PSTN usage records are text labels. MS Teams uses them to link components in the call routing process that share the same label:
Each emergency routing policy has a single PSTN usage. Calls routed by the policy can use voice routes with the same PSTN usage.
Each voice routing policy has a list of PSTN usages. Calls routed by the policy can use voice routes set with one of those PSTN usages.
Each voice route has a single PSTN usage.