OC MEDIC / FIELD REFERENCE

Practical guides for the field.

Assessment, treatment, reassessment, and medication guidance, grounded in OCEMS sources.

OCEMS BLS scope of practice →Browse medication guides →Full document library →

Guide typeTopic

Clinical & medication guides

84 guides

Medical

Suspected sepsis

Recognize suspected sepsis, support perfusion, and know when to contact base.

Adult / adolescent · ALS Neurologic

Stroke: recognition, treatment & routing

Capture last known well, check stroke-triage findings, treat reversible problems, and coordinate destination.

Adult / adolescent · ALS Airway & breathing

CPAP: adult & pediatric

Select an eligible patient, check exclusions, apply the correct pressure, and reassess for deterioration.

Adult / pediatric age 8+ · BLS / ALS Operations

Base contact: common triggers

A quick check for medical-control contact before transport or escalation.

Adult & pediatric · ALS Assessment

Pediatric assessment triangle

Use appearance, breathing, and skin circulation for a rapid first impression.

Pediatric · Assessment Assessment

Glasgow Coma Scale

Score eye, verbal, and motor responses. Report each component and the total.

Adult & pediatric · Assessment BLS

BLS naloxone: 4 mg nasal spray

Use the preloaded 4 mg NARCAN device for suspected opioid overdose under SO-B-002.

See source criteria · BLS BLS

BLS oral glucose: gel / paste

Confirm the patient can swallow, give small portions, and reassess at 5 minutes.

See source criteria · BLS Cardiac

Chest pain & suspected ACS

Obtain an early 12-lead, check medication exclusions, and coordinate a cardiac destination.

Adult / adolescent · ALS Cardiac

Symptomatic bradycardia

Treat poor perfusion, prepare pacing, and obtain required base contact.

Adult / adolescent · ALS Cardiac

Regular narrow-complex tachycardia

Distinguish a compensatory fast rate from the adenosine or urgent-cardioversion pathway.

Adult / adolescent · ALS Medical

Allergic reaction & anaphylaxis

Separate rash-only reactions from angioedema and systemic anaphylaxis.

Adult / adolescent · ALS Respiratory

Respiratory distress

Use the wheeze, suspected CHF, or stridor pathway and reassess ventilation.

Adult / adolescent · ALS Neurologic

Altered mental status

Support the airway, check glucose, assess stroke criteria, and treat poor perfusion or suspected opioid toxicity.

Adult / adolescent · ALS Neurologic

Seizure / convulsions

Treat active or recurrent seizures, monitor ventilation, and check for hypoglycemia.

Adult / adolescent · ALS Medical

Overdose & poisoning

Support ventilation first, then identify the opioid, stimulant, cholinergic, or smoke-exposure pathway.

Adult / adolescent · ALS Medical

Nausea, vomiting & dehydration

Manage airway risk, assess perfusion, and use the adult or pediatric antiemetic pathway.

Adult & pediatric · ALS Trauma

Trauma: bleeding, limb injury & TBI

Control hemorrhage, protect perfusion and ventilation, and recognize destination needs.

Adult / adolescent · ALS Trauma

Burns & smoke inhalation

Support oxygenation, address pain and perfusion, and recognize burn-center referral criteria.

Adult / adolescent · ALS Pediatric

Pediatric respiratory distress

Distinguish wheeze, croup-like cough, anaphylaxis, and poor perfusion.

Pediatric · ALS Pediatric

Pediatric allergic reaction & anaphylaxis

Use weight-based epinephrine first for anaphylaxis, then treat airway, breathing, and perfusion.

Pediatric · ALS BLS

Tourniquet: uncontrolled extremity bleeding

Apply an approved tourniquet, keep it visible, and communicate the placement time.

Adult & pediatric · BLS / ALS Pediatric

Pediatric seizure / convulsions

Use weight-based seizure treatment, monitor ventilation, and contact base for every patient.

Pediatric · ALS Pediatric

Pediatric cardiac arrest

Follow the pediatric shockable and non-shockable pathways, with weight-based medication and early base contact.

Pediatric · ALS Pediatric

Pediatric bradycardia

Correct oxygenation and ventilation first; escalate persistent bradycardia with poor perfusion.

Pediatric · ALS Pediatric

Pediatric altered mental status

Protect ventilation, assess perfusion, check glucose, and treat the identified cause.

Pediatric · ALS Pediatric

Pediatric shock / hypotension

Reassess after each weight-based fluid bolus and obtain base direction for pediatric push-dose epinephrine.

Pediatric · ALS Pediatric

Pediatric overdose / poisoning

Support breathing, identify the exposure, and use the toxin-specific pediatric pathway.

Pediatric · ALS Pediatric

Pediatric nausea / vomiting

Treat dehydration, protect the airway, and use ondansetron only within its age-specific pediatric order.

Pediatric · ALS Pediatric

Pediatric burns

Assess inhalation injury, treat pain and poor perfusion, and coordinate the burn destination.

Pediatric · ALS Pediatric

Pediatric non-fatal drowning

Prioritize ventilation, reassess for deterioration, and obtain the required pediatric destination direction.

Pediatric · ALS Pediatric

Pediatric injury / trauma

Control hemorrhage, reassess perfusion, and keep pediatric analgesia and head-injury targets distinct.

Pediatric · ALS Pediatric

Pediatric heat illness / hypothermia

Separate cooling from warming pathways and recognize when altered mental status or arrest changes the response.

Pediatric · ALS Cardiac

Adult cardiac arrest

Use the OCEMS arrest sequence, track medication totals, and coordinate post-ROSC destination.

Adult / adolescent · ALS Cardiac

Wide-complex tachycardia with a pulse

Separate stable transport from unstable synchronized cardioversion and medication steps.

Adult / adolescent · ALS Medical

Adult shock / hypotension

Identify poor perfusion, reassess fluid response, and recognize the cardiogenic branch.

Adult / adolescent · ALS Medical

Adult hyperglycemia / suspected DKA

Use glucose together with mental status, breathing, vital signs, and comorbidity to choose support and transport.

Adult / adolescent · ALS Medical

Adult abdominal / flank pain

Treat perfusion, pain, and nausea while screening for cardiac or aortic emergencies.

Adult / adolescent · ALS Environmental

Adult non-fatal drowning

Support oxygenation and ventilation, assess associated trauma, and use CPAP only in the appropriate conscious patient.

Adult / adolescent · ALS Environmental

Adult heat illness / hyperthermia

Move promptly to cooling and escalate when mental status or perfusion is abnormal.

Adult / adolescent · ALS Environmental

Adult hypothermia

Warm, handle the slow pulse deliberately, and follow the hypothermic-arrest pathway when indicated.

Adult / adolescent · ALS BLS

OCEMS BLS scope of practice

A practical OCEMS BLS guide for Orange County EMTs: scope of practice, CPAP, medication assistance, ALS support, and transport limits.

Adult / pediatric — follow each procedure’s criteria · BLS Field medications

Adenosine

Regular narrow-complex tachycardia: adult treatment and pediatric base-order guidance.

Adult & pediatric guidance · ALS Field medications

Albuterol

Nebulized treatment for bronchospasm, with adult and pediatric protocol distinctions.

Adult & pediatric guidance · ALS Field medications

Amiodarone

Separate cardiac-arrest dosing from treatment of unstable wide-complex tachycardia with a pulse.

Adult & pediatric guidance · ALS Field medications

Aspirin

Adult suspected cardiac ischemia and the limits of pediatric and fire-service use.

Adult & pediatric guidance · ALS Field medications

Atropine

Symptomatic bradycardia and organophosphate poisoning require different doses and pediatric rules.

Adult & pediatric guidance · ALS Field medications

Dextrose 10% (D10)

Treat hypoglycemia with a titrated adult dose or measured pediatric volume.

Adult & pediatric guidance · ALS Field medications

Diphenhydramine (Benadryl)

Allergic and dystonic reactions: weight-based pediatric dosing and adjunctive use in anaphylaxis.

Adult & pediatric guidance · ALS Field medications

Epinephrine

Anaphylaxis, cardiac arrest, and push-dose shock treatment: concentrations and age-specific rules.

Adult & pediatric guidance · ALS Field medications

Fentanyl

Adult and pediatric analgesia, route-specific doses, and the young-child base-contact requirement.

Adult & pediatric guidance · ALS Field medications

Glucagon

IM hypoglycemia treatment when IV access cannot be established.

Adult & pediatric guidance · ALS Field medications

Oral glucose

Adult and pediatric use depends on a safe swallow, intact airway reflexes, and the matching product.

Adult & pediatric guidance · ALS Field medications

Hydroxocobalamin (Cyanokit)

Adult and pediatric cyanide-antidote treatment with base authorization and a dedicated infusion line.

Adult & pediatric guidance · ALS Field medications

Ketamine

OCEMS analgesia for eligible patients age 15 and older; pediatric exclusion is explicit.

Adult & pediatric guidance · ALS Field medications

Ketorolac (Toradol)

Non-opioid analgesia with strict age, renal, bleeding, and pregnancy exclusions.

Adult & pediatric guidance · ALS Field medications

Lidocaine

Separate antiarrhythmic dosing from preservative-free IO-infusion analgesia.

Adult & pediatric guidance · ALS Field medications

Midazolam (Versed)

Seizure control and indication-specific sedation, with distinct adult and pediatric limits.

Adult & pediatric guidance · ALS Field medications

Morphine sulfate

Adult formulation-dependent doses and pediatric weight-based analgesia.

Adult & pediatric guidance · ALS Field medications

Naloxone (Narcan)

Restore ventilation in suspected opioid toxicity; distinguish ALS routes from the BLS nasal-product pathway.

Adult & pediatric guidance · ALS Field medications

Nitroglycerin

Sublingual adult cardiac/pulmonary-edema treatment and separately authorized transport infusions.

Adult & pediatric guidance · ALS Field medications

Normal saline (0.9% sodium chloride)

Fluid resuscitation, pediatric bolus limits, and nebulized saline are different uses.

Adult & pediatric guidance · ALS Field medications

Ondansetron (Zofran)

Adult oral/IV treatment and the pediatric age-4-and-older ODT pathway.

Adult & pediatric guidance · ALS Field medications

Oxygen

Adult and pediatric oxygen delivery, ventilation support, and condition-specific exceptions.

Adult & pediatric guidance · ALS Field medications

Sodium bicarbonate

Indication-specific adult treatment and pediatric source-chart guidance.

Adult & pediatric guidance · ALS Field medications

DuoDote (atropine / pralidoxime)

Combination auto-injector for organophosphate/nerve-agent toxicity, with age and weight restrictions.

Adult & pediatric guidance · BLS / ALS Transport medications

Heparin infusion

Monitoring a prescribed infusion during interfacility transport; not a field initiation protocol.

Adult & pediatric scope · IFT-ALS Transport medications

Alteplase (tPA) infusion

Interfacility monitoring of a stroke thrombolytic infusion and its explicit stop criteria.

Adult & pediatric scope · IFT-ALS Fire-service OTC

Acetaminophen

OTC analgesic/antipyretic listed for the FS-ARN program.

Adult & pediatric scope · FS-ARN Fire-service OTC

Ibuprofen

OTC NSAID listed for the FS-ARN program.

Adult & pediatric scope · FS-ARN Fire-service OTC

Claritin / OTC antihistamine

The non-prescription antihistamine example named in SO-F-02.

Adult & pediatric scope · FS-ARN Fire-service OTC

Imodium A-D (loperamide)

The OTC antidiarrheal product listed in the fire-service source.

Adult & pediatric scope · FS-ARN Fire-service OTC

Caladryl or equivalent

Topical OTC preparation listed for eligible firefighting personnel.

Adult & pediatric scope · FS-ARN Fire-service OTC

Poison oak / sumac products

OTC poison oak and sumac product-category guidance under SO-F-02.

Adult & pediatric scope · FS-ARN Fire-service OTC

OTC cough preparations

Alcohol-free liquid or tablet cough preparations in the FS-ARN list.

Adult & pediatric scope · FS-ARN Fire-service OTC

Moisturizing eye drops

OTC ocular-lubrication products listed in SO-F-02.

Adult & pediatric scope · FS-ARN Fire-service OTC

Body & foot powders

Talcum/corn-starch body powders and foot powders in the FS-ARN list.

Adult & pediatric scope · FS-ARN Fire-service OTC

Neosporin ointment

The topical OTC ointment product listed in the fire-service source.

Adult & pediatric scope · FS-ARN Fire-service OTC

Bacitracin ointment

Topical bacitracin listed in the FS-ARN OTC program.

Adult & pediatric scope · FS-ARN Fire-service OTC

Antifungal powders & sprays

OTC antifungal product categories listed for fire-service personnel.

Adult & pediatric scope · FS-ARN Fire-service OTC

Antacid preparations

Liquid or tablet OTC antacids under SO-F-02.

Adult & pediatric scope · FS-ARN Fire-service OTC

Mouthwash preparations

Oral-care products listed in the fire-service OTC supply program.

Adult & pediatric scope · FS-ARN Vaccination references

Influenza vaccine

Influenza vaccine: historical OCEMS program scope, adult/pediatric limits, and current-authorization requirements.

Adult & pediatric scope · Program-specific Vaccination references

COVID-19 vaccine

COVID-19 vaccine: historical OCEMS program scope, adult/pediatric limits, and current-authorization requirements.

Adult & pediatric scope · Program-specific

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Source-linked OCEMS summaries. Each guide links to its official sources and applicable scope.