EMT CPG 2026

Pre-Hospital Emergency Care Council (PHECC) Clinical Practice Guidelines (CPGs) for EMT Level 2026 Edition

Contents Overview

  • General Structure of CPGs

  • Abbreviations

  • Care Principles

  • Emergency Responses

  • Clinical Conditions

  • Pharmacology

  • Trauma Management

  • Patient Assessment

  • Pain Management

  • Mental Health Emergencies

  • Palliative Care and End-of-Life Situations

General Structure of CPGs

  • Clinical Practice Guideline (CPG) Indexing:

    • The first set of numbers denote clinical levels (e.g., 4/5/6).

    • 'x' indicates section in CPG manual while 'y' designates CPG number.

    • 'mm/yy' indicates publication date.

Accepted Abbreviations

  • AP: Advanced Paramedic

  • ALS: Advanced Life Support

  • ABC: Airway, Breathing, and Circulation

  • DNR: Do Not Resuscitate

  • EMT: Emergency Medical Technician

  • CPG: Clinical Practice Guideline

  • GP: General Practitioner

Example Abbreviations

  • BG: Blood Glucose

  • BLS: Basic Life Support

  • BP: Blood Pressure

  • GCS: Glasgow Coma Scale

  • IV: Intravenous

  • IM: Intramuscular

Care Principles

Comprehensive Patient Care

  1. Safety of all parties involved (practitioners, patients, public).

    • Use appropriate Personal Protective Equipment (PPE).

    • Perform hand hygiene before and after interactions.

  2. Respect for patient autonomy and capacity.

    • Follow the Assisted Decision-Making (Capacity) Act 2015.

  3. Acquire informed consent before any intervention.

  4. Identification and management of life-threatening conditions.

  5. Ensure ventilation and oxygenation.

    • Strive to optimize tissue perfusion.

  6. Conduct primary evaluations and reassessments continuously.

    • Document findings on Patient Care Report (PCR).

  7. Communication and management of personal care plans for patients.

  8. Ensure effective and safe transportation to medical facilities.

Procedural Responsibilities

  • Practitioners must verify the presence of a clinical lead on site.

  • Maintain the highest standards of infection control following patient interactions.

Emergency Responses

Primary Survey Protocol

  • A: Ensure airway is patent and protected.

  • B: Confirm adequate ventilation.

  • C: Assess and control circulation.

Secondary Survey Protocol

  1. Collect SAMPLE history (Signs, Allergies, Medications, Previous illnesses, Last oral intake, Events leading to present illness).

  2. Record vital signs and perform focused assessments based on findings.

Clinical Conditions Management

Pain Management Guidelines

  • Timely provision of pain relief ensuring it does not delay diagnostic procedures.

  • Use a tiered approach to address severe to mild pain.

Pharmacologic Interventions

  • Opioids, NSAIDs, adjunct therapies as per professionalism and guideline appropriateness.

Pharmacology Basics

  • Clear indication for each medication’s administration route (IV, IM, buccal, etc.).

  • Specific dosages for adults and pediatrics delineated.

Examples of Medications

  1. Adrenaline:

    • Indications: Anaphylaxis.

    • Dosage: 500 mcg IM (repeat as necessary).

  2. Oxygen Therapy:

    • Indications: Hypoxia and respiratory distress.

    • Dosage: Titrate to achieve SpO2 94%-98%.

Trauma Management Strategies

  • Hemorrhage Control: Assess and apply appropriate dressings, pressure points, and tourniquets per protocol.

  • Advanced Trauma Life Support: Include manual stabilization of spinal injury where indicated.

Patient Assessment Techniques

Effective Triage Tools

  • Implement the Ten Second Triage method to categorize casualties.

  • Utilize the Paediatric Assessment Triangle in pediatric assessments.

Monitoring Vital Signs

  • Maintain regular checks of pulse, blood pressure, and SpO2.

Mental Health Emergencies

  • Understand the protocols for dealing with patients in crises.

  • Ensure supportive engagement and documentation for patient safety.

Palliative and End-of-Life Care Protocols

  • Implement guidelines for transference to appropriate care settings in end-of-life situations.

  • Ensure compassionate and respectful handling of patients and families.

Appendix 1 - Medication Formulary

Provides a detailed list of medications, their classifications, indications, dosages, and any specific notes about contraindications and administration routes.

  • For example: Activated Charcoal - indicated for oral poisoning; dosage and contraindications defined explicitly.

Appendix 2 - Medications & Skills Matrix

Outlines new medications/skills for practitioner levels, and identifies the relevant CPGs for each competency.