The Clinical Practice of Emergency Medical Services Medicine

Reaffirmed June 2023.

Originally approved October 2017, replacing the following rescinded/sunsetted policy statements: Discontinuing Resuscitation in the Out-of-Hospital Setting (1997-2017); Early Defibrillation Programs (1998-2017); Implementation of EMS Interventions (1992-2017); Out-of-Hospital 12-Lead ECG (1999-2017); Out-of-Hospital Severe Hemorrhage Control (2014); Out-of-Hospital Use of Analgesia and Sedation (2015)


The American College of Emergency Physicians (ACEP) considers emergency medical services (EMS) a practice of medicine, reaffirms its commitment to evidence-based decisions in practices of medicine, and supports the following principles:

  • Clinical standards of care (including treatments that can be provided by laypersons prior to EMS arrival) developed, established, and promulgated by EMS physician medical directors should be based upon peer-reviewed, published, evidence-based treatments and outcomes. Where such supported treatments and outcomes do not exist, expert consensus statements should substantially form the basis for clinical standards of care.
  • Clinically-related research initiatives involving EMS systems and providers should be encouraged and supported, with careful adherence to the ethical and legal principles of human subjects protection.
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