NYC REMAC Unified Prehospital Treatment Protocols Vocabulary

Vocabulary flashcards covering core definitions, clinical terms, and protocol criteria from the NYC REMAC Unified Prehospital Treatment Protocols (2026-01).

Alternative Destination

A regionally-approved 911 system receiving facility that may have limited and/or specialized capabilities but is NOT a 911 system ambulance destination emergency department.

Continuous Quantitative Waveform Capnography

Continuous quantitative measurement of the partial pressure of carbon dioxide during respiration, required for all patients receiving advanced airway management except supraglottic airways used during insufficient resource events.

Discretionary Orders

Medications, treatments, or procedures within the scope of practice of a provider's certification level that differ from their delineated use or dosage in a specific protocol.

Hyperactive Delirium

A behavioral syndrome characterized by psychomotor agitation (aggression, reduced sensitivity to pain, violent struggling), physiologic excitation (tachycardia, tachypnea, diaphoresis), and delirium.

High Index of Suspicion

The clinical concern that a patient may have an acute medical, traumatic, psychiatric, behavioral, or other condition that could result in a life-threatening or life-altering outcome.

Low Index of Suspicion

Any patient condition that does not meet the established criteria for a high index of suspicion.

Medication Administration

The administration of ANY medication to a patient by prehospital providers, other healthcare providers, bystanders, or the patient themselves during or immediately preceding the call for emergency medical aid.

Medical Control Options

Treatments and procedures within prehospital protocols that may only be administered or performed after contacting Online Medical Control (OLMC).

Online Medical Control (OLMC)

Real-time communication between a REMAC OLMC certified physician and prehospital providers via radio, telephone, telemetry, video, or face-to-face to direct medical care and transport choices.

Procedural Sedation

A medical procedure involving the administration of medications to conscious patients who require short-term analgesia and/or anxiolysis for procedures such as synchronized cardioversion, transcutaneous pacing, or advanced airway management.

Spinal Motion Restriction

Procedures utilized to minimize potential or further spinal injury in patients with suspected spinal trauma, including rigid cervical collar application, supine positioning, and maintaining inline stabilization.

Standing Orders

Protocols authorizing specific medications and treatments that prehospital providers may perform without contacting Online Medical Control (OLMC).

Telehealth

Real-time two-way interactive audio-visual communication between a patient and a distant site high-level medical provider (such as a physician, nurse practitioner, or physician assistant).

Endotracheal Intubation Attempt

The introduction of the laryngoscope blade past the teeth, which is counted as an attempt regardless of whether the endotracheal tube is successfully inserted.

Adult Patient (Age Definition)

Any patient aged $\ge 15\text{ years}$, who must be treated according to adult prehospital treatment protocols.

Preterm Infant

An infant born prior to the 37th week of gestation.

Neonate

A pediatric patient defined from the period after the first few hours following birth up to $28\text{ days}$ of age.

Shock (Adult Definition)

A clinical condition where a patient is hypotensive with mean arterial blood pressure $\text{MAP} < 65\,mmHg$ or systolic blood pressure $\text{SBP} < 90\,mmHg$ AND symptomatic with signs of hypoperfusion.

Hypotension (Pediatric Definition)

A pediatric blood pressure threshold defined as a systolic blood pressure $\text{SBP} < 70 + (2 \times [\text{age in years}])\,mmHg$.

Chemical Restraint

The administration of a sedative or dissociative medication to prevent injury in patients suffering from hyperactive delirium who are violently struggling.

Class Order

A general order issued by an FDNY OMA Medical Director to perform specific medical interventions at a specific location during a specified time period, typically utilized in disaster or WMD scenarios.

SLUDGEM

An acronym listing clinical signs of nerve agent exposure: Salivation, Lacrimation, Urination, Defecation/diarrhea, Gastrointestinal upset, Emesis, and Miosis/muscle twitching.

NYC S-LAMS Scale

A standardized prehospital stroke assessment scoring tool evaluating Facial Droop, Arm Drift, Speech Deficit, and Grip Strength, producing a total score from $0$ to $6$.