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Covering 64 counties in Colorado · Protocols current as of June 22, 2026
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Denver Metropolitan Prehospital Protocols
January 1st, 2026 ↗
PDF document
196
Flashcards
101
Quiz questions
43
Medications
4
Resources
Study tools for Denver Metropolitan Prehospital Protocols
A few real flashcards and quiz questions from Colorado's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
Why Roll a Pregnant Trauma Patient to the Left?
Rolling a second-trimester or later pregnant patient to the left prevents the gravid uterus from compressing the inferior vena cava. IVC occlusion reduces venous return to the heart, worsening hemodynamic instability in a trauma patient.
Post Cardiac Arrest Care: Three main goals of extended care treatment
The three goals are: (1) identify STEMI if present, (2) prepare for and treat post cardiac arrest complications, and (3) minimize damage to the heart and brain.
STEMI Alert: Goals of extended care treatment
The three goals of extended care treatment in a STEMI alert are: (1) serial ECGs, (2) pain control, and (3) identification and treatment of arrhythmia. These are ongoing priorities throughout transport.
Clinically significant bradyarrhythmia — heart rate threshold (adults & children)
A clinically significant bradyarrhythmia is generally associated with heart rates less than 60 beats per minute in both adults and children. Reference ACLS/PALS for further care details.
Post Cardiac Arrest Care: How often should reassessments be performed, and what four areas are assessed?
Reassessments should be performed at least every 10 minutes. The four areas assessed are: airway and ventilation, circulatory status, neurologic status, and pain control.
Diltiazem: Indications
Diltiazem is indicated for (1) Atrial Fibrillation/Atrial Flutter with a rapid ventricular response and (2) Narrow complex tachycardia refractory to adenosine. Both indications require Base Contact.
Clinically significant tachyarrhythmia — heart rate thresholds by age
In adults, clinically significant tachyarrhythmia is generally associated with heart rates >150 bpm. In children it is >180 bpm, and in infants it is >220 bpm. Lower heart rates in children likely represent sinus tachycardia; search for and treat underlying causes.
Post Cardiac Arrest STEMI Notification: What should you specify when notifying the accepting facility?
When the ECG meets cardiac alert criteria, notify the accepting facility and specify that you have a cardiac arrest with ROSC and an ECG showing a STEMI.
Quiz questions
According to the STEMI Alert protocol, how frequently must reassessment of airway/ventilation, circulatory status, ECG, and pain control be performed at a minimum?
- Every 5 minutes
- ✓ Every 10 minutes
- Every 15 minutes
- Every 20 minutes
You achieve ROSC in a patient following cardiac arrest. The 12-lead ECG meets cardiac alert criteria. Which action is required by protocol?
- ✓ Notify the accepting facility, specifying you have a cardiac arrest with ROSC and ECG showing a STEMI
- Administer aspirin and transport without notification until arrival
- Perform serial ECGs every 5 minutes and notify only if the STEMI resolves
- Contact medical control for permission before notifying the receiving facility
A patient in narrow complex tachycardia refractory to adenosine receives the first dose of diltiazem without conversion. Which of the following correctly describes the repeat dosing per protocol?
- Repeat the same 0.25 mg/kg dose in 5 minutes
- ✓ Repeat at 0.35 mg/kg IV/IO over at least 2-3 minutes in 10 minutes if necessary
- Repeat at 0.25 mg/kg IV/IO over at least 2-3 minutes in 10 minutes if necessary
- Administer a third dose of adenosine before repeating diltiazem
Your STEMI patient develops shock. The 12-lead ECG shows ST elevation in leads II, III, and aVF with reciprocal changes, and the patient now has a complete heart block. Which intervention is most appropriate per protocol?
- Administer atropine and follow the vasopressor protocol
- Administer a fluid bolus up to 2 × 500 mL of crystalloid
- ✓ Utilize the transcutaneous pacing protocol rather than atropine
- Initiate vasopressor support immediately without attempting fluids
Your post-cardiac arrest patient has an inferior MI with bradycardia and a high-grade heart block. According to protocol, what is the correct intervention?
- Administer atropine per the bradycardia protocol
- Administer a fluid bolus to treat the heart block
- ✓ Utilize the transcutaneous pacing protocol, not atropine
- Initiate vasopressor support as the first-line treatment
A patient with cardiogenic shock is found to have a heart rate of 165 bpm. According to this protocol, which statement BEST describes how this tachyarrhythmia should be approached?
- Immediately begin volume replacement and vasopressors to treat the shock.
- ✓ Attempt to correct the unstable arrhythmia prior to treating with volume replacement or vasopressors.
- Administer a 250 mL fluid bolus and reassess for pulmonary edema.
- Treat as sinus tachycardia and search for underlying causes without further intervention.
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Colorado protocols — FAQ
Are Colorado's EMS protocols available offline?
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Is Pocket Protocols official, or affiliated with Colorado?
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How do Colorado protocol updates reach the app?
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