PA IALS Protocol Guide
AEMT Ready · source: Pennsylvania Statewide IALS Protocols 2023 v1.2, effective March 31, 2024.
High-yield scope boundaries
- AEMTs may acquire and transmit a 12-lead ECG for suspected ACS. Independent continuous ECG rhythm monitoring is outside PA AEMT scope unless directly supervised while assisting a higher-level provider.
- Supraglottic airway placement requires electronic waveform ETCO₂ confirmation and continuous monitoring, clinical confirmation, securement, and reassessment after every move.
- IV epinephrine is restricted to cardiac arrest. IV/IO epinephrine, diphenhydramine, and ondansetron are optional and require agency medical-director approval.
- IO access must be indicated by protocol, use an approved extremity site/device, and requires documented competency and agency policy.
- When patient needs exceed IALS capability, consider ALS while beginning in-scope care and transport. Do not create an avoidable transport delay.
- After any IALS procedure, contact medical command before handing the patient to BLS.
Required IALS vehicle medications
Albuterol, aspirin, dextrose (at least one 10–25% formulation), epinephrine 1 mg/mL, glucagon, naloxone, nitroglycerin, normal saline, and oxygen. Additional drugs may be optional under the current approved list and agency medical director.
Core protocol sections
- Operations and IALS-to-BLS release
- ALS-use indications and airway confirmation
- Adult/pediatric and traumatic cardiac arrest
- Airway, allergy, bronchospasm and pediatric croup
- ACS, trauma, burns and crush syndrome
- Altered consciousness, pain, shock/sepsis, stroke, nausea/vomiting and postpartum hemorrhage
- Medical-command contact