| Intervention | Nature of Complaint | New Recommendation | Old Recommendation | Date of Change |
| Vector change | Cardiac Arrest - VF/VT-Pulseless (Shock Advised) | Moderate Supportive | Not yet Graded | Mar 1, 2023 |
| Tranexamic acid poly trauma including TBI | Trauma - Traumatic Brain Injury | Moderate Neutral | Not yet Graded | Feb 27, 2023 |
| Percutaneous Cricothyrotomy | Advanced Airway Management - Airway Management (Non-intubation) | Moderate Neutral | Moderate Against | Feb 27, 2023 |
| Hypertension Control | Stroke-CVA-TIA - Stroke-CVA-TIA | Strong Neutral | Strong Supportive | Feb 27, 2023 |
| Corsette Style Compression Device (e.g. T-Pod) | Trauma - Pelvic Trauma | Moderate Neutral | Moderate Supportive | Feb 27, 2023 |
| Head-up CPR | Cardiac Arrest - General Cardiac Arrest Care | Moderate Supportive | Not yet Graded | Feb 19, 2023 |
| Suction | Airway Emergency - Foreign Body Obstruction(Complete/Partial) | Moderate Supportive | Not yet Graded | Feb 19, 2023 |
| Blood transfusion | Shock (non-septic) - Hemorrhagic Shock | Moderate Supportive | Moderate Neutral | Jan 25, 2023 |
| Advanced Notice/ Optimal Trip Destination | Stroke-CVA-TIA - Stroke-CVA-TIA | Strong Supportive | Moderate Supportive | Jan 25, 2023 |
| Screening for Large Vessel Occlusion | Stroke-CVA-TIA - Stroke-CVA-TIA | Moderate Supportive | Not yet Graded | Jan 15, 2023 |
| Epinephrine | Cardiac Arrest - Post-Cardiac Arrest Care | Moderate Neutral | Not yet Graded | Jan 15, 2023 |
| Norepinephrine | Cardiac Arrest - Post-Cardiac Arrest Care | Strong Supportive | Not yet Graded | Jan 15, 2023 |
| Dopamine | Cardiac Arrest - Post-Cardiac Arrest Care | Strong Supportive | Not yet Graded | Jan 15, 2023 |
| Screening for Intimate Partner Violence | Treat and Release/Refer - Refer | Moderate Supportive | Not yet Graded | Jan 15, 2023 |
| Buprenorphine | Toxicologic Emergency - Opioid withdrawal | Moderate Supportive | Weak Supportive | Jan 15, 2023 |
| Oxymetry Monitoring | Pediatric Trauma (ABCs/Major) - Pediatric General Trauma Care | Moderate Supportive | Not yet Graded | Dec 15, 2022 |
| Rapid Sequence Induction | Advanced Airway Management - Medication for Airway Management | Moderate Supportive | Moderate Neutral | Dec 15, 2022 |
| LMA (without AW reflexes) | Advanced Airway Management - Airway Management (Non-intubation) | Moderate Neutral | Strong Neutral | Dec 15, 2022 |
| Crystalloid Infusion | Pediatric Trauma (ABCs/Major) - Pediatric General Trauma Care | Moderate Neutral | Not yet Graded | Dec 15, 2022 |
| Midazolam-IV | Pediatric Altered Mental State-Dec. LOC - Pediatric Seizure | Moderate Supportive | Moderate Against | Dec 15, 2022 |
| Thoracotomy | Cardiac Arrest - Traumatic Arrest | Moderate Neutral | Weak Supportive | Dec 15, 2022 |
| AER (Active External Rewarming) | Environmental Emergency - Hypothermic Cardiac Arrest | Moderate Neutral | Weak Supportive | Nov 30, 2022 |
| Identification tools-SIRS | Sepsis - Sepsis Syndrome | Strong Supportive | Moderate Supportive | Nov 30, 2022 |
| Identification tools-NEWS | Sepsis - Sepsis Syndrome | Strong Supportive | Moderate Supportive | Nov 30, 2022 |
| FAST | Trauma - Abdominal Trauma | Moderate Supportive | Weak Supportive | Nov 30, 2022 |
| Chest pain prediction tool | Chest Pain - ACS/Suspected Cardiac Origin | Strong Supportive | Moderate Supportive | Oct 30, 2022 |
| Blood transfusion | Cardiac Arrest - Traumatic Arrest | Moderate Supportive | Not yet Graded | Oct 30, 2022 |
| Tranexamic Acid | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Strong Supportive | Not yet Graded | Oct 3, 2022 |
| Blood Glucose Monitoring | Cardiac Arrest - General Cardiac Arrest Care | Moderate Neutral | Not yet Graded | Sep 29, 2022 |
| Point of Care Troponin | Chest Pain - ACS/Suspected Cardiac Origin | Strong Supportive | Moderate Supportive | Sep 29, 2022 |
| Ketorolac (Toradol) | Trauma - General Major Trauma Care | Strong Supportive | Moderate Supportive | Sep 29, 2022 |
| Temperature Monitoring | Trauma - General Major Trauma Care | Moderate Supportive | Moderate Neutral | Sep 29, 2022 |
| Optimal Trip Destination | Cardiac Arrest - Traumatic Arrest | Moderate Supportive | Not yet Graded | Sep 10, 2022 |
| Oxygen-high flow | Trauma - General Major Trauma Care | Moderate Against | Strong Supportive | Aug 21, 2022 |
| Ketamine | Psychiatric - Violent-Agitated | Strong Supportive | Moderate Supportive | Aug 21, 2022 |
| Spinal Precautions | Trauma - Spinal Injury | Moderate Neutral | Weak Neutral | Aug 21, 2022 |
| Pressure | EENT - Epistaxis | Strong Supportive | Moderate Neutral | Aug 21, 2022 |
| Epinephrine | Pediatric Allergic Reaction - Pediatric Anaphylaxis | Moderate Supportive | Weak Supportive | Aug 21, 2022 |
| Blood transfusion | Pediatric Trauma (ABCs/Major) - Pediatric General Trauma Care | Moderate Supportive | Weak Supportive | Aug 21, 2022 |
| Pelvic Binding | Cardiac Arrest - Traumatic Arrest | Moderate Neutral | Not yet Graded | Jul 16, 2022 |
| Acetaminophen IV | Chest Pain - ACS/Suspected Cardiac Origin | Strong Neutral | Not yet Graded | Jun 29, 2022 |
| Sedation scale | Advanced Airway Management - Medication for Airway Management | Weak Supportive | Not yet Graded | Jun 29, 2022 |
| Identification tools- qSOFA | Sepsis - Sepsis Syndrome | Strong Neutral | Moderate Supportive | Jun 26, 2022 |
| Ultrasound | Trauma - Chest Trauma | Strong Supportive | Moderate Supportive | Jun 26, 2022 |
| Tourniquet (limb) | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Strong Neutral | Moderate Supportive | Jun 26, 2022 |
| HEMS | Trauma - Traumatic Brain Injury | Moderate Supportive | Not yet Graded | Jun 24, 2022 |
| Methoxyflurane (Penthrox) | Pediatric Trauma (ABCs/Major) - Pediatric General Trauma Care | Moderate Supportive | Not yet Graded | Jun 24, 2022 |
| Oxymetry Monitoring | Perinatal Care - Newborn Care | Weak Supportive | Not yet Graded | May 26, 2022 |
| ETCO2 | Shock (non-septic) - Hemorrhagic Shock | Moderate Supportive | Not yet Graded | May 12, 2022 |
| ETCO2 | Pediatric Cardiac Arrest - General Cardiac Arrest Care | Moderate Neutral | Weak Supportive | Apr 2, 2022 |
| Thoracostomy | Cardiac Arrest - Traumatic Arrest | Moderate Supportive | Weak Supportive | Apr 2, 2022 |
| Hydroxocobalamin | Toxicologic Emergency - Cyanide Poisoning | Weak Neutral | Moderate Neutral | Apr 2, 2022 |
| POCUS | Cardiac Arrest - Traumatic Arrest | Moderate Supportive | Not yet Graded | Mar 30, 2022 |
| Oxygen-titrated | Trauma - General Major Trauma Care | Moderate Supportive | Not yet Graded | Mar 27, 2022 |
| Capsaicin | Toxicologic Emergency - Cannabinoid hyperemesis | Moderate Supportive | Not yet Graded | Mar 19, 2022 |
| Magnesium | Respiratory Distress (SOB) - COPD | Strong Neutral | Moderate Supportive | Feb 23, 2022 |
| Transport to an ECMO capable facility | Cardiac Arrest - General Cardiac Arrest Care | Strong Supportive | Moderate Supportive | Feb 23, 2022 |
| Passive leg raise | Cardiac Arrest - General Cardiac Arrest Care | Strong Neutral | Not yet Graded | Feb 22, 2022 |
| Hypertension Control | Trauma - Traumatic Brain Injury | Weak Supportive | Not yet Graded | Feb 22, 2022 |
| Shock Prediction Tool | Sepsis - Septic Shock | Moderate Supportive | Not yet Graded | Feb 22, 2022 |
| Oxygen | Trauma - Traumatic Brain Injury | Moderate Supportive | Not yet Graded | Feb 22, 2022 |
| Benzodiazepines | Toxicologic Emergency - ETOH Withdrawal | Moderate Supportive | Strong Supportive | Jan 24, 2022 |
| Direct Pressure | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Moderate Supportive | Weak Neutral | Jan 24, 2022 |
| Mechanical Intraosseous Insertion | Pediatric Cardiac Arrest - General Cardiac Arrest Care | Moderate Neutral | Moderate Supportive | Dec 15, 2021 |
| Epinephrine | Shock (non-septic) - Cardiogenic Shock | Moderate Neutral | Moderate Supportive | Dec 15, 2021 |
| Needle Decompression | Cardiac Arrest - Traumatic Arrest | Moderate Neutral | Moderate Supportive | Dec 15, 2021 |
| High flow nasal canula | Respiratory Distress (SOB) - Respiratory Distress NYD | Moderate Neutral | Weak Neutral | Dec 14, 2021 |
| Dispatcher video assistance | Cardiac Arrest - General Cardiac Arrest Care | Weak Supportive | Not yet Graded | Dec 14, 2021 |
| Wound packing | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Weak Supportive | Not yet Graded | Dec 14, 2021 |
| IV access | Pediatric Cardiac Arrest - General Cardiac Arrest Care | Moderate Neutral | Not yet Graded | Dec 14, 2021 |
| Suction | Advanced Airway Management - Airway Management (Non-intubation) | Moderate Supportive | Not yet Graded | Nov 27, 2021 |
| 12-Lead ECG | Cardiac Arrest - Post-Cardiac Arrest Care | Moderate Supportive | Moderate Neutral | Nov 27, 2021 |
| Mechanical Intraosseous Insertion | Cardiac Arrest - General Cardiac Arrest Care | Strong Neutral | Moderate Neutral | Nov 27, 2021 |
| Needle Decompression | Trauma - Chest Trauma | Moderate Neutral | Weak Supportive | Nov 27, 2021 |
| NSAIDs | Non-Traumatic MSK - Mechanical Back Pain | Moderate Supportive | Strong Supportive | Oct 25, 2021 |
| I-Gel | Advanced Airway Management - Airway Management (Non-intubation) | Strong Supportive | Moderate Supportive | Oct 25, 2021 |
| Tranexamic acid for isolated TBI | Trauma - Traumatic Brain Injury | Strong Neutral | Moderate Against | Oct 25, 2021 |
| Methoxyflurane (Penthrox) | Trauma - General Major Trauma Care | Strong Supportive | Not yet Graded | Oct 25, 2021 |
| TIA Score | Stroke-CVA-TIA - Stroke-CVA-TIA | Weak Supportive | Not yet Graded | Oct 24, 2021 |
| Transfer of ECMO patients | Respiratory Distress (SOB) - Respiratory Distress NYD | Moderate Supportive | Weak Supportive | Sep 30, 2021 |
| Oxygen-high flow | Chest Pain - ACS/Suspected Cardiac Origin | Strong Neutral | Strong Against | Jul 29, 2021 |
| Epinephrine | Sepsis - Septic Shock | Weak Supportive | Not yet Graded | Jul 29, 2021 |
| Norepinephrine | Sepsis - Septic Shock | Strong Supportive | Not yet Graded | Jul 29, 2021 |
| Dobutamine | Sepsis - Septic Shock | Weak Supportive | Not yet Graded | Jul 29, 2021 |
| Dopamine | Sepsis - Septic Shock | Strong Neutral | Not yet Graded | Jul 29, 2021 |
| Tranexamic Acid | Pediatric Shock - Hypovolemic Shock | Moderate Supportive | Not yet Graded | Jul 28, 2021 |
| IV access | Cardiac Arrest - General Cardiac Arrest Care | Strong Neutral | Moderate Neutral | Jul 28, 2021 |
| ALS | Trauma - General Major Trauma Care | Moderate Neutral | Moderate Supportive | Jul 15, 2021 |
| Methoxyflurane (Penthrox) | Pediatric Burns - Pediatric Burns (fire/flame) | Weak Neutral | Not yet Graded | Jul 15, 2021 |
| Intubation | Trauma - General Major Trauma Care | Moderate Against | Not yet Graded | Jul 15, 2021 |
| POCUS for COPD evaluation | Treat and Release/Refer - Treat and release | Weak Neutral | Not yet Graded | Jun 30, 2021 |
| Transport to an ECMO capable facility | Environmental Emergency - Hypothermic Cardiac Arrest | Weak Supportive | Not yet Graded | Jun 30, 2021 |
| Early epinephrine | Pediatric Cardiac Arrest - General Cardiac Arrest Care | Moderate Supportive | Not yet Graded | Jun 26, 2021 |
| Opioid | Headache - Headache-Migraine | Weak Against | Not yet Graded | Jun 26, 2021 |
| Fibrinogen concentrate | Shock (non-septic) - Hemorrhagic Shock | Strong Supportive | Not yet Graded | Jun 26, 2021 |
| Reduction | Trauma - Dislocation | Weak Supportive | Not yet Graded | Jun 26, 2021 |
| Stroke Diagnosis Scales (any) | Stroke-CVA-TIA - Stroke-CVA-TIA | Strong Supportive | Moderate Supportive | May 26, 2021 |
| Medical clearance in the field | Psychiatric - Depressed Suicidal | Moderate Supportive | Not yet Graded | May 26, 2021 |
| Intra-arrest transport (load and go) | Cardiac Arrest - General Cardiac Arrest Care | Moderate Neutral | Not yet Graded | May 26, 2021 |
| Chest Compression devices | Cardiac Arrest - General Cardiac Arrest Care | Strong Neutral | Strong Supportive | May 5, 2021 |
| Beta Blockers | Chest Pain - ACS/Suspected Cardiac Origin | Strong Neutral | Strong Supportive | May 5, 2021 |
| Morphine | Chest Pain - ACS/Suspected Cardiac Origin | Moderate Neutral | Moderate Against | May 5, 2021 |
| Acetaminophen PO | Acute Pain - Analgesia | Strong Supportive | Strong Neutral | May 5, 2021 |
| IV Fluid as a cooling agent | Environmental Emergency - Hyperthermia | Weak Neutral | Moderate Neutral | May 5, 2021 |
| Bystander CPR | Cardiac Arrest - General Cardiac Arrest Care | Moderate Supportive | Strong Supportive | May 5, 2021 |
| Nitrous Oxide | Chest Pain - ACS/Suspected Cardiac Origin | Strong Neutral | Weak Supportive | May 5, 2021 |
| Double Sequential Defibrillation | Cardiac Arrest - VF/VT-Pulseless (Shock Advised) | Strong Neutral | Moderate Supportive | May 5, 2021 |
| Humidified oxygen | Respiratory Distress (SOB) - COPD | Weak Neutral | Moderate Neutral | May 2, 2021 |
| High flow nasal canula | Pediatric Respiratory Distress (SOB) - Pediatric Wheeze/Bronchospasm | Moderate Supportive | Moderate Neutral | May 2, 2021 |
| Oxygen | Trauma - General Major Trauma Care | Weak Neutral | Not yet Graded | May 2, 2021 |
| Crystalloid Infusion | Sepsis - Septic Shock | Moderate Neutral | Strong Supportive | May 2, 2021 |
| Pre-alert (massive transfusion protocol) | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Moderate Supportive | Weak Supportive | May 2, 2021 |
| Tourniquet (junctional) | Trauma - Limb Amputation/Mangled/Major Hemorrhage | Weak Neutral | Not yet Graded | May 2, 2021 |
| Antiarrhythmic - Class I (Na+ channel blockers) | Cardiac Arrhythmia - Stable Narrow Complex Tachycardia | Strong Supportive | Weak Supportive | May 2, 2021 |
| Trauma Team Activation | Trauma - General Major Trauma Care | Moderate Supportive | Not yet Graded | May 2, 2021 |
| Therapeutic hypothermia | Perinatal Care - Neonatal Resuscitation | Weak Neutral | Not yet Graded | May 2, 2021 |
| Isopropyl alcohol | GI-GU-Gyne - Nausea and Vomiting | Strong Supportive | Not yet Graded | May 2, 2021 |
| Ketamine | Pediatric Respiratory Distress (SOB) - Pediatric Wheeze/Bronchospasm | Weak Supportive | Not yet Graded | May 2, 2021 |
| Metoclopramide plus diphenhydramine | Headache - Headache-Migraine | Strong Supportive | Moderate Supportive | May 2, 2021 |
| Wet/hydrogel dressing | Burns - Burns (fire/flame) | Moderate Neutral | Not yet Graded | May 2, 2021 |
| Predictive Tools | Treat and Release/Refer - Treat and release | Moderate Supportive | Not yet Graded | May 2, 2021 |
| Mechanical Intraosseous Insertion | Pediatric Shock - Hypovolemic Shock | Moderate Supportive | Strong Supportive | May 2, 2021 |
| Hypertonic Saline-Nebulized | Respiratory Distress (SOB) - Asthma | Strong Supportive | Not yet Graded | May 2, 2021 |
| Epinephrine-IV | Respiratory Distress (SOB) - Asthma | Moderate Neutral | Weak Neutral | May 2, 2021 |
| Flush with > 1L Saline | EENT - Foreign Body/Welders Flash/Chemical Splash Eye | Moderate Supportive | Not yet Graded | May 2, 2021 |
| Diphenhydramine | Allergic Reaction - Anaphylaxis | Moderate Supportive | Not yet Graded | May 2, 2021 |
| Rapid Sequence Induction | Pediatric Advanced Airway Management - Medication for Airway Management | Weak Supportive | Moderate Supportive | May 2, 2021 |
| Antibiotic (open fracture) | Trauma - Extremity Trauma | Weak Supportive | Moderate Supportive | Apr 26, 2021 |
| Status epilepticus scale | Altered Mental State-Dec. LOC - Seizure (Adult) | Moderate Supportive | Not yet Graded | Mar 31, 2021 |