【国外标准】 Standard Practice for Emergency Medical Dispatch

5.1 This practice is intended to promote the use of trained telecommunicators in the role of emergency medical dispatcher. It defines the basic skills and medical knowledge to permit understanding and resolution of the problems that constitute their daily routine. To use trained telecommunicators fully as functioning members of the emergency medical team, it is deemed necessary to upgrade the telecommunicators' training by the addition of the concept of emergency medical dispatch priorities.5.2 All agencies or individuals who routinely accept calls for emergency medical assistance from the public and dispatch emergency medical personnel shall have in effect an emergency medical dispatcher program in accordance with this practice. The program shall include medical direction and oversight and an emergency medical dispatch priority reference system.5.3 The successful use of the EMD concept depends on the medical community's awareness of the “prearrival” state of EMS affairs and their willingness to provide medical direction in dispatch.5.4 This practice may assist in overcoming some of the misconceptions regarding emergency medical dispatching. These include the uncontrollable nature of the caller's hysteria, lack of time of the dispatcher, potential danger and liability to the EMD, lack of recognition of the benefits of dispatch prearrival instructions, and misconceptions that red lights, siren, and maximal response are always necessary.5.5 The EMD is the member of the EMS response team with the broadest view of the entire emergency system's current status and capabilities. The EMD has immediate lifesaving capability in converting the caller into an effective first responder. This practice recognizes the EMD's role as including:5.5.1 Interrogation techniques,5.5.2 Triage decisions,5.5.3 Information transmission,5.5.4 Telephone medical intervention, and5.5.5 Logistics and resource coordination during the event.5.6 For the EMD, this practice supersedes any other EMSS standards under which an individual may be qualified, such as Practice F1031. It is not the role of the EMD to generate a specific diagnosis but rather to elicit accurately a finite body of information, assign the appropriate response, and to communicate clearly among persons and units involved in the response. The protocols for inquiry, response, and resource coordination are essential and must not be modified based on an individual's possible experiences as a responder.5.7 As an initial contact with the EMS system, the EMD is subject to questioning of actions as they relate to medical practice. This practice may be used by agencies as a recognized baseline for EMD training, practice, and organization and is intended to supplant de facto standards that exist in some areas. This practice will assist in developing sound EMD programs that will reduce the need and potential for legal action and provide a common set of expectations for performance.5.8 It will bring more accurate information into the dispatch office by way of appropriate understanding of the medical condition and therefore better interrogation, caller intervention, and decision-making. It allows for preplanned responses, safer responses (fewer units responding with lights and siren), fuel and energy savings (smaller units and fewer units used when possible), and may save advanced life-support resources for true advanced life-support emergencies when a tiered-level response is available.1.1 This practice covers the definition of responsibilities, knowledge, practices, and organizational support required to implement, perform, and effectively manage the emergency medical dispatch function.1.2 This practice is useful for planning and evaluating the training, implementation, and organizational support to satisfy the functional needs of emergency medical dispatching.1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.1.4 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.