ALS Standing Medical Orders

The following Standing Medical Orders (SMOs) are to be utilized as the pre-hospital medical treatment guidelines by the system’s EMT-Ps.  It is understood that deviations from the SMOs may be necessary in the interest of assuring that a patient is transported to an appropriate medical facility rather than receive no care at all.

Download Complete ALS Standing Medical Orders

A. GENERAL

Routine Medical Care (RMC)

B. CARDIAC

Suspected Acute Coronary Syndrome
Pulmonary Edema
Ventricular Fibrillation & Pulseless Ventricular Tachycardia
Pulseless Electrical Activity / Asystole
Wide Complex Tachycardia with Pulse
Narrow QRS Complex Tachycardia
Bradycardia with Pulse
Ventricular Assist Device (VAD)

C. RESPIRATORY

Respiratory Distress
Respiratory Obstruction
Allergic Reaction and/or Anaphylaxis
Suspect Carbon Monoxide Poisoning

D. MEDICAL

Altered Mental Status
Seizures
Suspected Acute Stroke
Behavioral Emergency
Taser/Electrical Weapon Device Exposure
Non-Cardiogenic/Non-Traumatic Shock
Renal Patients

E.ENVIRONMENTAL

Frostbite
Hypothermia
Heat Illness
Burns
Burns – Electrical
Burns – Chemical
Haz Mat / Toxic Exposure
Hazardous Events / Nuclear/ Blast Injuries
Hazardous Events / Suspected Biological
Hazardous Events / Chemical
Hazardous Events / Cyanokit Antidote Administration

F. TRAUMA

Routine Trauma Care (RTC)
Head Trauma
Spinal Trauma
Airway Trauma
Chest Trauma
Extremity Trauma
Trauma in Pregnancy
Traumatic Hemorrhagic Shock
Traumatic Arrest

G.OBSTETRICS

Emergency Childbirth
Postpartum Care
Obstetrical Complications
Neonatal Resuscitation

H. PEDIATRICS

Pediatric Initial Assessment
Pediatric Routine Medical Care (PRMC)
Pediatric Routine Trauma Care (PRTC)
Pediatric Ventricular Fibrillation & Pulseless Ventricular Tachycardia
Pediatric Pulseless Electrical Activity / Asystole
Pediatric Wide Complex Tachycardia
Pediatric Narrow QRS Complex Tachycardia
Pediatric Bradycardia
Pediatric Respiratory Distress
Pediatric Respiratory Obstruction
Pediatric Allergic Reaction and/or Anaphylaxis
Pediatric Tracheostomy with Respiratory Distress
Pediatric Suspect Croup or Epiglottitis
Pediatric Altered Mental Status
Pediatric Seizures
Pediatric Extremity Trauma
Pediatric Non-Traumatic Shock
Pediatric Hypothermia
Pediatric Heat Illness
Pediatric Burns
Pediatric Burns – Electrical/Lightning Burns
Pediatric Burns – Chemical
Pediatric Hazardous Events/Toxic Exposure
Pediatric Hazardous Events/Nuclear Blast Injuries
Pediatric Hazardous Events / Suspected Biological
Pediatric Hazardous Events / Chemical
Pediatric Hazardous Events / Nerve Agents
Pediatric Near Drowning
Pediatric Drug Dosing Reference Guide
Pediatric Resuscitation Card

I.APPENDIX

Approved Oxygen Delivery Methods
Glasgow Coma Scale
Cincinnati Stroke Scale
Advanced Airway Management
Cardiac Arrest Management
Adult Post-Cardiac Arrest Care & Therapeutic Hypothermia
Needle Cricothyrotomy
Needle Decompression
Automatic Ventilators
Continuous Positive Airway Pressure (CPAP)
Intra-Nasal Drug Administration
Defibrillation/Cardioversion
LifePack 1000 Automated External Defibrillator (3 lead AED)
Transcutaneous Pacing
Intravenous Therapy
Manual Pediatric Intraosseous Infusion
EZ-IO Pediatric Intraosseous Infusion
EZ-IO Adult Intraosseous Infusion
Alternate Vascular Sites for Patients in Extremis
Tourniquet Application
Spinal Immobilization
Latex Allergic Patients
Abbreviations/Acronyms