Pre-Hospital Care Protocols

The State of Maine uses statewide EMS protocols for the care of patients in the pre-hospital environment. Protocols are developed by the Maine EMS Medical Direction & Practices Board (MDPB) and are reviewed/updated on a 2-year cycle.

Maine EMS protocols are available via a free app for smartphones.  It can be found in the App Store (iPhones/iPads) or Google Play (Android) as the "Maine EMS Protocol App" from Maine Emergency Medical Services.  Statewide protocols are no longer printed by Maine EMS but can be viewed, saved, and printed via the PDF link (below).


Maine EMS 2021 Statewide Protocols

Maine EMS and the Medical Direction & Practices Board (MDPB) developed updated statewide EMS protocols that were implemented on December 1, 2021.  

The MDPB has spent countless hours researching, drafting, and revising these EMS protocols.  In addition to monthly public meetings and volunteering many work hours, the MDPB held six statewide public protocol discussion forums. 

The Education Committee, MDPB, and Maine EMS released the following information regarding protocol updates:

All EMS clinicians are required to attend a 2021 protocol update course and this can be accomplished through 2 options:

1. Complete the protocol update via MEMSEd (now available)

2. Or have attended one of the seven live, virtual, protocol update sessions listed below, 

  • Region 1 was held on October 27, 2021
  • Region 2 was held on October 12, 2021
  • Region 3 was held on October 25, 2021
  • Region 4 was held on October 19, 2021
  • Region 5 was held on October 18, 2021
  • Region 6 was held on October 28, 2021
  • An additional session was held on November 15, 2021

EMS clinicians only need to do one of the above options.

Maine EMS 2021 Pre-Hospital Care Protocol Documents

  • Complete 2021 Maine EMS Protocols (PDF) (12/7/21)

    • Corrections:

      • Red 8: Under 13.a., the dose was hidden by the pediatric teddy bear logo.  It read "VF/VT: amiodarone 300 mg IV/IO; may consider additional mg IV/IO one time".  It has been corrected to read "VF/VT: amiodarone 300 mg IV/IO; may consider additional 150 mg IV/IO one time". This has been updated to the full protocol pdf and protocol app.  If you have printed the entire protocol pdf, you can print the single replacement Red 8 corrected page (PDF) (12/7/21).

      • Red 12: Under Amiodarone, the dose read "Can repeat in 3-5 minutes up to a total dose of".  This has been corrected to read "Can repeat in 3-5 minutes up to a total dose of 15 mg/kg".  This has been updated to the full protocol pdf and protocol app.  If you have printed the entire protocol pdf, you can print the single replacement Red 12 corrected page (PDF) (11/23/21).

      • Yellow 3: Under PEARLS, "MSDS" was changed to "SDS". This has been updated to the full protocol pdf and protocol app.  If you have printed the entire protocol pdf, you can print the single replacement Yellow 3 corrected page (PDF) (11/23/21).

    • Please note that for existing smartphone apps, users should manually update the apps on or after December 1, 2021.  Maine EMS does not print protocol books.  To download the free 2021 protocol app, visit the Apple store (iPhones/iPads) or Google Play store (Android devices) and search for the "Maine EMS Protocol App".  Please make sure you update regularly for any updates/changes/improvements in the app.

  • 2021 Protocol Change Summary (PDF)

  • 2021 Protocol FAQs v1.4 (PDF) (11/30/21)

  • Maine EMS Protocol Formulary (Excel) (4/20/2022)

    • If you wish to print this Excel file out, we recommend that within Excel, after choosing print, you select "Narrow margins" and change "Scaling" to "Fit all columns on one page".  This will result in a 5 page document (otherwise printing may result in many pages and poor results).

  • Maine EMS Protocol Formulary (PDF) (4/20/2022)

    • This is the same document as above but in PDF format and prints as a 5 page document but is smaller font.

  • Epinephrine Infusion Dosing Reference Chart (PDF) (1/12/23)

  • Norepinephrine Infusion Dosing Reference Chart (PDF) (1/12/23)

2021 Pandemic Protocols & Resources

Many additional resources can be found on the COVID Resource Page

2021 Protocol Resources

2021 Protocol Resources for Hospitals

2021 White Papers

The MDPB has released several white papers surrounding decisions and changes that will go into effect with the next protocol change.  These white papers are:

Interested in learning about and participating in the Maine EMS 2023 Statewide Protocols Development?


Interfacility Transports

Lifeflight of Maine Protocols

Emergency Shortage Protocols 

Archived Protocols