previous edition approved in 2006 as F1560 00 (2006).DOI: 10.1520/F1560-00R14.Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States12. R

16、eferenced Documents2.1 ASTM Standards:2F1258 Practice for Emergency Medical DispatchF1552 Practice for Training Instructor Qualification andCertification Eligibility of Emergency Medical Dispatch-ers3. Terminology3.1 Definitions of Terms Specific to This Standard:3.1.1 case review template, na struc

17、tured performanceevaluation document containing all necessary input and outputactions required of dispatchers that parallels the EMDson-lineprotocols, policies, and procedures related to call-taking andprocessing. It contains check-off lists and compliance scoringmechanisms that objectively rate the

18、 EMDs performance on asingle call.3.1.2 dispatch life support, nthe 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

19、 medical dispatch agency, nany 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

20、pursuant to such requests.3.1.4 performance evaluation, nthe documented,objective, quantitative measure of an individual emergencymedical dispatchers performance based upon compliance withdepartmental protocols, policies and procedures.3.1.5 pre-arrival instructions, ntelephone-rendered, medi-cally

21、approved written instructions provided 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),nthe comprehensive program of prospectively settingstandards, concur

22、rently monitoring the performance of clinical,operational and personnel components, and retrospectivelyimproving these components in the emergency medical dis-patch agency when compared with these standards.3.1.7 risk management, na sub-component of the qualityassurance/quality improvement program d

23、esigned to: identifyproblematic situations 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 modifystructural, resource, and protocol deficie

24、ncies that may exist inthe emergency 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 systemimplementation, employee selection, training, and cert

25、ification,QA/QI, performance evaluation, continuing dispatcheducation, recertification, and risk management activities.These functions must be designed and implemented to assistthe medical director, dispatch supervisor, and emergencymedical dispatcher in monitoring and modifying EMD perfor-mance fou

26、nd deficient by QA/QI to protect the public againstincompetent practitioners, as well as modify organizationalstructure, resource, or protocol deficiencies that exist in theemergency medical dispatch system.4.1.1 Entry Level SelectionThe selection and evaluationof new dispatchers must include clearl

27、y written objectivestandards to 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 funct

28、ion within the organizations standards, practices,policies, and procedures.4.1.3 Quality Assurance/Quality ImprovementWithin aphysician medically directed emergency medical dispatchsystem, the development and implementation of employeeperformance thresholds, concurrent evaluation of complianceto the

29、se thresholds through on-line 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 be

30、deficient.4.1.4 Performance 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 perform

31、ance affects the efficiency 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

32、for thebenefit of that agencys 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

33、 practice and procedureshall 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 omissio

34、n or commissionidentified 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 o

35、rder to provide theEMD due 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.F1560 00 (2014)24.1.7 Cert

36、ification, RecertificationAll 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 b

37、e established by each certifying 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

38、-tions having programs that 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 cert

39、ifica-tion status as required 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 asse

40、ssing grounds for a possible 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 need

41、s from amedical, legal, and 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 phy

42、sician medical director,who 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 inc

43、lude the medicaloversight 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

44、 unsafe practi-tioners through 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

45、 dispatch specific medical 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

46、EMDPRS is used as intended. Sincethe EMD is clearly defined as a pre-hospital medicalprofessional, it is necessary to establish sound medical man-agement processes through a multi-component QA/QI programadministered by the EMDs agency in conjunction with thephysician medical director. Prompt, correc

47、t, and appropriatepatient care can be enhanced through the use of a standardizedapproach to quality assurance, especially the component ofEMD performance assessment. This practice is intended foruse by agencies, organizations, and jurisdictions having theresponsibility for providing such services an

48、d assurances to thepublic through the correct management of the nations emer-gency medical 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 me

49、dical dispatchers.It 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 emplo