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TL;DR

POLST/MOLST Forms: Portable physician orders for life-sustaining treatment recognized across care settings.

By Valenke Exam Prep Team·Last updated 2026-06-02

POLST/MOLST Forms

NREMT EMTNREMT PARAMEDIC

Definition

Portable physician orders for life-sustaining treatment recognized across care settings.

Related Procedures

Procedures related to polst/molst forms in the EMS setting:

  1. STEMI protocol: 12-lead ECG within 10 min then aspirin 324mg then NTG if SBP >90 then notify cath lab then transport code 3
  2. Pediatric weight-based dosing: Broselow tape for length-based weight estimation in emergencies

Practical Example

Field Scenario: A construction worker stung by wasps, developing urticaria, stridor, and hypotension. Anaphylaxis: epinephrine 0.3mg IM, IV fluids, diphenhydramine, albuterol for bronchospasm.

This scenario tests your ability to apply knowledge of polst/molst forms under time pressure with incomplete information, exactly the type of decision-making the certification exam assesses.

Regulatory Context

Regulatory context for polst/molst forms includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.

Differential Diagnosis

When assessing polst/molst forms, use structured assessment tools to differentiate between possible causes:

Trauma Score: Components: GCS, Systolic BP, Respiratory rate. Scoring: Revised Trauma Score: coded values 0-4, sum correlates with survival probability.

APGAR: Components: Appearance, Pulse, Grimace, Activity, Respiration. Scoring: 0-10 at 1 and 5 minutes, under 7 needs intervention.

Equipment & Tools

Equipment used in polst/molst forms assessment and treatment:

Waveform capnograph
Measures end-tidal CO2 continuously with waveform display. Available sizes: Mainstream (inline), Sidestream (sampling)
IO drill
Intraosseous access device for emergent vascular access. Available sizes: EZ-IO: 15mm (peds), 25mm (adult), 45mm (obese)
King airway
Supraglottic blind-insertion airway device. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
BVM
Bag-valve-mask for manual ventilation. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)

Calculation Methods

Dosage calculations related to polst/molst forms in EMS:

Pediatric dosing: always calculate by weight (mg/kg). Use Broselow tape if weight is unknown.

Why It Matters

POLST legal authority in prehospital setting tested on EMT and Paramedic exams.

Related Terms

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Frequently Asked Questions

What protocol applies to polst/molst forms in prehospital care?
For polst/molst forms: STEMI protocol: 12-lead ECG within 10 min then aspirin 324mg then NTG if SBP >90 then notify cath lab then transport code 3
What equipment is needed for managing polst/molst forms in the field?
For polst/molst forms: IO drill provides Intraosseous access device for emergent vascular access. Pulse oximeter provides Measures SpO2 via infrared absorption through capillary bed. Waveform capnograph provides Measures end-tidal CO2 continuously with waveform display.
What assessment tools help evaluate polst/molst forms?
For polst/molst forms: SAMPLE: evaluates Signs/symptoms, Allergies, Medications, Past history, Last intake, Events; scoring is Mnemonic for patient history gathering. Cincinnati Stroke Scale: evaluates Facial droop, Arm drift, Speech abnormality; scoring is Any 1 positive = 72% probability of stroke.