ASTM_F_1086_-_94_2008.pdf

Designation:F108694(Reapproved 2008)Standard Guide forStructures and Responsibilities of Emergency MedicalServices Systems Organizations1This standard is issued under the fixed designation F1086;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 guide establishes optimum guidelines for the struc-tures and responsibilities that will facilitate development,delivery,and assessment of Emergency Medical Services(EMS)on state,regional,and local levels.1.1.1 State LevelAt the state level,this guide sets forth abasic structure for the organization and management of a stateemergency medical services program and outlines the respon-sibilitiesofthestateintheplanning,development,coordination,and regulation of emergency medical servicesthroughout the state.1.1.2 Regional LevelAt the regional level,this guideaddresses the planning,development,and coordination of afunctional and comprehensive EMS system which consists ofall personnel,equipment,and facilities necessary for theresponse to the emergently ill or injured patient,according tonational and state lead agency standards.1.1.3 Local LevelAt the local level,this guide sets forth abasic structure for the organization and management of a localEMS system and outlines the responsibilities that a local EMSshould assume in the planning,development,implementation,and evaluating of its EMS system.2.Significance and Use2.1 This guide is not meant to mandate a specific structureor responsibility at the various levels but rather to suggest ameans or method that will allow for the creation or furtherdevelopment of a state,regional,or local EMS system.2.2 This guide will assist state,regional,or local organiza-tions in establishing EMS systems or refining existing EMSsystems.3.Descriptions of EMS Systems3.1 State EMS SystemA state EMS system includes all ofthe components of all EMS systems within the state,however,particular emphasis is placed upon the following:3.1.1 Legislation establishing authority and responsibilityfor EMS systems.3.1.2 Development and enforcement of minimum regula-tions and standards.3.1.3 Development and dissemination of a statewide planand goals for EMS systems.3.1.4 Provision of technical assistance.3.1.5 Funds for the development,maintenance,and en-hancement of EMS systems.3.1.6 Supportive components,including training,communi-cations systems,record keeping and evaluation,publiceducation,and acute care center designation.3.1.7 Overall coordination of EMS programs within thestate and in concert with other states or federal authorities asneeded.3.2 Regional EMS SystemA recommended method ofstructuring substate EMS systems to provide for EMSplanning,development,and coordination is to delineate spe-cific geographic areas within which one organization is desig-nated as responsible for the arrangement of personnel,facilities,and equipment for the effective,coordinated,andexpeditious delivery of health care services in a region(3.2.1)under emergency conditions occurring as a result of thepatients condition or because of accidents,natural disasters,orsimilar situations.3.2.1 RegionTo implement a regional EMS system,thestate lead agency will identify the geographic or demographicarea that is a natural catchment area for EMS provision formost,if not all,patients in the designated area.Since thiscannot be a perfect definition from an EMS delivery point ofview,administrative and coordinating efficiency considerationswill have to be made in establishing boundaries.The state leadagency should determine and define the substate structure forplanning,coordination,and provision of emergency medicalservices.When a regional EMS system lies near a state bordersuch that appropriate and efficient care of patients will requirecooperation of prehospital system in another state and medicalcenters in another state,the state lead agency will develop aplan with the adjoining state lead agency.This plan mustprovide for the triage and transfer of patients across the stateborder under supervision of the REMSO.1This guide 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 Feb.1,2008.Published March 2008.Originallyapprove in 1987.Last previous edition approved in 2002 as F1086 94(2002).DOI:10.1520/F1086-94R08.Copyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959.United States1 3.2.2 Regional EMS Organization(REMSO)A REMSO isa staffed organization responsible and accountable to the stateEMS lead agency for coordinating the system in a regionincluding system operations,and organization and coordina-tion of resources.A REMSO should have a medical directorand other te