Administrative Bulletin No. 24 - BUL - 001: Protocol Update: Medical Arrest

Administrative Bulletin
No. 24 – BUL - 001
Re: Protocol update - Medical Arrest
Effective – July 1, 2024

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Stanislaus County EMS Agency recently updated the Medical Arrest protocol, with an effective date of July 1, 2024.The EMS Agency Medical Directors decided to reduce the maximum total dose to 3 mg. This decision was based on recent literature supporting the limited total amount of Epinephrine administered in a medical arrest, in conjunction with the continued shortage of Epinephrine 1:10,000.

Previous Dosage of Epinephrine: 1mg (1:10,000) q 3-5 minutes; Max of 5mg
New/Updated Dosage of Epinephrine: 1mg (1: 10,000) q 3-5 minutes; Max of 3mg

This change has been made to the Medical Arrest protocol and has been updated on the Agency’s website. This change applies ONLY to adults, there has been no change in pediatrics. If you have any questions or concerns, please reach out to Stanislaus County EMS Agency.


David Murphy
QI / Trauma Coordinator
Stanislaus County EMS Agency