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Covering 29 counties in Utah · Protocols current as of June 18, 2026
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Utah EMS Protocol Guidelines
September 2025 ↗
PDF document
142
Flashcards
70
Quiz questions
34
Medications
3
Resources
Study tools for Utah EMS Protocol Guidelines
A few real flashcards and quiz questions from Utah's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
Post-ROSC: target ETCO₂ and 12-lead EKG timing
After ROSC, assist ventilations to maintain ETCO₂ 35-45 mmHg. Acquire and transmit a 12-lead EKG immediately after establishing ROSC (unless clear non-cardiac cause), then acquire and transmit a second 12-lead EKG 10-15 minutes post-ROSC and prior to scene departure.
Pediatric defibrillation energy dosing
The first shock is delivered at 2 J/kg using either a monophasic or biphasic defibrillator. Subsequent shocks increase by 2 J/kg up to a maximum dose of 10 J/kg.
Cardiogenic shock — fluid therapy decision
In patients with CHF, pulmonary edema, and cardiogenic shock, IV fluids should be withheld to avoid worsening the condition. Management focuses on rapid transport to the hospital; for pediatric patients, apply high-flow oxygen as well.
Resuscitation duration thresholds and survival rates
Patients with an initial shockable rhythm have less than 5% survival after 40 minutes of resuscitation. Patients with initial asystole or PEA have less than 1% survival after 20 minutes. Prolonged attempts should be considered for witnessed collapse with an initial shockable rhythm.
Adult synchronized cardioversion: energy settings for unstable tachycardia
Signs of unstable tachycardia include acute cardiac chest pain, heart failure, altered mental status, or shock (SBP <90 mmHg, cool/pale skin). Initial energy is 100J; repeat doses are 200J. Consider sedation if the patient is awake and peri-stable.
Severe hypothermia cardiac arrest: defibrillation and transport considerations
In cardiac arrest with temperature <86°F (30°C), limit defibrillation attempts to 3 and do not use external pacing, as likelihood of successful defibrillation improves as the patient warms. Pediatric patients should be transported directly to SLC Primary Children's Medical Center for ECMO; adult patients to University of Utah Medical Center or Intermountain Medical Center. Do NOT rewarm these patients en route.
FSED bypass criteria: Cardiac (STEMI)
Suspected STEMIs should bypass FSEDs and be transported to a facility with a Cardiac Cath Lab unless stabilization is needed. Stable chest pain patients without STEMI or serious arrhythmia may be evaluated at an FSED.
Termination of CPR: minimum resuscitation duration requirements
Termination of CPR requires OLMC concurrence and a minimum duration of professional resuscitative efforts of 20 minutes for non-shockable rhythms and 40 minutes for shockable rhythms (not including bystander CPR). Adult cardiac arrest resuscitation may also be terminated if the arrest was unwitnessed by EMS, no shockable rhythm was identified at any time, and no ROSC occurred at any time.
Quiz questions
According to the Utah EMS Cardiac Arrest protocol, after delivering a defibrillation shock to an adult patient in VF, what should the provider do IMMEDIATELY?
- Check the patient's pulse for up to 10 seconds before resuming CPR
- ✓ Resume chest compressions and continue for 2 minutes before checking rhythm/pulse
- Administer 1 mg of epinephrine IV/IO before resuming compressions
- Recharge the defibrillator and prepare for a second immediate shock
You are managing an avalanche victim in cardiac arrest. The patient has a core temperature of 28°C (82.4°F), a burial time of 75 minutes, and a patent airway at extraction. Per the Utah Avalanche Victim Management protocol, what is the most appropriate transport destination?
- Nearest emergency department
- Freestanding Emergency Department (FSED)
- ✓ ECMO facility
- Trauma center
A Paramedic crew is transporting a patient with a suspected STEMI. According to the Utah EMS FSED bypass guidelines, what is the most appropriate destination?
- The nearest FSED, since it is staffed by Board-Certified Emergency Physicians
- The nearest FSED for initial stabilization, then transfer to a Cardiac Cath Lab facility
- ✓ A facility with a Cardiac Cath Lab, bypassing the FSED unless stabilization is needed
- Any emergency department, as STEMI care is not time-sensitive enough to dictate destination
EMS arrives on scene to find an adult patient apneic, pulseless, and in asystole after an unwitnessed cardiac arrest. Bystanders estimate the patient collapsed approximately 20 minutes before EMS arrived and no CPR was started. According to the protocol, which action is most appropriate?
- Begin resuscitation immediately since the arrest was unwitnessed.
- ✓ Withhold resuscitation because the unwitnessed arrest has an estimated collapse-to-CPR interval of >15 minutes with an initial rhythm of asystole.
- Begin resuscitation and terminate after 20 minutes of professional resuscitative efforts for a non-shockable rhythm.
- Contact OLMC immediately before making any decision about resuscitation.
You are an EMT treating a 55-year-old male with chest pain consistent with ACS. His SBP is 96 mmHg. He states he took sildenafil (Viagra) approximately 18 hours ago. Which action is most appropriate regarding nitroglycerin?
- Administer nitroglycerin 0.4 mg SL because his SBP is above 90 mmHg
- Administer nitroglycerin only after confirming IV access is established
- ✓ Do NOT administer nitroglycerin because he took an erectile dysfunction medication within the last 24 hours
- Administer half the standard nitroglycerin dose (0.2 mg) since it has been more than 12 hours since he took sildenafil
A post-ROSC adult patient is hypotensive despite fluid resuscitation. The paramedic is considering a vasopressor infusion. Per the protocol, what is the correct norepinephrine infusion range and target SBP for an adult?
- 0.01–0.5 mcg/kg/min titrated to SBP >90 mmHg
- ✓ 0.05–1 mcg/kg/min titrated up to 30 mcg/min to maintain SBP >100 mmHg
- 1–5 mcg/kg/min titrated to SBP >110 mmHg
- 0.05–1 mcg/kg/min titrated to maintain SBP >70 mmHg
Sourced from Utah's EMS authority
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Utah protocols — FAQ
Are Utah's EMS protocols available offline?
Yes. Download Utah'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 Utah?
Yes. Utah'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 Utah?
No — Pocket Protocols is an independent app and isn't affiliated with or endorsed by any EMS authority. We bring Utah's protocols into a faster, fully offline app and link the authority's own source for every set.
How do Utah protocol updates reach the app?
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