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A detailed overview of standard operating procedures (sops) for emergency medical technicians (emts), covering essential medications, skills, and protocols. it includes formularies for various medications, outlining their classes, actions, dosages, routes of administration, contraindications, and adverse reactions. the document also details procedures such as cervical stabilization, hemorrhage control, and medication administration, offering key procedural considerations and contraindications for each. this resource is valuable for emt training and reference.
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SOP ✔✔Scope of practice
Medications Emergency Medical Technicians (EMT's) can provide. ✔✔Acetylsalicylic Acid
(aspirin).
Activated Charcoal.
Bronchodilator Metered Dose Inhaler.
Epinephrine Auto-injector.
Glucose - oral.
Nitroglycerin.
Skills Emergency Medical Technicians
(EMTs) can perform. ✔✔Airway adjunct - NPA.
Airway adjunct - OPA/NPA.
Airway suction.
Cervical stabilization.
Defibrillation - AED.
Glucose measurement.
Medication administration.
Oxygen administration.
Action.
Platelet inhibition.
Dose.
Adult.
324 mg PO (81 mg tablets x 4).
Pediatric.
Not recommended for use.
Route.
PO. (chew and swallow)
Contraindications.
Allergy to aspirin.
Adverse reactions.
none.
Formulary.
Activated charcoal ✔✔Class.
Absorbent.
Action.
Inhibits gastrointestinal absorption of toxic substances.
Dose.
Adult.
50 gm PO
Pediatric.
1.0 gm/kg PO; dose 10 gm max. Dose 50 gm.
Formulary.
Activated charcoal.
Continued ✔✔Contraindications.
Inhalation.
Contraindications. Hypersensitivity to the drug.
Adverse reactions. tachycardia; palpitations; anxiousness; headache
Sympathomimetic.
Bronchodilation; positive chronotrope; positive inotrope.
Adult.
Assist patient with his or her own Epinephrine auto-injector.
(Pediatric
same as adult)
Formulary.
EPINEPHRINE AUTO-INJECTOR.
Continued ✔✔CONTRAINDICATIONS.
Underlying cardiovascular disease / angina; hypertension; pregnancy; patient over 40 years of age;
hyperthyroidism.
Palpitation due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present;
elevation of blood pressure; headache; anxiousness.
Formulary,
GLUCOSE ✔✔CLASS.
Carbohydrate.
Assist pt with own NTG as prescribed; may repeat x 3 ✔✔CLASS.
Vasodilator.
Dilates systemic arteries and veins; reduces both preload and afterload.
Adult.
See specific protocol.
(Pediatric
Same)
Sublingual spray or tablet.
Formulary.
NITROGLYCERIN.
Assist pt with own NTG as prescribed; may repeat x 3.
Continued. ✔✔CONTRAINDICATIONS.
Hypotension (do not administer if systolic pressure below 100 mmHg unless ordered by a physician);
use of Viagra (Sildenafil) or similar medication within the past 24 hours or 48 hours for Tadalafil (Cialis);
patients with demonstrated hypersensitivity to nitrates or nitrites.
Hypotension.
part 1 ✔✔Cervical stabilization is indicated in any patient who meets the indications (A-E)
below:
Indications:
This procedure may be performed on any patient with potential for spinal injury
based upon the following (NEXUS) criteria:
B. Injuries where placement of the collar might compromise patient
assessment, airway management, ventilation and/or hemorrhage control.
C. Patients in cardiac arrest.
Continued part 3 ✔✔Key procedural considerations:
A. If (A-E) above are ALL NEGATIVE, cervical stabilization is not required.
B. If required, cervical stabilization is the placement of an approved, properlysized
cervical collar before the patient is moved.
C. Backboards are only indicated for extrication and patient movement. Patients
are not to be transported on backboards (unless movement off the backboard
would delay immediate transport of patients with life-threatening injuries
or acute spinal injuries).
D. Tape, head straps, wedges, and head and/or neck support devices are not
recommended.
E. Patients found in motor vehicles should be asked if they are able to exit
the motor vehicle on their own. If so, they should be assisted to a soft
stretcher and secured for transport. Patients unable to exit the vehicle on
their own accord should be removed by the appropriate extrication method.
F. Once on the stretcher, the patient may be moved to a semi-Fowler's or
high-Fowler's position for comfort.
G. If a backboard is used for extrication or movement, the patient should be
immediately moved to a soft mattress, if possible.
H. In special situations, alternate stabilization devices (e.g. vacuum mattress,
KED, etc. may be used as indicated).
I. Pediatric patients may be stabilized in an approved car seat or with a
commercial pediatric stabilization device.
HEMORRHAGE CONTROL TOURNIQUET ✔✔Indications:
This procedure may be performed on any patient that has bleeding from an
extremity than can not be controlled by direct pressure.
Contraindications: None
Right patient
Right dose
Right time
Right route
Right documentation
E. Dispose of syringe and other material in proper container
TRACTION SPLINT ✔✔Indications:
This procedure may be performed on any patient with an isolated closed midshaft
femur fracture.
Contraindications:
A. Pelvic fracture or instability
B. Knee, lower leg, or ankle instability.
(Key procedural considerations:
A. Assess motor, sensory, and circulatory function in the involved extremity.
B. Apply traction splint per the manufacturer's guidelines.
C. Initiate mechanical traction to match manual traction.
D. Reassess motor, sensory, and circulatory function in the involved extremity.)
CHRONIC PUBLIC INEBRIATE ✔✔1. A person who is suspected to be under the influence of
alcohol and has no other emergent medical need may be
transported to an approved alcohol and drug abuse facility rather than a hospital's emergency department IF the
patient meets ALL of the following criteria:
A. Patient is able to stand with minimal assistance of one or two people.
B. Vitals as follows:
Diastolic 60 - 100
. 3) Respiratory rate: 12 - 22
Blood glucose between 50 - 250
Glasgow Coma Score ≥
O2 >94% or 90% if smoker
B. For any medical emergency in which the EMS provider's judgment suggests consultation with a telemetry
physician is necessary.
C. For all trauma patients going to a trauma center.
D. When telemetry contact is required per protocol.
A. Patient age
B. Gender
C. Mechanism of injury
D. Ambulatory at scene
E. Suspected injuries
F. Vital signs
G. Airway status
H. Neurologic status
I. ETA
J. An incident identifier if multiple patients are involved (e.g. fire department command code "Main Street
Command")
A. Attendant/vehicle identification
B. Nature of call: INFORMATION ONLY or REQUEST FOR PHYSICIAN ORDERS
C. Patient information (i.e. number, age, sex)
D. Patient condition (i.e. stable, full arrest)
E. History
Basic problem or chief complaint
Pertinent associated symptoms
Time since onset
Past history, if pertinent
F. Objective findings
General status of patient
Level of responsiveness
Vital signs
Pertinent localized findings
Working impression of patient's problem
G. Treatment
In progress
Requests for drugs or procedures
