How the EMS Census is built

Where documents come from

Medics upload their own agency's protocol, or we add a published one. Each document keeps its origin and is identified by the hash of its contents, so a re-post is the same document and a revision is a new one. We host no PDFs; we link to the agency's own copy.

Only public agencies (state, regional, county, city, fire district) are named. Others count toward totals, unnamed. A document whose agency or date is unsettled waits in pending review: 136 of 926 right now.

How doses are compared

• Mass units are canonicalized to mg (300 mcg = 0.3 mg). Nothing else converts; mL, units and joules stay separate.
• Weight-based and flat doses never share a median.
• A range contributes its low end only: 0.3–0.5 mg counts as 0.3.
• A raw entry never enters a distribution (for example "per medical control"). 1,165 of 42,344 (3%) are raw.
• One vote per protocol, and a distribution needs 5 or more protocols.
• When the agreed dose, or the median, equals the dose a national guideline states for that drug, indication and population, or falls inside the range it states, the row says so and links the guideline: NASEMSO's National Model EMS Clinical Guidelines, American Heart Association algorithms, or a national society's guidance. A dose that differs gets no tag.

Sources and named agencies are two different counts

A source is one protocol document; a named agency is a public one we identify. Sources are always the larger number.

Outlier review

Nightly, any dose over 3 times or under a third of its group's median is likely a misread, so it is left out of every number until checked. It is one pass with no feedback, so the same documents give the same flags. 2,418 of 42,344 entries (6%) are left out right now.

Accuracy

We do not publish a dose-level accuracy number, because we have not measured one. This is a training reference, not a clinical order. Check your own protocol and medical director.

Corrections and freshness

Send a newer public link and the listing is rebuilt. If an agency wants its listing removed, it comes down the same day. Documents over 24 months old are marked as possibly outdated, and the build refuses to publish when the number of named agencies drops sharply.

Citation

United States EMS Protocol Census, as of 2026-10-31. https://protoquiz.com/census/ · Data license