Not quite sure what the fuss is about here - as you say they are guidelines which is a very positive and very significant thing in the modern world of tight regulations and idiot-proofing... You can clearly justify your actions so go ahead. Tom, I know you are pissed off but this actually seems to highlight a positive change in the ambulance service. (PS I'm not from management, just an occasional interested and pretty satisfied customer whose job is far less satisfying than yours I'm sure!)