Protocols and Destination Guidance

If an agency would like to adopt the entire state protocols without changes, complete the following steps for approval:

• A letter should be drafted on agency letterhead, stating the desire to adopt the Kentucky State Protocols completely.
• This letter needs to be signed by the Agency Director and Medical Director
• In KEMSIS, complete the Medical Protocol Application and upload the above referenced document.

Licensed Ambulance agencies wishing to "opt-out" of certain portions of the approved Kentucky State EMS Protocol, but wish to implement all other portions shall complete the following steps:

• A letter should be drafted on agency letterhead, stating the desire to opt out of the specific omissions requested from the approved Kentucky State EMS Protocols.
• This letter needs to be signed by the Agency Director and Medical Director.
• In KEMSIS, complete the Medical Protocol Application, citing the page number and addition and/or exclusions, and upload the following documents within the application:

1. A copy of the letter referenced above.
2. A copy of the protocols as requested.

Licensed Ambulance agencies wishing to use agency specific protocols in lieu of the approved Kentucky State EMS Protocols shall complete the following steps:

• A letter should be drafted on agency letterhead, stating the desire to use agency specific protocols instead of the approved Kentucky State EMS Protocols.
• This letter needs to be signed by the Agency Director and Medical Director.
• In KEMSIS, complete the Medical Protocol Application and upload the above referenced document along with a copy of the protocols.

Review of agency specific protocols may take up to four months.

If an agency wishes to adopt restricted protocols, a specific written request for authorization to utilize the protocol must be submitted and approved prior to implementation. This request needs to include signatures of the Service Director and the Medical Director.

*map showing hospitals in the Kentucky Trauma System (updated 01/04/2016)

Memo from Transportation Cabinet, Office of Transportation Delivery Dated 12/14/2015

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