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Suffolk County ALS Protocol Modification
Published Friday, December 21, 2018
by William Michael Masterton, Chief, Education and Training

Suffolk County ALS Protocol Modification

By William Michael Masterton

Dear EMS Provider;

The Suffolk Regional Emergency Medical Advisory Committee (REMAC), along with the Regional EMS Medical Director, have adopted the following changes to the RSI Protocol, effectively immediately. 

1.  ADULT RAPID SEQUENCE INTUBATION – This protocol is intended for use by agencies authorized by their Service  Medical Director and approved by the REMAC. Providers must have received specialized training in Rapid Sequence Intubation prior to implementing this protocol.  INDICATIONS: RSI may be utilized by a single paramedic on standing orders in any adult protocol requiring advanced airway management when definitive airway control is necessary for patients in imminent respiratory compromise and / or failure; and where no other means of securing an airway can be obtained without the use of sedative agents.


Click here for the updated protocol.


2.  Reaffirmation that for Cardiac Arrest, the Team Resuscitation approach, performing high quality CPR, and rapid assessment for, and treatment of VF or pulseless VT is paramount in increasing chances of survival from sudden cardiac arrest. 

3.  Reaffirmation that for patients with STEMI, acquisition and transmission of 12-lead ECG, with rapid transport, and early pre-notification to a designated PCI-Capable hospital are critical objectives. EMT-P – Please remember that voice contact with Medical Control is required to link an ambulance service with a patient and a transmitted ECG that is positive for STEMI. EMT-CC – Please remember that voice contact with Medical Control is required for any 12-lead ECG. 

4.  Reaffirmation for EMT-Bs that a post-call phone to Medical Control is required any time an EMT-B administers or assists with the administration of Narcan, nitroglycerine, albuterol, or epinephrine (auto-injector or through the SEK Check & Inject Program).

The protocol can be found on the Suffolk REMSCO website under Protocols.  The ALS Policies and Procedures Manual will be updated shortly.  Thank you.

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Suffolk County REMSCO | 360 Yaphank Ave, Suite 1B | Yaphank, NY 11980 Phone: 631-852-5080 | Fax: 631-852-5028
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