{
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  "indexChecked": "2026-11-14",
  "releaseDate": "2026-10-27",
  "implementationDeadline": "2027-04-27",
  "indexEffectiveLabel": "2027-04-01",
  "memoUrl": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/%236032%2010-2026%20Memo%20-Policy%20Updates.pdf",
  "memoPages": "1–2",
  "dateNote": "County indexes retain April 1 labels. Memo #6032, dated October 27, 2026, permits implementation upon release and extends required full implementation to April 27, 2027 for this release. Check express exceptions and agency adoption.",
  "notice": "Source-index reconciliation and preparation queue, not clinical sign-off or agency adoption confirmation.",
  "sources": [
    {
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      "checked": "2026-11-14",
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    },
    {
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      "checked": "2026-11-14",
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    {
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      "checked": "2026-11-14",
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    {
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      "checked": "2026-11-14",
      "sha256": "3d4237b5d711ba02780c42eeec6aba64b379681f95158c33424c145d342b74cc"
    },
    {
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      "checked": "2026-11-14",
      "sha256": "6be01fff29d88037d82812e67a0e7726803e0e04cdd07a69fa7a6c3e485de93f"
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  "resources": [
    {
      "title": "#6032 New and Updated Policies, Procedures, and Standing Orders",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/%236032%2010-2026%20Memo%20-Policy%20Updates.pdf"
    },
    {
      "title": "October 2026 OCEMS Updates Webinar - PowerPoint Slides",
      "url": "https://ochealthinfo.com/sites/healthcare/files/2026-10/OCEMS_October_2026_Updates_Final.pdf"
    },
    {
      "title": "Video Recording of Webinar",
      "url": "https://youtu.be/pBPr-kWaNYM"
    }
  ],
  "immediate": [
    {
      "code": "300.31",
      "title": "300.31 OC-MEDS PCRS Data Dictionary (10/2026)",
      "url": "https://ochealthinfo.com/sites/healthcare/files/2026-10/OCEMS%20300.31%20-%20OC-MEDS%20Data%20Dictionary%20261001.pdf",
      "status": "effective-immediately",
      "indexChecked": "2026-11-14",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/upcoming",
      "clinicalReview": "not-performed"
    },
    {
      "code": "300.51",
      "title": "300.51 OC-MEDS Stroke Registry Data Dictionary (10/2026)",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/300.51%20Stroke%20Registry%20Data%20Dictionary%20260101.pdf",
      "status": "effective-immediately",
      "indexChecked": "2026-11-14",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/upcoming",
      "clinicalReview": "not-performed"
    }
  ],
  "upcoming": [
    {
      "code": "090.00",
      "title": "Definitions",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/090.00%20Definitions%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
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      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "305.00",
      "title": "Prehospital Leave Behind Naloxone Program",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/305.00%20Leave%20Behind%20Naloxone%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "309.00",
      "title": "Transport of Public Safety Working Dogs",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/309.00%20Transport%20of%20Public%20Safety%20Working%20Dogs%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
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      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "310.00",
      "title": "911 ALS Base Contact, Standing Order, Hospital Contact, and Transport",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/310.00%20ALS%20Base%20Contact%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "base-contact",
          "title": "Base contact: common triggers",
          "status": "published"
        },
        {
          "slug": "pediatric-assessment",
          "title": "Pediatric assessment triangle",
          "status": "published"
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        {
          "slug": "pediatric-respiratory-distress",
          "title": "Pediatric respiratory distress",
          "status": "published"
        },
        {
          "slug": "stroke",
          "title": "Stroke & intracerebral hemorrhage",
          "status": "published"
        },
        {
          "slug": "hazmat",
          "title": "HazMat response",
          "status": "draft"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "310.30",
      "title": "Trauma Triage",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/310.30%20Trauma%20Triage%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "310.31",
      "title": "Trauma Triage Algorithm",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/310.31%20Trauma%20Triage%20Algorithm%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "315.00",
      "title": "OCEMS EMT Scope of Practice",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/315.00%20Attachment%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "bls-scope-of-practice",
          "title": "OCEMS BLS scope of practice",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "315.00",
      "title": "OCEMS EMT Scope of Practice: Field Reference Guide",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/315.00%20EMT%20Scope%20%2810-2026%29_0.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "bls-scope-of-practice",
          "title": "OCEMS BLS scope of practice",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "325.00",
      "title": "Advanced Life Support (ALS) Provider Unit Minimum Inventory ***UPCOMING 04/01/2027***",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/325.00%20ALS%20Minimum%20Equip%20%2810-2026%29%20%282%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "duodote",
          "title": "DuoDote (atropine / pralidoxime)",
          "status": "published"
        },
        {
          "slug": "hydroxocobalamin",
          "title": "Hydroxocobalamin (Cyanokit)",
          "status": "published"
        },
        {
          "slug": "naloxone",
          "title": "Naloxone (Narcan)",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "B-003",
      "title": "Pediatric Vital Signs",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/B-003%20Pediatric%20Vital%20Signs%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "B-009",
      "title": "Public Working Dog Transport",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/B-009%20Public%20Working%20Dog%20Transport%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "BH-AMA",
      "title": "BH-AMA (10/2026)",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/BH-AMA%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/upcoming",
      "indexChecked": "2026-11-14",
      "indexUpdated": "October 2026",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "C-010",
      "title": "Cardiac Arrest",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/C-010%20Cardiac%20Arrest%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "adult-cardiac-arrest",
          "title": "Adult cardiac arrest",
          "status": "published"
        },
        {
          "slug": "amiodarone",
          "title": "Amiodarone",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        },
        {
          "slug": "sodium-bicarbonate",
          "title": "Sodium bicarbonate",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "E-005",
      "title": "Burns",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/E-005%20Burns%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "burns",
          "title": "Burns & smoke inhalation",
          "status": "published"
        },
        {
          "slug": "fentanyl",
          "title": "Fentanyl",
          "status": "published"
        },
        {
          "slug": "morphine",
          "title": "Morphine sulfate",
          "status": "published"
        },
        {
          "slug": "oxygen",
          "title": "Oxygen",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "E-010",
      "title": "Decompression Sickness",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/E-010%20Decompression%20Sickness%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "E-015",
      "title": "Drowning",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/E-015%20Drowning%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "drowning",
          "title": "Adult non-fatal drowning",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "E-025",
      "title": "Thermal Disorders",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/E-025%20Thermal%20Disorders%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "heat-illness",
          "title": "Adult heat illness / hyperthermia",
          "status": "published"
        },
        {
          "slug": "hypothermia",
          "title": "Adult hypothermia",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "E-030",
      "title": "Snake Envenomation",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/E-030%20Snake%20Envenomation%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "I-10",
      "title": "Abbreviations and Definitions",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/I-10%20Abbreviations%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "I-15",
      "title": "Adult / Adolescent Standing Order Drug Guide",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/I-15%20Adult%20SO%20Drug%20Guide%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "source-compared-clinical-review-pending",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "adenosine",
          "title": "Adenosine",
          "status": "published"
        },
        {
          "slug": "albuterol",
          "title": "Albuterol",
          "status": "published"
        },
        {
          "slug": "amiodarone",
          "title": "Amiodarone",
          "status": "published"
        },
        {
          "slug": "aspirin",
          "title": "Aspirin",
          "status": "published"
        },
        {
          "slug": "atropine",
          "title": "Atropine",
          "status": "published"
        },
        {
          "slug": "dextrose",
          "title": "Dextrose 10% (D10)",
          "status": "published"
        },
        {
          "slug": "diphenhydramine",
          "title": "Diphenhydramine (Benadryl)",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        },
        {
          "slug": "fentanyl",
          "title": "Fentanyl",
          "status": "published"
        },
        {
          "slug": "glucagon",
          "title": "Glucagon",
          "status": "published"
        },
        {
          "slug": "ketamine",
          "title": "Ketamine",
          "status": "published"
        },
        {
          "slug": "ketorolac",
          "title": "Ketorolac (Toradol)",
          "status": "published"
        },
        {
          "slug": "lidocaine",
          "title": "Lidocaine",
          "status": "published"
        },
        {
          "slug": "midazolam",
          "title": "Midazolam (Versed)",
          "status": "published"
        },
        {
          "slug": "morphine",
          "title": "Morphine sulfate",
          "status": "published"
        },
        {
          "slug": "naloxone",
          "title": "Naloxone (Narcan)",
          "status": "published"
        },
        {
          "slug": "nitroglycerin",
          "title": "Nitroglycerin",
          "status": "published"
        },
        {
          "slug": "normal-saline",
          "title": "Normal saline (0.9% sodium chloride)",
          "status": "published"
        },
        {
          "slug": "ondansetron",
          "title": "Ondansetron (Zofran)",
          "status": "published"
        },
        {
          "slug": "oral-glucose",
          "title": "Oral glucose",
          "status": "published"
        },
        {
          "slug": "oxygen",
          "title": "Oxygen",
          "status": "published"
        },
        {
          "slug": "sodium-bicarbonate",
          "title": "Sodium bicarbonate",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Complete previous/released chart comparison performed; resolve the recorded clinical-review findings and related-procedure conflicts.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "sourceComparison": "2026-11-14",
      "comparisonUrl": "/updates/drug-guide-reconciliation/",
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "I-20",
      "title": "Pediatric Medication Volume Dose by Weight",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/I-20%20Pediatric%20Drug%20Guide%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "source-compared-clinical-review-pending",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-respiratory-distress",
          "title": "Pediatric respiratory distress",
          "status": "published"
        },
        {
          "slug": "adenosine",
          "title": "Adenosine",
          "status": "published"
        },
        {
          "slug": "albuterol",
          "title": "Albuterol",
          "status": "published"
        },
        {
          "slug": "amiodarone",
          "title": "Amiodarone",
          "status": "published"
        },
        {
          "slug": "aspirin",
          "title": "Aspirin",
          "status": "published"
        },
        {
          "slug": "atropine",
          "title": "Atropine",
          "status": "published"
        },
        {
          "slug": "dextrose",
          "title": "Dextrose 10% (D10)",
          "status": "published"
        },
        {
          "slug": "diphenhydramine",
          "title": "Diphenhydramine (Benadryl)",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        },
        {
          "slug": "fentanyl",
          "title": "Fentanyl",
          "status": "published"
        },
        {
          "slug": "glucagon",
          "title": "Glucagon",
          "status": "published"
        },
        {
          "slug": "hydroxocobalamin",
          "title": "Hydroxocobalamin (Cyanokit)",
          "status": "published"
        },
        {
          "slug": "ketamine",
          "title": "Ketamine",
          "status": "published"
        },
        {
          "slug": "ketorolac",
          "title": "Ketorolac (Toradol)",
          "status": "published"
        },
        {
          "slug": "lidocaine",
          "title": "Lidocaine",
          "status": "published"
        },
        {
          "slug": "midazolam",
          "title": "Midazolam (Versed)",
          "status": "published"
        },
        {
          "slug": "morphine",
          "title": "Morphine sulfate",
          "status": "published"
        },
        {
          "slug": "naloxone",
          "title": "Naloxone (Narcan)",
          "status": "published"
        },
        {
          "slug": "nitroglycerin",
          "title": "Nitroglycerin",
          "status": "published"
        },
        {
          "slug": "normal-saline",
          "title": "Normal saline (0.9% sodium chloride)",
          "status": "published"
        },
        {
          "slug": "ondansetron",
          "title": "Ondansetron (Zofran)",
          "status": "published"
        },
        {
          "slug": "sodium-bicarbonate",
          "title": "Sodium bicarbonate",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Complete previous/released chart comparison performed; resolve the recorded clinical-review findings and related-procedure conflicts.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "sourceComparison": "2026-11-14",
      "comparisonUrl": "/updates/drug-guide-reconciliation/",
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "M-005",
      "title": "Abdomen Pain",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/M-005%20Abdomen%20Pain%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "abdominal-pain",
          "title": "Adult abdominal / flank pain",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "M-010",
      "title": "Diabetic Emergencies",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/M-010%20Diabetic%20Emergencies%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "hyperglycemia",
          "title": "Adult hyperglycemia / suspected DKA",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "M-015",
      "title": "Allergic Reaction",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/M-015%20Allergic%20Reaction%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "anaphylaxis",
          "title": "Allergic reaction & anaphylaxis",
          "status": "published"
        },
        {
          "slug": "diphenhydramine",
          "title": "Diphenhydramine (Benadryl)",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "O-010",
      "title": "Hypertensive Disorders of Pregnancy",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/O-010%20Hypertensive%20Disorders%20of%20Pregnancy%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "O-015",
      "title": "Vaginal Bleeding",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/O-015%20Vaginal%20Bleeding%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "P-005",
      "title": "BRUE",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-005%20BRUE%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "P-015",
      "title": "Ped General Injury",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-015%20Ped%20General%20Injury%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-trauma",
          "title": "Pediatric injury / trauma",
          "status": "published"
        },
        {
          "slug": "fentanyl",
          "title": "Fentanyl",
          "status": "published"
        },
        {
          "slug": "morphine",
          "title": "Morphine sulfate",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "P-060",
      "title": "Ped Allergic Reaction",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-060%20Ped%20Allergic%20Reaction%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-anaphylaxis",
          "title": "Pediatric allergic reaction & anaphylaxis",
          "status": "published"
        },
        {
          "slug": "pediatric-respiratory-distress",
          "title": "Pediatric respiratory distress",
          "status": "published"
        },
        {
          "slug": "albuterol",
          "title": "Albuterol",
          "status": "published"
        },
        {
          "slug": "diphenhydramine",
          "title": "Diphenhydramine (Benadryl)",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "P-065",
      "title": "Ped Altered Mental Status",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-065%20Ped%20Altered%20Mental%20Status%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-altered-mental-status",
          "title": "Pediatric altered mental status",
          "status": "published"
        },
        {
          "slug": "pediatric-assessment",
          "title": "Pediatric assessment triangle",
          "status": "published"
        },
        {
          "slug": "dextrose",
          "title": "Dextrose 10% (D10)",
          "status": "published"
        },
        {
          "slug": "glucagon",
          "title": "Glucagon",
          "status": "published"
        },
        {
          "slug": "oral-glucose",
          "title": "Oral glucose",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "P-075",
      "title": "Ped Seizure",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-075%20Ped%20Seizure%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-seizures",
          "title": "Pediatric seizure / convulsions",
          "status": "published"
        },
        {
          "slug": "dextrose",
          "title": "Dextrose 10% (D10)",
          "status": "published"
        },
        {
          "slug": "glucagon",
          "title": "Glucagon",
          "status": "published"
        },
        {
          "slug": "midazolam",
          "title": "Midazolam (Versed)",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "P-100",
      "title": "Ped Drowning",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-100%20Ped%20Drowning%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "pediatric-drowning",
          "title": "Pediatric non-fatal drowning",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "P-115",
      "title": "Ped Stroke",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/P-115%20Ped%20Stroke%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "PR-006",
      "title": "Pediatric Vital Signs",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-006%20Pediatric%20Vital%20Signs%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-060",
      "title": "Needle Thoracostomy",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-060%20Needle%20T%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "needle-thoracostomy",
          "title": "Needle thoracostomy: adult & pediatric",
          "status": "draft"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "PR-065",
      "title": "Needle Thoracostomy - Pediatric",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-065%20Ped%20Needle%20T%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "needle-thoracostomy",
          "title": "Needle thoracostomy: adult & pediatric",
          "status": "draft"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "PR-080",
      "title": "TXA",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-080%20TXA%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-081",
      "title": "TXA - Pediatric",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-081%20Ped%20TXA%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-115",
      "title": "Intraosseous Infusion",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-115%20IO%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "intraosseous-infusion",
          "title": "Intraosseous infusion",
          "status": "draft"
        },
        {
          "slug": "adenosine",
          "title": "Adenosine",
          "status": "published"
        },
        {
          "slug": "lidocaine",
          "title": "Lidocaine",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-130",
      "title": "Hydroxocobalamin",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-130%20Hydroxocobalamin%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "burns",
          "title": "Burns & smoke inhalation",
          "status": "published"
        },
        {
          "slug": "pediatric-poisoning",
          "title": "Pediatric overdose / poisoning",
          "status": "published"
        },
        {
          "slug": "hydroxocobalamin",
          "title": "Hydroxocobalamin (Cyanokit)",
          "status": "published"
        },
        {
          "slug": "hazmat",
          "title": "HazMat response",
          "status": "draft"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-205",
      "title": "Push Dose Epinephrine - Pediatric",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-205%20Ped%20PDE%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "base-contact",
          "title": "Base contact: common triggers",
          "status": "published"
        },
        {
          "slug": "pediatric-shock",
          "title": "Pediatric shock / hypotension",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        },
        {
          "slug": "normal-saline",
          "title": "Normal saline (0.9% sodium chloride)",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "PR-230",
      "title": "Push Dose Epinephrine",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/PR-230%20PDE%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "adult-cardiac-arrest",
          "title": "Adult cardiac arrest",
          "status": "published"
        },
        {
          "slug": "base-contact",
          "title": "Base contact: common triggers",
          "status": "published"
        },
        {
          "slug": "bradycardia",
          "title": "Symptomatic bradycardia",
          "status": "published"
        },
        {
          "slug": "sepsis",
          "title": "Suspected sepsis",
          "status": "published"
        },
        {
          "slug": "shock",
          "title": "Adult shock / hypotension",
          "status": "published"
        },
        {
          "slug": "epinephrine",
          "title": "Epinephrine",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "SO-ALS",
      "title": "ALS General Standing Orders - OCEMS Accredited Paramedic",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/SO-ALS%20General%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ],
      "focusedDrugFindingCrossCheck": {
        "date": "2026-11-14",
        "url": "/updates/drug-guide-reconciliation/#clinical-review",
        "scope": "Only the 18 drug-chart questions were checked; full document reconciliation and clinical sign-off remain separate.",
        "clinicalReview": "pending"
      }
    },
    {
      "code": "SO-AMA",
      "title": "Signing Against Medical Advice (AMA) in the Field",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/SO-AMA%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "SO-BLS",
      "title": "Basic Life Support Standing Orders",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/SO-BLS%20General%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "bls-scope-of-practice",
          "title": "OCEMS BLS scope of practice",
          "status": "published"
        },
        {
          "slug": "cpap",
          "title": "CPAP: adult & pediatric",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    },
    {
      "code": "T-005",
      "title": "General Injury & Trauma",
      "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-10/T-005%20General%20Injury%20%2810-2026%29.pdf",
      "indexUrl": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-standing",
      "indexUpdated": "10/26/2026",
      "indexChecked": "2026-11-14",
      "indexEffectiveLabel": "2027-04-01",
      "implementationDeadline": "2027-04-27",
      "releaseDate": "2026-10-27",
      "status": "transition-review",
      "clinicalReview": "pending",
      "agencyAdoption": "not-confirmed",
      "relatedGuides": [
        {
          "slug": "gcs",
          "title": "Glasgow Coma Scale",
          "status": "published"
        },
        {
          "slug": "trauma",
          "title": "Trauma: bleeding, limb injury & TBI",
          "status": "published"
        },
        {
          "slug": "fentanyl",
          "title": "Fentanyl",
          "status": "published"
        },
        {
          "slug": "morphine",
          "title": "Morphine sulfate",
          "status": "published"
        },
        {
          "slug": "normal-saline",
          "title": "Normal saline (0.9% sodium chloride)",
          "status": "published"
        }
      ],
      "reviewSteps": [
        "Compare complete previous and released documents, including medication tables and diagrams.",
        "Confirm agency adoption, training, equipment and medical-direction requirements.",
        "Record reviewer, review date and source versions before changing published clinical content."
      ]
    }
  ],
  "drugGuideReconciliation": {
    "url": "/updates/drug-guide-reconciliation/",
    "sourceCompared": 2,
    "clinicalReview": "pending",
    "remainingSourceComparisons": 44
  },
  "clinicalSourceReview": {
    "compared": "2026-11-14",
    "counts": {
      "source-resolved": 9,
      "partially-resolved": 5,
      "unresolved": 4
    },
    "scope": "Focused reconciliation of 18 I-15/I-20 findings against complete applicable protocols; not full migration of every document or clinical sign-off.",
    "clinicalReview": "pending",
    "clinicalReviewer": null,
    "agencyAdoption": "not-confirmed"
  }
}