Emergency medical services (EMS) is responsible for the prehospital management of medical emergencies. EMS professionals operate under the license of a practicing physician, or “medical director.” The skills and procedures which EMS providers may perform are outlined as written “protocols.” To investigate the evidence-based nature (or lack thereof) of EMS protocols, a convenience sample of ground EMS agencies within the state of Kentucky which provide ALS-level patient care was used. This sample consisted of agencies of varying run volumes that were located across all major geographic regions of the state. Twenty six agencies constituted the final sample. The full list of approved protocols for these agencies were requested through an open records request through the Kentucky Board of Emergency Medical Services (KBEMS), along with KBEMS’ protocols. These protocols were examined for compliance with evidence-based practices which were supported by a literature review. Ten practices were selected for review, five pertaining to the management of suspected spinal injury through spinal motion restriction and five pertaining to the management of chest pain of suspected cardiac origin. Conclusion: Over 90% of agencies were compliant with 7 of the 10 examined practices, while less than 15% were compliant with the remaining 3 practices. KBEMS protocols were compliant with the same 7 practices, and non-compliant with the remaining 3. Overall, level of adherence with state-wide protocols had a much stronger relationship to compliance with the evidence base than any other studied agency demographical information (agency run volume, urban vs. rural).

Semester/Year of Award

Fall 2018


Sandy L. Hunter

Mentor Professional Affiliation

Safety, Security, and Emergency Management

Access Options

Open Access Thesis

Document Type

Bachelor Thesis

Degree Name

Honors Scholars

Degree Level



Safety, Security, and Emergency Management

IRB Approval Number (if applicable)