2017 Protocols CoverOne of PEMS primary responsibilities to our regional EMS system is the development, publication and maintenance of a consistent set of patient care guidelines for all prehospital providers in the PEMS region.  These protocols are under a constant state of revision, with a new version published in the spring of each year.  While many people and committees are involved in this process, the Protocols, Policies & Procedures Committee carries out most of the research and development to keep our protocols current and relevant.  They provide a draft recommendation to the Medical Advisory Committee who approves new and changed protocols before publication. 

   Click here to download the 2018 (Ch2: June 2018) version of the PEMS Regional Patient Care Protocols, Policies & Procedures .  This is a full-color, 8 1/2 x 11 inch version of the protocols for individuals and agencies desiring to print their own protocols. 

Click here to download the 2018 (Ch1) version of the PEMS Regional Patient Care Protocols, Policies & Procedures. This is a full-color, 8 1/2 x 11 inch version of the protocols for individuals and agencies desiring to print their own protocols.

Click here to download the 2018 initial change package (1 March 2018).

Or click here to download only the 2018 (Ch1) change package (2 April 2018).

Or click here to download only the 2018 (Ch2) change package (29 June 2018).

 Contact PEMS at 804-693-6234 for questions or clarification.

dark blue horiz line290x10

Protocol tests for the 2018 PEMS Protocols, Policies, & Procedures are available through agency Operational Medical Directors (OMDs). Please contact your OMD to receive a current protocol test.

OMDs- please download a PEMS Protocol Test Authorization letter here. Sign and return to PEMS via fax or emal attachment to receive the current version of the test.

dark blue horiz line290x10

2018 PEMS Protocols Available by Smartphone App Now!

For a long time now, providers throughout the PEMS region have been asking for a smartphone app with the PEMS Regional Patient Care Protocols, Policies & Procedures. 

In 2017, the Gloucester Rotary Club, Gloucester, VA learned of this need and agreed to sponsor a protocol app.  Through their generosity, every EMS provider, agency administrator and hospital staff member can download an app with the current version of the PEMS protocols free of charge! (2018 Protocols will update on 1 March.)

Providers will have the protocols with them on scene when they need them, rather than sitting under the bench seat outside on the truck or back in the office.  They will have them where they can read them in the dark with poor lighting and in the rain.  They will have them with them in the classroom and during drills and exercises.


Anyone involved in our regional EMS system can download the app at the following links for either iOS or Android.


iOS: https://www.acidremap.com/customAppDownload.php?bundleID=PPPPEMSPatientCareProtocols&platform=iOS

Android: https://www.acidremap.com/customAppDownload.php?bundleID=PPPPEMSPatientCareProtocols&platform=android

You may also find them by searching for PEMS Protocols on the iOS or Android application stores or by linking with our application contractor at:  https://www.acidremap.com and following the links for PEMS from there.

A website is available with the current protocols for desktop and laptop systems at:  https://www.acidremap.com/sites/PeninsulasEMS/

Again, there is no charge to the provider for the app.  Updates to the application or the protocols will take place automatically if connected to Wi/Fi, so you will never have to wonder if you have the most recent version.

In the near future we will be adding other functions to the app like MCI Position Checklists, regional EMS planning documents, resource contacts, and text notifications of critical information such as ED closures, medication shortages, etc.

Thanks again to the Gloucester Rotary Club for supporting this important project.   It wouldn't have happened without you!


dark blue horiz line290x10

We are also providing a PEMS YouTube Link to the 2018 Protocol Rollout Training Video.  This video is the only training material necessary to provide rollout training for your agencies.  Please feel free to distribute the link to your providers and trainers.  Click here to see the 2018 PEMS Protocols Rollout Training Video.
dark blue horiz line290x10

Clarification to Change 2 of the PEMS Protocols

There has been some confusion regarding the recent change to the PEMS Regional Patient Care Protocols, Policies & Procedures.  This change involved two areas of the protocols:

Item 1:  The window for transport of RACE positive stroke patients was extended from 6 to 24 hours.  This change impacted the following protocols:

  • Administrative Policy: Stroke Field Triage
  • Adult Protocol: Medical – Stroke/TIA

Item 2:  In response to an anticipated shortage of Dopamine, and the large quantity of our supply expiring on 30 June, 2018, PEMS Medication Kits may not be stocked with any of this medication.  Norepinephrine (Levophed) has been added to the Medication Kits to provide an alternative medication for hypotension that is not related to trauma.  This change impacted the following protocols:

  • Adult Protocol: Medical – Hypotension/Shock (Non-Traumatic)
  • Pharmacology: Norepinephrine

Please note that Norepinephrine has only been approved for use in non-traumatic hypotension in this emergent change.  Epinephrine remains the secondary medication for treating hypotension for cardiac conditions and is also an acceptable substitute for Dopamine for non-traumatic hypotension.

Emergent changes to PEMS Regional Patient Care Protocols, Policies & Procedures are not taken lightly.  We understand that they place a significant burden on agencies and providers to provide just-in-time training to providers.  When our medical directors concur that an emergent change is necessary to provide proper care to our citizens however, we will act quickly to produce and publish the changes.  We are continuing to improve this process and we greatly appreciate the input of our constituent agencies and providers in ensuring that the final product is clear, concise and accurate.

Please update your In-Service Training curriculum to address these changes and ensure that they receive maximum distribution within your organizations.

Thank you.

dark blue horiz line290x10

Protocol Changes (2)

Two Protocol changes will go into effect today (29 June 2018) at 1400. Both are emergent clinical changes. Change 1 was directly developed and approved by the Stroke Task Force. Per PEMS Policies, both Change 1 and 2 have been reviewed and approved by the Medical Advisory Committee, the Chair of the Policies, Procedures, and Protocols Committee, and by the PEMS Executive Director.

Change 1 is located in the Administrative Policies: Stroke Field Triage.

  • The Stroke Task Force has extended the window for transport of RACE positive patients from 6 to 24 hours.  This change affected the "Stroke Field Triage" and the "Stroke/TIA Protocol".

Change 2 is to the "Medical: Hypotension/Shock (Non-Trauma)" Protocol and Pharmacology Section.

  • In response to a potential shortage of Dopamine, EMS providers may receive Norepinephrine (Levophed) in the PEMS Regional Drug Box.  This change affected the "Hypotension/Shock (Non-Trauma)" Protocol and Norepinephrine (Levophed) has been added to the Pharmacology Section.

PEMS website links to protocol files have been updated.

Agencies with printed protocols be sure to download, print, and insert change pages.

All users of the protocol app will update automatically when connected to Wi-Fi.

Main Menu

Back To Top