Report

State of US EMS Protocols, Q3 2026

8 doses where US EMS protocols vary most, widest first — some spread far apart, some barely at all. Every figure is drawn from agencies' published protocols and app users' uploads, one value per protocol, as of 2026-09-20.

How these were chosen

Nothing here was picked by hand. Every comparable group in the census was ranked by spread — the width of the middle half of protocols, as a fraction of the median — among groups with at least 15 published protocols, and the top 8 are below. The floor stepped down from 15 to 10 to 8 until 6 groups cleared it; this edition used 15.

This edition names no agencies. A few agencies outside the US are included. The figures are aggregate distributions with their counts; individual agencies' protocols are published on their own census pages. How the census is built covers what is measured, what is not, and why no dose-level accuracy number is published.

1. Naloxone for Opioid overdose

Across 142 published protocols, the adult naloxone dose for opioid overdose has a median of 1 mg, with the middle half between 0.4 and 2 mg. The full published range runs 0.4 to 2 mg.

min	p25	median	p75	max
0.4	0.4	1	2	2

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=142 protocols from 122 named agencies / 32 states, updated Sep 2026

2. Albuterol for Hyperkalemia

Across 73 published protocols, the adult albuterol dose for hyperkalemia has a median of 5 mg, with the middle half between 2.5 and 10 mg. The full published range runs 2.5 to 15 mg.

min	p25	median	p75	max
2.5	2.5	5	10	15

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=73 protocols from 64 named agencies / 26 states, updated Sep 2026

3. Naloxone for Opioid overdose (pediatric)

Across 24 published protocols, the pediatric naloxone dose for opioid overdose has a median of 1 mg, with the middle half between 0.5 and 2 mg. The full published range runs 0.4 to 2 mg.

min	p25	median	p75	max
0.4	0.5	1	2	2

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=24 protocols from 18 named agencies / 15 states, updated Sep 2026

4. Dopamine for Cardiogenic shock, weight-based

Across 21 published protocols, the adult dopamine dose for cardiogenic shock has a median of 0.002 mg/kg, with the middle half between 0.002 and 0.005 mg/kg. The full published range runs 0.001 to 0.005 mg/kg.

min	p25	median	p75	max
0.001	0.002	0.002	0.005	0.005

mg/kg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=21 protocols from 20 named agencies / 14 states, updated Sep 2026

5. Dopamine for Hypotension / shock (pediatric), weight-based

Across 18 published protocols, the pediatric dopamine dose for hypotension / shock has a median of 0.002 mg/kg, with the middle half between 0.002 and 0.005 mg/kg. The full published range runs 0.001 to 0.005 mg/kg.

min	p25	median	p75	max
0.001	0.002	0.002	0.005	0.005

mg/kg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=18 protocols from 16 named agencies / 13 states, updated Sep 2026

6. Dopamine for Sepsis, weight-based

Across 18 published protocols, the adult dopamine dose for sepsis has a median of 0.002 mg/kg, with the middle half between 0.002 and 0.005 mg/kg. The full published range runs 0.002 to 0.005 mg/kg.

min	p25	median	p75	max
0.002	0.002	0.002	0.005	0.005

mg/kg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=18 protocols from 17 named agencies / 12 states, updated Sep 2026

7. Calcium Gluconate for Hyperkalemia (pediatric), weight-based

Across 38 published protocols, the pediatric calcium gluconate dose for hyperkalemia has a median of 60 mg/kg, with the middle half between 25 and 100 mg/kg. The full published range runs 20 to 100 mg/kg.

min	p25	median	p75	max
20	25	60	100	100

mg/kg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=38 protocols from 33 named agencies / 14 states, updated Sep 2026

8. Diazepam for Agitation

Across 29 published protocols, the adult diazepam dose for agitation has a median of 2.5 mg, with the middle half between 2 and 5 mg. The full published range runs 1 to 5 mg.

min	p25	median	p75	max
1	2	2.5	5	5

mg. One value per protocol — a document listing a drug several times gets one vote, its own median.

United States EMS Protocol Census, n=29 protocols from 28 named agencies / 16 states, updated Sep 2026

What these numbers are not

They are a description of what agencies have published, not a recommendation and not a judgment about which protocol is right. A wide spread can mean genuine clinical disagreement, different patient populations, different transport times, or a difference in how a dose is written down — this data cannot tell those apart.

Dose-level extraction accuracy has not been measured, and no accuracy figure is published anywhere on this site. Entries under outlier review are excluded from every number here.

Citation

United States EMS Protocol Census, State of US EMS Protocols, Q3 2026, as of 2026-09-20. https://protoquiz.com/census/report/2026-q3/

Summaries are published under CC BY-NC 4.0. Quote a finding with the citation line printed beneath it — the n is part of the number.