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 2023 Statewide Protocols

Maine EMS and the Medical Direction & Practices Board (MDPB) developed updated statewide EMS protocols that go into effect on January 31, 2024.  

View the Maine EMS 2023 Protocols

  • NOTE: These are NOT in effect until January 31, 2024.  DO NOT USE THESE PROTOCOLS UNTIL 12:01am OF JANUARY 31, 2024!
  • These protocols will populate the Maine EMS app on/after January 31, 2024 and require an update by users within their app

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 statewide public protocol discussion forums as well as protocol suggestion forms for submission directly to the MDPB.  We encourage you to be involved and meeting information can be found at the MDPB web page

Maine EMS 2023 EMS Protocol Update Education for all EMS clinicians.

Protocol update information was also sent to all Maine EMS licensed clinicians on November 7, 2023 to the email on file for your EMS license.  If you did not receive it, please check your spam/junk folder or log into your eLicensing account to ensure your email address is up to date.

Clinicians must complete the Maine EMS protocol update for their license level prior to using the Maine EMS protocols that will go into effect on January 31, 2024.  At that point, the protocols from December 1, 2021 will sunset and no longer be valid and cannot be used.

Please note that per Maine EMS Rules, Chapter 5, §4, licensed Maine EMS clinicians must complete the most recent Maine EMS prehospital protocol update in order to perform emergency medical treatment. The following information outlines how to complete this.

All EMRs, EMTs, AEMTs, and Paramedics MUST complete this education via one of the 3 methods below:

Option 1: Via live webinar; OR

Option 2: Via live in-person presentation; OR

Option 3: Via MEMSEd

Only one method is needed, but clinicians are welcome to attend multiple sessions if helpful.

Option 1: Webinars

Maine EMS and the MDPB will conduct FIVE Protocol Update webinars via Zoom.

Attendance at ONE of these webinars satisfies the requirement for completion of the 2023 EMS Protocol Update Education.

The webinars will include protocol updates for ALL levels of EMS licensure.

Attendees MUST register prior to attending. Attendance will be obtained from Zoom system log-in information and entered into eLicensing by Maine EMS staff for CEH credit.

Attendees must be logged in for the duration of the webinar for credit.  

Webinar group session for agencies

If an agency wishes to have a group participate in a webinar, one of the attendees (preferably the person signing the roster as described below) must register prior to attending (as if they were doing the session alone).  This will be used to login to the webinar and the log in info will track attendance for the group. 

Agencies wishing to do a group viewing session must then fill out a Maine EMS CEH training roster and include the following information:

  • Course Title – 2023 Maine EMS Protocol Update Webinar
  • Date of webinar
  • Town/City where class was held - Please use the name of the organization where the group viewing was conducted
  • CEH Topic & Credit will be based on the new NCCP categories for relicensure 
    • ARV (0.25 hours)
    • Cardiology (0.5 hours)
    • Medical (1 hour)
    • Trauma (0.75 hours)
    • Operations (0.75 hours)
  • On the roster, each attendee must legibly write their
    • Maine EMS license number
      • Do NOT use a NREMT certification number. Attendees listing an NREMT # will NOT receive credit.
    • First and last name
    • EMS License level – please write in next to attendee name (EMR, EMT, AEMT, or Paramedic)
  • Name and signature of primary instructor – This should be the service chief, supervisor, or training officer coordinating the webinar viewing. This signature attests that all of the attendees attended the entire program.
    • If attendee(s) leave during the webinar (i.e., on a call), they will need to complete the update on a different day or method.
  • Please write clearly on the sheet the email address and individuals name used for the registration and login – this information will be used to track and verify attendance.
  • Please scan the roster and email it to  Do NOT mail it to a regional office or training center.

Webinar sessions are anticipated to last 3 hours. 

Courses are listed below.  Click on a date to register for the session (pre-registration is REQUIRED).

November 17, 2023 at 1pm 

December 8, 2023 at 9am

December 15, 2023 at 9am

January 26, 2024 at 9am

January 27, 2024 at 9am

Option 2: Live In-person Session

Maine EMS will hold a live in-person protocol update on November 28, 2023 at 1pm

This in-person ONLY session will be held at Maine General Hospital - Thayer Campus, 149 North Street, Waterville, Me 04901 in the Dean Auditorium (Driving directions)

There is no pre-registration required.

This course is anticipated to last 3 hours.

Option 3: MEMSEd

EMS clinicians may complete the protocol update via MEMSEd, using their login information. This option is available 24/7.

Please note - group sessions via MEMSEd are not permitted.  

The MEMSEd protocol update course has been split into two separate courses, by level of licensure.  Courses take approximately 3 hours to complete.

  • 2023 Maine EMS Protocol Update – EMR/EMT
    • AEMT/Paramedics should not complete this course
  • 2023 Maine EMS Protocol Update – AEMT/Paramedic
    • All AEMTs and Paramedics must use this course.
    • This course also contains all of the information in the EMR/EMT course.
    • EMR/EMTs do not need to complete this course but are welcome to

Clinicians will only receive CEH credit for ONE course.

Both courses are live and open for enrollment at this time. Links to the courses are provided near the middle of the MEMSEd home page.

Certificates of completion are issued by MEMSEd upon completion of the course. Maine EMS recommends clinicians download and save their certificates upon completion of the course.

Other Important Information

View the Clinical Bulletins regarding the protocol updates (these were emailed to all EMS clinicians statewide)

View the Maine EMS 2023 Protocols

  • NOTE: These are NOT in effect until January 31, 2024.  DO NOT USE THESE PROTOCOLS UNTIL 12:01am OF JANUARY 31, 2024!
  • These protocols will populate the Maine EMS app on/after January 31, 2024 and require an update by users within their app
  • These protocols will move to the top of this webpage on January 31, 2024 for easier access


If you have questions, please contact Chris Azevedo, Maine EMS Education Coordinator via 


Phone: 207-626-3866

US Mail: Maine EMS, 152 State House Station, 45 Commerce Drive, Suite 1, Augusta, ME 04333

2023 Formulary Update (coming soon)

2023 Change Summary Document (coming soon)

2023 White Papers

Bougie Use (PDF) (11/16/23)
Dexamethasone Update (PDF) (11/16/23)
Magnesium Sulfate and the Treatment of Eclampsia (PDF) (11/16/23)
Naloxone Dispensation (PDF) (11/16/23)
New England Donor Services Reporting (PDF) (11/16/23)
Newborn Warmth Maintainence (PDF) (11/16/23)
Out of Hospital Cardiac Arrest (PDF) (11/16/23)
Oxytocin (PDF) (11/16/23)
Pediatric Cardiac Arrest and Pediatric Post Cardiac Arrest (PDF) (11/16/23)
Posterior Circulation Stroke (PDF) (11/16/23)

All current and previous MDPB white papers can be found on the MDPB Resources page 

For reference: 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:

Interfacility Transports

Lifeflight of Maine Protocols

Emergency Shortage Protocols 

Archived Protocols