Prehospital care varies from agency to agency, and nobody could see how.
Protocols live in thousands of separate PDFs, so the differences between them have never been readable in one place. The United States EMS Protocol Census reads what agencies publish and turns it into a versioned public record of the drugs, doses and routes they carry, so you can compare agencies across the country. It rebuilds itself every night from the agencies' own documents.
251 protocols223 agencies159 agency pages1,739 documents read241 waiting to be matched to an agency27,740 dosesas of 2026-09-20
Why it matters
- A medic who changes agencies relearns every dose. The drug is the same and the number is different, and until now there was no way to see which agencies differ or by how much.
- A medical director revising a protocol has no benchmark. Writing the next version means guessing at what everyone else does. The census shows what the rest of the country actually carries, with the documents behind it.
- Researchers have never had the dataset. There has been no denominator for prehospital medicine, so questions about how care varies could not be asked, let alone answered.
- Arguing for EMS pay, training and staffing takes evidence. Anecdote loses those arguments. Numbers that anyone can check and cite do better.
- It updates every night, and agencies decide whether they are in it. New documents are read and revisions become new versions with the old one kept in the history. Send a public URL to be listed, or ask to be removed and it comes down the same day, no reason needed.
26,551 entries parsed to a number and route, 477 partially, 712 kept as written. Raw entries are counted and shown as written, never dropped. 64 more agencies are counted but have too little published detail for a page yet.
Drugs272
Doses, indications and routes for each, across every agency that carries it.
- Acetaminophen
- Acetazolamide
- Acetylcysteine
- Activated Charcoal
- Acyclovir
- Adenosine
- Adenozi̇N
- Adrenali̇N
- Albumin
- Albuterol
- Albuterol-Ipratropium
- Alteplase
- Aminophylline
- Ami̇Odaron
- Amiodarone
- Amoxicillin-Clavulanate
- Ampicillin
- Andexanet Alfa
- Antacid
- Aseti̇Lsali̇Si̇Li̇K Asi̇T
- Aspirin
- Atnaa Kit
- Atox Combopen
- Atropi̇N
- Atropine
- Benztropine
- Betamethasone
- Bismuth Subsalicylate
- Blood Products
- Box Jellyfish Antivenom
- Bumetanide
- Buprenorphine
- Buprenorphine-Naloxone
- Caffeine
- Caffeine Citrate
- Calcium
- Calcium Chloride
- Calcium Gluconate
- Cana
- Captopril
- Casirivimab
- Cefazolin
- Cefepime
- Ceftriaxone
- Cephalexin
- Cetirizine
- Charcoal
- Cimetidine
- Ciprofloxacin
- Cisatracurium
- Clevidipine
- Clindamycin
- Clonidine
- Clopidogrel
- Clopidogrel Bisulfate
- Dantrolene
- Dexamethasone
- Dexmedetomidine
- Dextrose
- Diazepam
- Di̇Azepam
- Diazoxide
- Di̇Fenhi̇Drami̇N
- Digoxin
- Diltiazem
- Di̇Lti̇Azem
- Dimenhydrinate
- Dimercaprol
- Diphenhydramine
- Dobutamine
- Dopami̇N
- Dopamine
- Doxycycline
- Droperidol
- Enalapril
- Enalaprilat
- Enoxaparin
- Epinephrine
- Eptifibatide
- Ertapenem
- Esmolol
- Etomidate
- Famotidine
- Feni̇Rami̇N Maleat
- Feni̇Toi̇N
- Fentani̇L
- Fentanyl
- Fentanyl And Midazolam
- Fexofenadine
- Flumazenil
- Fluorescein Stain
- Fomepizole
- Fosphenytoin
- Furosemi̇D
- Furosemide
- Gentamicin
- Glucagon
- Glucose Paste
- Haloperidol
- Heparin
- Heparin Sodium
- Hextend
- Human Fibrinogen
- Hydralazine
- Hydrocortisone
- Hydrocortisone Succinate
- Hydromorphone
- Hydroxocobalamin
- Hydroxocobalamine
- Hydroxycobalamin
- Hydroxyzine
- Hypertonic Saline
- Ibuprofen
- İBuprofen
- Ibutilide
- Idarucizumab
- Imdevimab
- Insulin
- Ipatropium
- Ipecac
- Ipratropium
- Ipratropium Bromide-Albuterol
- İPratropi̇Um BromüR
- İSosorbi̇D Di̇Ni̇Trat
- Isosorbide Dinitrate
- Iv Acetaminophen
- Kalsi̇Yum Glukonat
- Karbetosi̇N
- Kayexalate
- Ketamine
- Ketorolac
- Labetalol
- Levalbuterol
- Levetiracetam
- Leveti̇Rasetam
- Levosalbutamol
- Lidocaine
- Lidocaine Gel
- Li̇Dokai̇N
- Loperamide
- Loratadine
- Lorazepam
- Low Titer O Whole Blood
- Magnesium Sulfate
- Magnesium Sulphate
- Magnezyum SüLfat
- Mannitol
- Meclizine
- Meloxicam
- Meperidine
- Metaproterenol
- Metaraminol
- Methohexital
- Methoxyflurane
- Methylene Blue
- Methylergonovine
- Methylprednisolone
- Methylprednisolone Sodium Succinate
- Methylprednisone
- Meti̇L Predni̇Zolon
- Metoclopramide
- Metoprolol
- Metoprolol Tartrate
- Midazolam
- Mi̇Dazolam
- Milrinone
- Misoprostol
- Modafinil
- Morphine
- Morphine And Midazolam
- Moxifloxacin
- N-Acetylcysteine
- Naak
- Nalokson
- Naloxone
- Naproxen
- Nerve Agent Antidote Kit
- Nicardipine
- Ni̇Fedi̇Pi̇N
- Nifedipine
- Nitro-Glycerine
- Nitro-Glycerine Paste
- Nitroglycerin
- Norepinephrine
- Octaplex
- Octreotide
- Odansetron
- Olanzapine
- Ondansetron
- Opioids
- Oral Glucose
- Oral Glucose Gel
- Oxycodone
- Oxymetazoline
- Oxytocin
- Pancuronium
- Pantoprazole
- Parasetamol
- Phenobarbital
- Phenylephrine
- Phenytoin
- Phosphenytoin
- Phytonadione
- Piperacillin Sodium-Tazobactam Sodium
- Piperacillin-Tazobactam
- Plasma
- Potassium Chloride
- Potassium Iodide
- Pralidoxime
- Prednisolone
- Prednisone
- Procainamide
- Prochlorperazine
- Promethazine
- Proparacaine
- Propofol
- Propranolol
- Prostaglandin E1
- Prostaglandins
- Protamine
- Proton Pump Inhibitors
- Pseudoephedrine
- Pyridoxine
- Racemic Epinephrine
- Ranitidine
- Recombinant Factor Xa
- Rectal Valium
- Reteplase
- Risperidone
- Rocephin
- Rocuronium
- Salbutamol
- Scopolamine
- Sildenafil
- Sodium
- Sodium Bicarbonate
- Sodium Chloride
- Sodium Nitrate
- Sodium Nitrite
- Sodium Nitroprusside
- Sodium Thiosulfate
- Sodyum Bi̇Karbonat
- Sotalol
- Streptokinase
- Suboxone
- Succinylcholine
- Sucrose
- Tadalafil
- Tenecteplase
- Terbutaline
- Tetracaine
- Thiamine
- Thrombolytics-Fibrinolytics
- Ticagrelor
- Tirofiban
- Tissue Plasminogen Activator
- Topical Ophthalmic Anesthetics
- Tramadol
- Tranexamic Acid
- Trimethoprim-Sulfamethoxazole
- Unfractioned Heparin
- Valproic Acid
- Valproi̇K Asi̇T
- Vancomycin
- Vasopressin
- Vecuronium
- Verapamil
- Vitamin K
- Whole Blood
- Xylometazoline
- Zaleplon
- Ziprasidone
States37
- Alabama2 agencies
- Arizona1 agency
- California18 agencies
- Colorado5 agencies
- District of Columbia1 agency
- Delaware1 agency
- Florida11 agencies
- Georgia2 agencies
- Idaho2 agencies
- Illinois7 agencies
- Indiana3 agencies
- Kentucky2 agencies
- Louisiana1 agency
- Massachusetts2 agencies
- Maryland1 agency
- Michigan14 agencies
- Missouri2 agencies
- Montana1 agency
- North Carolina11 agencies
- Nebraska2 agencies
- New Hampshire1 agency
- New Jersey1 agency
- Nevada1 agency
- New York3 agencies
- Ohio4 agencies
- Oklahoma2 agencies
- Oregon3 agencies
- Pennsylvania1 agency
- South Carolina5 agencies
- Tennessee5 agencies
- Texas17 agencies
- Utah3 agencies
- Virginia4 agencies
- Vermont2 agencies
- Washington11 agencies
- Wisconsin3 agencies
- West Virginia1 agency
Coverage by state
| State | Agencies with a protocol | Agencies without | Statewide protocol |
|---|---|---|---|
| Alabama | 0 | 2 | Yes |
| Arizona | 1 | 0 | Yes |
| California | 18 | 0 | No |
| Colorado | 5 | 0 | No |
| District of Columbia | 1 | 0 | No |
| Delaware | 0 | 1 | Yes |
| Florida | 11 | 0 | No |
| Georgia | 2 | 0 | Yes |
| Idaho | 1 | 1 | Yes |
| Illinois | 7 | 0 | No |
| Indiana | 3 | 0 | Yes |
| Kentucky | 1 | 1 | Yes |
| Louisiana | 1 | 0 | Yes |
| Massachusetts | 0 | 2 | Yes |
| Maryland | 0 | 1 | Yes |
| Michigan | 9 | 5 | Yes |
| Missouri | 2 | 0 | No |
| Montana | 0 | 1 | Yes |
| North Carolina | 10 | 1 | Yes |
| Nebraska | 0 | 2 | Yes |
| New Hampshire | 0 | 1 | Yes |
| New Jersey | 0 | 1 | Yes |
| Nevada | 1 | 0 | Yes |
| New York | 2 | 1 | Yes |
| Ohio | 2 | 2 | Yes |
| Oklahoma | 1 | 1 | Yes |
| Oregon | 3 | 0 | No |
| Pennsylvania | 0 | 1 | Yes |
| South Carolina | 4 | 1 | Yes |
| Tennessee | 4 | 1 | Yes |
| Texas | 17 | 0 | No |
| Utah | 2 | 1 | Yes |
| Virginia | 4 | 0 | No |
| Vermont | 0 | 2 | Yes |
| Washington | 10 | 1 | Yes |
| Wisconsin | 3 | 0 | No |
| West Virginia | 0 | 1 | Yes |
Outside the United States3
Protocols the census has read from outside the US. They are held to the same sourcing rules, and are kept out of every United States figure on this page.
- British Columbia, Canada1 agency
- Ontario, Canada1 agency
- Queensland, Australia1 agency
Agencies159
Each agency page holds that agency's protocol, its earlier versions and every dose it publishes. 64 more agencies are counted but have too little published detail for a page yet.
- Ada County-City Emergency Services System Idaho
- Adams, Benton, Franklin, Yakima Counties Washington
- Adams, Benton, Franklin, Yakima Counties EMS Washington
- Alabama Department of Public Health (ADPH) Office of EMS (OEMS) Alabama
- Alabama Department of Public Health Office of Emergency Medical Services Alabama
- Alameda County Emergency Medical Services California
- Alameda County EMS California
- Anderson County Emergency Medical Services Tennessee
- Arlington EMS System Texas
- Ascension Saint Joseph Hospital EMS System Illinois
- BC Emergency Health Services British Columbia, Canada
- Berrien County Michigan
- Berrien County Medical Control Authority Michigan
- BEST EMS Texas
- Bexar County ESD 4 Fire Rescue Texas
- Boulder County EMS Colorado
- Boulder County Protocol Committee Colorado
- Brigham City, Cache County, Logan City, Smithfield Fire Departments Utah
- Brilliant Fire Department Ohio
- Brunswick County EMS North Carolina
- Bureau of EMS, Trauma & Preparedness Michigan
- Cabarrus County EMS North Carolina
- Campbell County Emergency Medical Service Tennessee
- Central Arizona Regional EMS Arizona
- Central California Emergency Medical Services California
- Chelan/Douglas/Okanogan/Grant County Washington
- City of Austin Texas
- City of Austin / Austin-Travis County EMS System Texas
- City of Austin Office of the Chief Medical Officer Texas
- Clark County EMS System Nevada
- Cochran County Emergency Medical Services Texas
- Confederated Tribes of Grand Ronde Department of Emergency Services Oregon
- County of Marin EMS California
- County of Riverside Emergency Medical Services (EMS) Agency (REMSA) California
- County of Riverside Emergency Medical Services Agency California
- County of San Diego Emergency Medical Services California
- Craven, Jones, Pamlico Counties EMS North Carolina
- Crowley Fire Department Texas
- Davidson County Emergency Services North Carolina
- Daviess County EMS Indiana
- Delaware Office of Emergency Medical Services Delaware
- Denver Health Paramedic Division Colorado
- Denver Metro EMS Medical Directors Colorado
- Department of Health Services, County of Los Angeles California
- District of Columbia Fire and EMS Department District of Columbia
- Dorchester County EMS South Carolina
- Escambia County Emergency Medical Services Florida
- Evansville Fire Department Indiana
- Fairfax County Fire and Rescue Department Virginia
- Fern Creek Fire and Emergency Medical Services Kentucky
- FirstHealth of the Carolinas North Carolina
- Fort Lauderdale Fire Rescue Florida
- Franklin County Emergency Medical Services Georgia
- Galveston Area Ambulance Authority Texas
- Giles County EMS Tennessee
- Greater Miami Valley EMS Council Ohio
- Hays County ESD 9 EMS Texas
- Haywood County EMS System North Carolina
- HEMS, Inc Michigan
- HEMS, INC (WW/DR) Michigan
- Houston Fire Department Texas
- Hunt County EMS Texas
- Idaho EMS Physician Commission Idaho
- Inland Counties Emergency Medical Agency California
- Kentucky Board of Emergency Medical Services Kentucky
- Kern County Public Health California
- Kershaw County Emergency Medical Services South Carolina
- Lake Cities Fire Department Texas
- Lake County Emergency Medical System Florida
- Laurens County Emergency Medical Services South Carolina
- Madison Fire Department Wisconsin
- Manatee County Emergency Medical Services Florida
- Marin County Emergency Medical Services Agency California
- Maryland Institute for Emergency Medical Services Systems Maryland
- Massachusetts Department of Public Health, Office of Emergency Medical Services Massachusetts
- Massachusetts Office of Emergency Medical Services Massachusetts
- Mecklenburg EMS Agency North Carolina
- MEP (In partnership with SSM Health) Wisconsin
- MEP (Medical Emergency Partnership) in partnership with SSM Health Wisconsin
- Metro Regional EMS Oregon
- Metro Regional EMS Consortium Oregon
- MetroCare Services and Abilene Fire Department Texas
- Michigan Department of Health & Human Services, Bureau of Emergency Preparedness, EMS and Systems of Care Michigan
- Michigan Department of Health and Human Services (MDHHS) Michigan
- Michigan Department of Health and Human Services (MDHHS) / Berrien County Michigan
- Michigan Department of Health and Human Services (MDHHS) / Berrien County MCA Michigan
- Michigan Department of Health and Human Services (MDHHS) / Midland Gladwin MCA Michigan
- Michigan Department of Health and Human Services (MDHHS) / West Michigan Regional MCC Michigan
- Ministry of Health, Emergency Health Regulatory and Accountability Branch Ontario, Canada
- Miramar Fire Rescue Department Florida
- Montana Board of Medical Examiners Montana
- Muskegon County Michigan
- Muskogee County EMS Oklahoma
- Nash County Emergency Medical Services North Carolina
- National Emergency Medical Services Georgia
- Nebraska Board of Emergency Medical Services Nebraska
- Nebraska Medicine Division of Prehospital and Emergency Medical Services Nebraska
- New Hampshire Bureau of Emergency Medical Services New Hampshire
- New Jersey Department of Health New Jersey
- New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems New York
- North Carolina Office of Emergency Medical Services (NC OEMS) North Carolina
- Northwest Community EMS System Illinois
- Northwest Region Emergency Medical Services & Trauma Care Council Washington
- Oakland County Medical Control Authority Michigan
- Oakland County Medical Control Authority (OCMCA) Michigan
- Ocala/Marion County Fire Rescue Florida
- Ocala/Marion County/The Villages Public Safety EMS Florida
- Office of the EMS Medical Director for Kansas City, Missouri Missouri
- Oklahoma State Department of Health Oklahoma
- Old Dominion EMS Alliance, Inc. Virginia
- Palm Beach Gardens Fire Rescue Florida
- Pend Oreille County Emergency Medical Services Washington
- Peninsulas EMS Council, Inc. Virginia
- Pennsylvania Department of Health, Bureau of Emergency Medical Services Pennsylvania
- Peoria Area EMS System Illinois
- Pettis County Ambulance District Missouri
- Pierce County Emergency Medical Services Washington
- Pinellas County Emergency Medical Services Florida
- Platte Valley Ambulance Service Colorado
- Queensland Ambulance Service Queensland, Australia
- Region 11 Chicago EMS System Illinois
- Region 4 EMS (Alton Memorial Hospital, Anderson Hospital, HSHS St. Elizabeth's Hospital, OSF St. Anthony's Health Center) Illinois
- Region One Metropolitan Ambulance Council (MAC) Louisiana
- Region X EMS Illinois
- Regional Emergency Medical Advisory Committee of New York City New York
- Richland County Emergency Medical Services South Carolina
- Riverside County Emergency Medical Services Agency (REMSA) California
- Riverside County EMS Agency California
- Rowan County Emergency Services EMS Division North Carolina
- Salt Lake County EMS Utah
- San Diego County Emergency Medical Services Office California
- Santa Barbara County Emergency Medical Services Agency California
- Santa Barbara County Public Health Department California
- Seattle and King County EMS Washington
- Sierra – Sacramento Valley EMS Agency California
- South Carolina Department of Public Health (DPH) Division of EMS South Carolina
- South Plains Emergency Medical Services Texas
- Southern Fox Valley EMS System Illinois
- Spokane County EMS Washington
- St. Johns County Fire Rescue Florida
- Stanislaus County Emergency Medical Services Agency California
- Stanly County EMS North Carolina
- State Board of Emergency Medical, Fire, and Transportation Services Ohio
- State Board of Emergency Medical, Fire, and Transportation Services (EMFTS Board) Ohio
- Stevens County Emergency Medical Services Washington
- Susquehanna Regional EMS New York
- Tennessee Emergency Medical Services Tennessee
- The Williamson County EMS System Texas
- Three Rivers Ambulance Authority & Fort Wayne Fire Department Indiana
- Thurston County Medic One Washington
- Tidewater Emergency Medical Services Council, Inc. Virginia
- Tri County Emergency Medical Services, Inc. Texas
- Utah Department of Public Safety, Bureau of Emergency Medical Services Utah
- Vermont Department of Health Vermont
- Vermont Department of Health, Office of Emergency Medical Services Vermont
- Washington State Department of Health Washington
- West Palm Beach Fire Department Florida
- West Virginia Department of Health, Office of Emergency Medical Services West Virginia
- Wilson County Emergency Management Agency Tennessee
How this is built
Methodology: where documents come from, what is read out of them, what is not captured, and why no dose-level accuracy number is published. Data license: summaries are CC BY 4.0; row-level data is not published.
State of US EMS Protocols, Q3 2026: the quarterly edition, the groups where published protocols disagree most, aggregate only.
List your agency
If your agency's protocols are a public record and you would like them in the census, or you want an existing listing corrected or removed, send the document's public URL and we will handle it. Removal is same-day, no reason needed.
Cite this
United States EMS Protocol Census, as of 2026-09-20. https://protoquiz.com/census/