Date of Award

January 2015

Degree Type

Open Access Thesis

Document Type

Master Thesis

Degree Name

Master of Science (MS)


Safety, Security, and Emergency Management

First Advisor

Sandy L. Hunter

Department Affiliation

Safety, Security, and Emergency Management

Second Advisor

Sarah Morris

Department Affiliation

Safety, Security, and Emergency Management

Third Advisor

Nancye Davis

Department Affiliation

Safety, Security, and Emergency Management


Many variances in prehospital Paramedic treatment protocols exist amongst Emergency Medical Service (EMS) Providers in the State of Kentucky. These differences lead to inconsistencies in quality of patient care delivered, reduce ease of mobility of providers and result in a decreased oversight from the Kentucky Board of EMS (KBEMS). To investigate the impact of protocol variances on patient care, a mixed methods study consisting of a convenience sample of Kentucky EMS prehospital Paramedic treatment protocols was collected and compared to the Kentucky state-wide treatment protocols. A literature review of best practices regarding EMS protocols was conducted. Of all protocols 81.9% average compliance was achieved to the state standard; of the custom protocols (e.g. Stanford and Rural Metro EMS) only 41.9% average compliance was achieved. Lapses in compliance result in deviation from both KBEMS and national standards of patient care. The markedly low compliance to state standards demonstrates the need for a mandated state-wide treatment protocol. When compared to national standards such as the American Heart Association, the Kentucky protocol was consistent in content, with opportunity for improvement in design and minor adjustments available to satisfy both national standards and local needs. An interview panel of Kentucky Paramedics supports these conclusions and suggests that the lack of a mandated protocol had clinically significant impacts on patient outcomes. With mandated adoption of a renovated statewide prehospital Paramedic treatment protocol, KBEMS would be able to ensure the highest quality of patient care throughout Kentucky while simultaneously supporting the national EMS vision and needs of local EMS providers.