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Covering 66 counties in South Dakota · Protocols current as of June 18, 2026
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South Dakota State BLS Guidelines
Updated: July 1, 2022 ↗
PDF document
616
Flashcards
308
Quiz questions
2
Resources
Study tools for South Dakota State BLS Guidelines
A few real flashcards and quiz questions from South Dakota's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
Definition of Syncope
Syncope is defined by both the loss of consciousness AND the loss of postural tone, resolving spontaneously without medical intervention. It is typically abrupt in onset and resolves equally quickly. EMS providers may find the patient already awake and alert on arrival.
12-lead EKG acquisition time goal in ACS
EMS providers must acquire a 12-lead EKG within 10 minutes for all patients exhibiting signs and symptoms of ACS. The 12-lead EKG is the primary diagnostic tool that identifies a STEMI, and serial EKGs are suggested, especially when clinical changes are noted.
VAD pump functioning — should CPR be performed?
CPR should NOT be performed if there is any evidence the pump is still functioning. The decision to perform CPR must be made using best clinical judgment in consultation with the patient's VAD-trained companion and the VAD coordinator (or direct medical oversight if the coordinator is unavailable).
Target oxygen saturation range in post-ROSC patients
The protocol targets an oxygen saturation of 94–98% in post-ROSC patients. Hyperoxygenation must be avoided, as it can worsen neurologic outcomes after resuscitation.
Non-traumatic arrest TOR criteria (EMT level) — list all required conditions
Patient ≥18 years old; arrest NOT witnessed by EMS/first responder; no ROSC after 3 full rounds of CPR and AED analysis; no AED shocks delivered; no evidence of neurological function (non-reactive pupils, no response to pain, no spontaneous movement); no evidence or suspicion of hypothermia; all EMS personnel agree termination is appropriate; and direct medical oversight is contacted before terminating.
Definition of Presyncope
Presyncope is defined as the prodromal symptoms of syncope — the warning signs that precede a syncopal episode. It usually lasts seconds to minutes and may be described by the patient as 'nearly blacking out' or 'nearly fainting.'
Defibrillation energy dose: monophasic vs. biphasic devices
For monophasic devices, use 360 J (or 4 J/kg for children). For biphasic devices, follow the manufacturer's recommendation; if unknown, use the highest setting possible. The maximum setting should be used for both initial and subsequent defibrillation attempts.
AC vs. DC: Which is more likely to cause ventricular fibrillation vs. asystole?
AC (alternating current) is more likely to cause ventricular fibrillation, while DC (direct current) is more likely to cause asystole. AC can also cause repeated muscle contractions, whereas DC typically causes only one muscle contraction.
Quiz questions
According to the protocol, what is the maximum time allowed from patient contact to acquisition of a 12-lead EKG for a patient exhibiting signs and symptoms of ACS?
- 5 minutes
- ✓ 10 minutes
- 15 minutes
- 20 minutes
You arrive on scene to find a 68-year-old male who fainted while jogging. He is now conscious and alert, denies any current complaints, and his vitals are within normal limits. Per this protocol, what is the most appropriate next step?
- Allow the patient to refuse transport since he is now asymptomatic and appears normal
- ✓ Transport the patient to the ED, as syncope during exercise often indicates an ominous cardiac cause
- Treat on scene and release to family care, as syncope resolved spontaneously without intervention
- Refer the patient to follow up with his primary care physician within 24 hours
You arrive on scene to find an LVAD patient who is unresponsive. The VAD is alarming, and you cannot auscultate the characteristic pump hum. You have attempted all troubleshooting steps and cannot restore pump function. Under which conditions may you initiate CPR per protocol?
- Immediately upon finding the patient unresponsive, regardless of pump status
- ✓ Only after confirming the pump has stopped, troubleshooting has failed, AND the patient is unresponsive with no detectable signs of life
- After contacting medical oversight, even if the pump is still functioning
- Only if the VAD coordinator explicitly orders CPR over the phone
You are ventilating an adult patient who just achieved ROSC after a prolonged cardiac arrest. According to the protocol, what is the correct target ventilation rate and ETCO2 range?
- 10-12 breaths/min with ETCO2 of 35-45 mmHg
- ✓ 6-8 breaths/min with ETCO2 of 30-40 mmHg
- 8-10 breaths/min with ETCO2 of 40-50 mmHg
- 6-8 breaths/min with ETCO2 of 45-55 mmHg
According to the protocol, what is the correct defibrillation energy setting for a monophasic defibrillator used on an adult patient in cardiac arrest?
- 200 J for initial shock, escalating to 360 J for subsequent shocks
- ✓ 360 J for both initial and subsequent defibrillation attempts
- 150–200 J following the manufacturer's biphasic recommendation
- 120 J, escalating by 20 J with each subsequent shock
An EMT arrives on scene to find a 45-year-old male in cardiac arrest. Bystanders state the arrest was not witnessed by EMS or first responders. After 3 full rounds of CPR and AED analysis, there is no ROSC, no AED shocks were delivered, pupils are non-reactive, and there is no response to pain. The patient has no signs of hypothermia. What is the NEXT required step before terminating resuscitation?
- Immediately terminate resuscitation since all criteria are met
- ✓ Contact direct medical oversight before termination of resuscitative efforts
- Transport the patient to the ED since field termination is not permitted
- Perform one additional round of CPR and repeat AED analysis
Sourced from South Dakota's EMS authority
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South Dakota protocols — FAQ
Are South Dakota's EMS protocols available offline?
Yes. Download South Dakota's protocol set once and every protocol, medication, and hospital is available with no signal — built for basements, rural calls, and dead zones.
Are the protocols specific to my county in South Dakota?
Yes. South Dakota's protocols are scoped by county and region, so every provider sees exactly the set that governs where they respond. You can add more than one if you run in multiple areas.
Is Pocket Protocols official, or affiliated with South Dakota?
No — Pocket Protocols is an independent app and isn't affiliated with or endorsed by any EMS authority. We bring South Dakota's protocols into a faster, fully offline app and link the authority's own source for every set.
How do South Dakota protocol updates reach the app?
When the EMS authority publishes a new version and it goes live in Pocket Protocols, the app refreshes automatically — crews are never working from a stale copy. We monitor official sources for changes every day.
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