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Tennessee EMS protocols,
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Offline, county-specific protocols for Tennessee EMS providers — searchable, with a full medication reference, hospital finder, and study tools built in.
Covering 95 counties in Tennessee · Protocols current as of June 18, 2026
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Tennessee State Guidelines
2024-2025 ↗
PDF document
1,032
Flashcards
330
Quiz questions
46
Medications
99
Resources
Study tools for Tennessee State Guidelines
A few real flashcards and quiz questions from Tennessee's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
Define 'para' and 'gravida' as used in the Placenta Previa history assessment.
'Para' refers to the number of births the patient has had, while 'gravida' refers to the total number of pregnancies, including the current one. Both are key components of the obstetrical history gathered during assessment of Placenta Previa.
Tracheal deviation in tension pneumothorax — which direction?
In tension pneumothorax, the trachea deviates AWAY from the affected (injured) side due to the buildup of pressure in the pleural space pushing mediastinal structures toward the opposite side. This is a late and ominous sign.
What does 'para' vs. 'gravida' mean in obstetrical assessment?
'Para' refers to the number of births the patient has had, while 'gravida' refers to the total number of pregnancies. Both are key components of the obstetrical history assessed in a prolapsed cord emergency.
When is SOP #111 (Persistent V-Fib/Pulseless V-Tach) indicated?
SOP #111 is used after the standard Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol has been ineffective. The patient presents unresponsive and pulseless, with persistent V-Fib/V-Tach or a return to this rhythm after ROSC or other rhythm changes.
Pulseless Electrical Activity (PEA) — Definition
PEA is the presence of an electrical cardiac rhythm on the monitor without a palpable pulse. The rhythm must be confirmed with electrodes in two leads to distinguish it from artifact or true cardiac activity.
SVT diagnostic criteria: adult vs. pediatric heart rate thresholds
Adults: heart rate > 160 bpm with QRS width < 0.12 sec (3 small blocks). Pediatrics: infant rate > 220 bpm, child rate > 180 bpm. Pediatric SVT typically shows no P waves and no beat-to-beat variability.
ECG criteria for Ventricular Tachycardia with a Pulse (adult vs. pediatric)
In adults, VT with a pulse is identified by a heart rate >150/min and QRS >0.12 sec (3 small blocks). In pediatrics, the criteria are heart rate >200/min and QRS >0.09 sec.
Symptomatic Bradycardia: Defining Heart Rate Thresholds (Adult vs. Pediatric)
In adults, symptomatic bradycardia is defined as a heart rate less than 60 bpm with symptoms. In pediatric patients, the threshold is a heart rate less than 80/min for infants or less than 60/min for children.
Quiz questions
According to SOP #101, what is the correct CPR compression rate for ALL ages using standard manual compressions?
- 80 per minute
- ✓ 100–110 per minute
- 90–100 per minute
- 110–120 per minute
You are an AEMT treating an adult patient with symptomatic bradycardia. The patient's fingerstick glucose reads 48 mg/dL. Per SOP #102, what is the correct action?
- Administer Atropine 0.5 mg IV immediately
- ✓ Titrate D10 slowly per hypoglycemia guidelines
- Administer Glucagon 1-2 mg IM
- Begin external transcutaneous pacing
According to SOP #106, which of the following PVC presentations meets the criteria for treatment intervention under this protocol?
- Unifocal PVCs at a rate of 10 per minute in an otherwise stable patient
- A single PVC in a non-AMI patient with no chest pain
- ✓ Multi-focal PVCs in any patient
- Unifocal PVCs at a rate of 12 per minute with no other symptoms
An EMT arrives on scene to find a 58-year-old male with atypical chest pain and a blood pressure of 112/74 mmHg. The patient has his own nitroglycerin prescription with him. Which of the following actions is within EMT scope per SOP #104?
- Establish IV access and administer NS TKO before giving nitroglycerin
- ✓ Assist the patient in self-administering his own nitroglycerin sublingually and reassess every 5 minutes up to 3 doses
- Administer 0.4 mg nitroglycerin independently without patient assistance, repeating every 5 minutes
- Withhold nitroglycerin until Medical Control is contacted, since the patient has atypical chest pain
A paramedic is treating an adult patient in SVT. After a successful Valsalva maneuver setup, Adenosine 12 mg IV is administered but the rhythm does not convert. According to the protocol, what is the correct next step?
- Immediately proceed to synchronized cardioversion at 50 joules
- ✓ Repeat Adenosine at 12 mg once, flushed with 10 cc NS
- Administer Adenosine 6 mg as a lower repeat dose
- Administer Diazepam 2–5 mg IV and prepare for cardioversion
You are a Paramedic treating an adult patient in PEA arrest. What is the correct dose and concentration of EPINEPHrine to administer, and how should it be timed?
- EPINEPHrine 1:1,000 (1 mg/mL), 1 mg IVP/IO, administered every 5–10 minutes
- ✓ EPINEPHrine 1:10,000 (0.1 mg/mL), 1 mg IVP/IO, administered as early in the arrest as possible
- EPINEPHrine 1:10,000 (0.1 mg/mL), 0.5 mg IVP/IO, administered only after two rounds of CPR
- EPINEPHrine 1:1,000 (1 mg/mL), 0.01 mg/kg IVP/IO, administered every 3–5 minutes
Sourced from Tennessee's EMS authority
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Tennessee protocols — FAQ
Are Tennessee's EMS protocols available offline?
Yes. Download Tennessee'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 Tennessee?
Yes. Tennessee'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 Tennessee?
No — Pocket Protocols is an independent app and isn't affiliated with or endorsed by any EMS authority. We bring Tennessee's protocols into a faster, fully offline app and link the authority's own source for every set.
How do Tennessee 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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