ASTM_F_1149_-_93_2013.pdf

Designation:F114993(Reapproved 2013)Standard Practice forQualifications,Responsibilities,and Authority of Individualsand Institutions Providing Medical Direction of EmergencyMedical Services1This standard is issued under the fixed designation F1149;the number immediately following the designation indicates the year oforiginal 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 practice covers the qualifications,responsibilities,and authority of individuals and institutions providing medicaldirection of emergency medical services.1.2 This practice addresses the qualifications,authority,andresponsibility of a Medical Director(off-line)and the relation-ship of the EMS(Emergency Medical Services)provider tothis individual.1.3 This practice also addresses components of on-linemedical direction(direct medical control)including the quali-fications and responsibilities of on-line medical physicians andthe relationship of the prehospital provider to on-line medicaldirection.1.4 This practice addresses the relationship of the on-linemedical physician to the off-line Medical Director.1.5 The authority for control of medical services at thescene of a medical emergency is addressed in this practice.1.6 The requirements for a Communication Resource arealso addressed within this practice.2.Referenced Documents2.1 ASTM Standards:2F1031 Practice for Training the Emergency Medical Tech-nician(Basic)F1086 Guide for Structures and Responsibilities of Emer-gency Medical Services Systems Organizations3.Terminology3.1 Description of Terms Specific to This Practice3.2 communication resourcean entity responsible forimplementation of direct medical control.(Also known asmedical control resource.)3.3 delegated practiceonly physicians are licensed topractice medicine;prehospital providers must act only underthe medical direction of a physician.3.4 direct medical controlwhen a physician or authorizedcommunication resource personnel,under the direction of aphysician,provides immediate medical direction to prehospitalproviders in remote locations.(Also known as on-line medicaldirection.)3.5 emergency medical services system(EMSS)all com-ponents needed to provide comprehensive prehospital andhospital emergency care including,but not limited to;MedicalDirector,transport vehicles,trained personnel,access anddispatch,communications,and receiving medical facilities.3.6 intervener physiciansa licensed M.D.or D.O.,havingnot previously established a doctor/patient relationship with theemergency patient and willing to accept responsibility for amedical emergency scene,and can provide proof of a currentMedical License.3.7 medical directionwhen a physician is identified todevelop,implement,and evaluate all medical aspects of anEMS system.(syn.medical accountability.)3.8 medical director off-linea physician responsible for allaspects of an EMS system dealing with provision of medicalcare.(Also known as System Medical Director.)3.9 on-line medical physiciana physician immediatelyavailable,when medically appropriate,for communication ofmedical direction to non-physician prehospital providers inremote locations.3.10 prehospital providerall personnel providing emer-gency medical care in a location remote from facilities capableof providing definitive medical care.3.11 protocolsstandards for EMS practice in a variety ofsituations within the EMS system.3.12 standing ordersstrictly defined written orders foractions,techniques,or drug administration when communica-tion has not been established with an on-line physician.1This practice is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.03 onOrganization/Management.Current edition approved June 1,2013.Published August 2013.Originallyapproved in 1988.Last previous edition approved in 2008 as F1149 98(2008).DOI:10.1520/F1149-93R13.2For 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.Copyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959.United States1 4.Significance and Use4.1 Implementation of this practice will ensure that the EMSsystem has the authority,commensurate with the responsibility,to ensure adequate medical direction of all prehospitalproviders,as well as personnel and facilities that meet mini-mum criteria to implement medical direction of prehospitalservices.4.1.1 The state will develop,recommend,and encourageuse of a plan that would assure the standards outlined in thisdocument 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 re-sponsib