EMS Protocols – ALS

These Region 11 Chicago EMS System Protocols, Policies, and Procedures for EMTs and Paramedics are prehospital medical guidelines for patient assessment, treatment, and transportation within the system.  They provide a framework for all patient encounters and Online Medical Control should be consulted in situations where there is not clear direction from the written documents.

Download Complete ALS Protocols


Adult Initial Assessment
Routine Medical Care (RMC)


Suspected Acute Coronary Syndrome/Cardiac Chest Pain
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)
Syncope or Presyncope


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


Altered Mental Status
Suspected Acute Stroke
Behavioral Emergency
Acute Nausea and Vomiting
Pain Management
Taser/Electrical Weapon Device Exposure
Non-Cardiogenic/Non-Traumatic Shock
Renal Patients
Suspected COVID-19


Heat Illness
Crush Injury
Burns – Electrical
Burns – Chemical
Haz Mat / Toxic Exposure
Hazardous Events / Suspected Biological
Hazardous Events / Chemical
Hazardous Events / Cyanokit Antidote Administration


General Trauma Management
Blast Injury (under revision)
Crush Injury (under revision)
Extremity Trauma / External Hemorrhage Management
Facial / Dental Injury (under revision)
Head Trauma
High Threat Considerations / Active Shooter Scenario (under revision)
Spinal Care
Traumatic Arrest


Emergency Childbirth
Postpartum Care
Obstetrical Complications
Neonatal Resuscitation


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 Acute Nausea and Vomiting
Pediatric Pain Management
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


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
LifePack 1000 Automated External Defibrillator (3 lead AED)
Transcutaneous Pacing
12 Lead Electrocardiogram (ECG) Procedure
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
Latex Allergic Patients