Live in Michigan
Michigan EMS protocols,
Michigan EMS protocols,
in your pocket.
Offline, county-specific protocols for Michigan EMS providers — searchable, with a full medication reference, hospital finder, and study tools built in.
Covering 83 counties in Michigan · Protocols current as of October 24, 2026
See it in the field
Pocket Protocols showing Michigan's protocols, medications, and hospitals — searchable and fully offline.
What's covered in Michigan
The protocol set serving Michigan right now.
Michigan EMS Protocol Suite — State Templates
Sept 2026 ↗
PDF document
1,252
Flashcards
662
Quiz questions
37
Medications
90
Resources
Study tools for Michigan EMS Protocol Suite — State Templates
A few real flashcards and quiz questions from Michigan's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
7.18 Pleural Decompression (Paramedic Use Only): insertion sites
a. Anterior axillary at the fourth intercostal space just above the fifth rib; b. Midaxillary at the fourth intercostal space just above the fifth rib; c. Midclavicular (if unable to access axillary) line at the second intercostal space just above the third rib. Midclavicular is the preferred site for pediatrics (≤ 14 years of age).
Serious symptomatic bradycardia: definition and treatment goal
This protocol is for paramedic use only. Serious symptomatic bradycardia is defined as a heart rate less than 60 bpm and hypotension, or shock. Titrate treatments to a heart rate above 60 bpm. If the patient remains hypotensive, refer to the Shock Treatment Protocol.
Tachycardia protocol activation threshold
This protocol is for paramedic use only. It is used for persistent tachycardia (ventricular rate greater than or equal to 150/minute) where the tachycardia is believed to be the primary cause of the patient's symptoms. For rates <150, believed to be causing symptoms, contact Medical Control for possible orders. It is not intended to treat tachycardia that is secondary to underlying conditions (i.e., dehydration, trauma, sepsis, or toxins).
7.1 12-Lead ECG: Protocol level
12-Lead ECG is a Paramedic Protocol (may be Specialist or EMT per MCA selection). MCAs will be responsible for maintaining a roster of the BLS and LALS agencies choosing to participate and will submit the roster to MDHHS.
7.8 Electrical Therapy: AED pad placement for all patients
For all patients, anterior/posterior placement of pads is preferred and should be used, if possible. There are no age or weight limits for AED use. In pediatric patients, attenuated pads should be used, if available; if adult pads are used in pediatric patients, pads must be placed in an anterior/posterior configuration.
7.11 Impedance Threshold Device (MCA Optional Protocol): indication and contraindications
The ITD protocol is an MCA Optional Protocol. Its indication is cardiopulmonary arrest (medical etiology) in patients > 10 kg (22 lbs.). Contraindications are cardiopulmonary arrest related to trauma and patients ≤ 10 kg (22 lbs.).
7.28 LVAD: devices NOT to use on an LVAD patient
Do NOT use an AED or a Mechanical Compression Device on an LVAD patient.
7.29 Mechanical Chest Compression Device (MCA Optional Protocol): standard of care and when a device may be used
Under this MCA Optional Protocol, manual chest compressions remain the standard of care for cardiac arrest. Mechanical chest compression devices may only be used as an alternative to conventional CPR in specific settings where delivery of high-quality manual compressions may be challenging or dangerous for the provider (e.g., limited rescuers available, CPR during hypothermic cardiac arrest, CPR in a moving ambulance).
Quiz questions
You are treating an adult cardiac arrest patient and have just successfully placed a supraglottic airway. According to the protocol, how should ventilations be delivered and at what rate?
- Synchronously with compressions at a ratio of 30:2
- ✓ Asynchronously at 10 breaths per minute (1 breath every 6 seconds)
- Asynchronously at 12 breaths per minute (1 breath every 5 seconds)
- Synchronously at 8 breaths per minute during compression pauses
After achieving ROSC in a medical cardiac arrest, how long should a patient be stabilized on scene before transport?
- Immediately load and go without delay
- Two to three minutes
- ✓ Five to ten minutes
- Fifteen to twenty minutes
As a Specialist/AEMT or Paramedic, you are treating a 68-year-old male in respiratory distress with crackles bilaterally and a SBP of 130 mmHg. He denies taking any erectile dysfunction medication or pulmonary hypertension medication in the last 48 hours. IV access has NOT yet been established. Which of the following is the correct nitroglycerin action per protocol?
- Withhold nitroglycerin until IV access is established
- ✓ Nitroglycerin 0.4 mg SL may be administered, up to a maximum of 3 doses
- Administer nitroglycerin 0.4 mg SL and repeat every 3-5 minutes as long as SBP remains above 100 mmHg
- Contact medical control before administering any nitroglycerin
You are treating a 58-year-old male complaining of chest pain. He tells you he took sildenafil (Viagra) 36 hours ago. Which of the following actions is most appropriate regarding nitroglycerin?
- Administer nitroglycerin 0.4 mg SL as normal, since 36 hours have passed.
- ✓ Do NOT administer or assist with nitroglycerin and contact Medical Control.
- Administer nitroglycerin only if systolic BP is above 120 mmHg.
- Administer half the normal nitroglycerin dose and monitor BP closely.
Under the Michigan 12-Lead ECG Paramedic Protocol (may be Specialist or EMT per MCA selection), a patient has nausea and diaphoresis only. When must a 12-lead ECG be performed?
- Only if the patient also reports chest pain
- ✓ If the etiology of the illness is indicative of an Acute Coronary Syndrome or the etiology is indeterminate
- Never; nausea and diaphoresis are not 12-lead indications
- Only when the receiving hospital requests it
Per 7.8 Electrical Therapy, which patient should NOT have an AED applied?
- A patient whose chest has been dried after being diaphoretic
- ✓ A patient with an LVAD
- A pediatric patient weighing under 10 kg
- An adult patient over 80 years of age
Sourced from Michigan's EMS authority
Pocket Protocols brings Michigan's EMS protocols into a faster, fully offline app.
Michigan protocols — FAQ
Are Michigan's EMS protocols available offline?
Yes. Download Michigan's protocol set once and every protocol, medication, and hospital is available with no signal — built for basements, rural calls, and dead zones.
Are the protocols specific to my county in Michigan?
Yes. Michigan's protocols are scoped by county and region, so every provider sees exactly the set that governs where they respond. You can add more than one if you run in multiple areas.
Is Pocket Protocols official, or affiliated with Michigan?
No — Pocket Protocols is an independent app and isn't affiliated with or endorsed by any EMS authority. We bring Michigan's protocols into a faster, fully offline app and link the authority's own source for every set.
How do Michigan protocol updates reach the app?
When the EMS authority publishes a new version and it goes live in Pocket Protocols, the app refreshes automatically — crews are never working from a stale copy. We monitor official sources for changes every day.
Carry Michigan's protocols on every call.
Download Pocket Protocols and keep your county's complete protocol set in your pocket — online or off.