Report

State of US EMS Protocols, Q3 2026

8 doses where US EMS protocols vary most, widest first — some spread far apart, some barely at all. Every figure is drawn from agencies' own published documents, one value per protocol, as of 2026-09-05.

How these were chosen

Nothing here was picked by hand. Every comparable group in the census was ranked by spread — the width of the middle half of protocols, as a fraction of the median — among groups with at least 15 published protocols, and the top 8 are below. The floor stepped down from 15 to 10 to 8 until 6 groups cleared it; this edition used 15.

This edition names no agencies. The figures are aggregate distributions with their counts; individual agencies' protocols are published on their own census pages. How the census is built covers what is measured, what is not, and why no dose-level accuracy number is published.

1. Naloxone for Opioid overdose

Across 32 published protocols, the adult naloxone dose for opioid overdose has a median of 0.5 mg, with the middle half between 0.4 and 1.2 mg. The full published range runs 0.4 to 2 mg.

min	p25	median	p75	max
0.4	0.4	0.5	1.2	2

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=32 protocols from 27 named agencies / 18 states, updated Sep 2026

2. Epinephrine for Hypotension / shock

Across 21 published protocols, the adult epinephrine dose for hypotension / shock has a median of 0.005 mg, with the middle half between 0.002 and 0.01 mg. The full published range runs 0.002 to 0.01 mg.

min	p25	median	p75	max
0.002	0.002	0.005	0.01	0.01

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=21 protocols from 18 named agencies / 11 states, updated Sep 2026

3. Glucagon for Beta-blocker / calcium-channel-blocker overdose

Across 29 published protocols, the adult glucagon dose for beta-blocker / calcium-channel-blocker overdose has a median of 2 mg, with the middle half between 1 and 3 mg. The full published range runs 1 to 5 mg.

min	p25	median	p75	max
1	1	2	3	5

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=29 protocols from 24 named agencies / 15 states, updated Sep 2026

4. Albuterol for Hyperkalemia

Across 17 published protocols, the adult albuterol dose for hyperkalemia has a median of 10 mg, with the middle half between 10 and 20 mg. The full published range runs 5 to 20 mg.

min	p25	median	p75	max
5	10	10	20	20

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=17 protocols from 13 named agencies / 11 states, updated Sep 2026

5. Norepinephrine for Hypotension / shock

Across 16 published protocols, the adult norepinephrine dose for hypotension / shock has a median of 0.002 mg, with the middle half between 0.002 and 0.004 mg. The full published range runs 0.001 to 0.005 mg.

min	p25	median	p75	max
0.001	0.002	0.002	0.004	0.005

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=16 protocols from 10 named agencies / 9 states, updated Sep 2026

6. Magnesium Sulfate for VF / pulseless VT (pediatric), weight-based

Across 15 published protocols, the pediatric magnesium sulfate dose for vf / pulseless vt has a median of 25 mg/kg, with the middle half between 25 and 50 mg/kg. The full published range runs 25 to 50 mg/kg.

min	p25	median	p75	max
25	25	25	50	50

mg/kg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=15 protocols from 12 named agencies / 12 states, updated Sep 2026

7. Ondansetron for Nausea / vomiting (pediatric)

Across 15 published protocols, the pediatric ondansetron dose for nausea / vomiting has a median of 2 mg, with the middle half between 2 and 4 mg. The full published range runs 1 to 4 mg.

min	p25	median	p75	max
1	2	2	4	4

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=15 protocols from 14 named agencies / 9 states, updated Sep 2026

8. Midazolam for Agitation

Across 23 published protocols, the adult midazolam dose for agitation has a median of 5 mg, with the middle half between 3.125 and 6.875 mg. The full published range runs 2 to 10 mg.

min	p25	median	p75	max
2	3.125	5	6.875	10

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=23 protocols from 18 named agencies / 15 states, updated Sep 2026

What these numbers are not

They are a description of what agencies have published, not a recommendation and not a judgment about which protocol is right. A wide spread can mean genuine clinical disagreement, different patient populations, different transport times, or a difference in how a dose is written down — this data cannot tell those apart.

Dose-level extraction accuracy has not been measured, and no accuracy figure is published anywhere on this site. Entries under outlier review are excluded from every number here.

Citation

United States EMS Protocol Census, State of US EMS Protocols, Q3 2026, as of 2026-09-05. https://protoquiz.com/census/report/2026-q3/

Summaries are published under CC BY 4.0. Quote a finding with the citation line printed beneath it — the n is part of the number.