Front Matter 0-020 - Standing Orders by Agency Type

CMH EMS & MIH Protocols

Dispatch Centers:

Public Safety Dispatchers and Emergency Medical Dispatchers (EMD) will utilize the following protocols while recieving emergency and non-emergency calls where persons may be ill, injured, and/or needing medical transport. Additionally, these protocols shall be used while dispatching ambulances to patients that are ill, injured, or needed medical transport.

Refer to each specific protocol based on the patient's complaint and follow the general guidance found in Guideline 1-200 - Ambulance Dispatch.

Community Responders:

Persons in the communities served by Citizens Memorial Hospital using or maintaining Automated External Defibrillators (AEDs) will utilize the following protocols to enhance survivability from cardiac arrest:

First Response Agencies:

Emergency Medical Responders (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), Registered Nurse (RN), Paramedic (Medic), and Community Paramedic (CP) providers will utilize the following protocols while on scene of an illness or injury to coordinate care and stabilize the patient. AEMT, RN, Medic, and CP providers responding with a first responder agencies will operate as EMTs using the following protocols, unless their agency is a licensed Emergency Medical Response Agency (EMRA) with the Missouri BEMS.

EMS Transport Agencies:

EMT, AEMT, RN, Medic, and CP providers will utilize the following protocols while on scene and during transport to coordinate care, stabilize the patient, and improve their condition where possible. The transporting ALS provider is ultimately responsible to ensure complete patient care, including BLS-level procedures.

ALS-Level Licensure Definition:

AEMT, RN, Medic, and CP providers responding with an EMRA or ALS Transport Agency are considered ALS personnel.


Change Log:

DateLink to
Description of change
02/03/16Added this section to handle specifics for each agency that were previously handled on separate signature pages.
02/06/16Added community responder AED content.
04/12/16pdfAdded reference for EMD to Section 6-020 - Air Ambulance.
07/28/16Clarified first responder standing orders regarding AEMT, RN, and paramedics responding with first responder agencies may only perform at the EMT level.
11/11/17pdfAdded reference to Protocol 6-090 - Hazardous Atmosphere Standby.
08/24/18pdfAdded dispatch codesother requirments for dispatchers to dispatch EMS SupervisorRescue Task Force.
07/23/19pdfAdded dispatch requirementslink to performance graphs.
03/28/20Added not to MPDS Protocol 33 that this card was only to be used for transfers out of the hospital - all other locations should use Protocols 1-32.
04/04/20Moved most of the EMD section (without substantive modification) to Protocol 1-200 - Ambulance Dispatch.
06/05/21pdfMoved to
03/15/23pdfAdded modifications to allow ALS providers responding with EMRA-licensed agencies. Approved by Dr. Butvilas and protocol committee on 1/25/23. Added CP.

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