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)
- Maine EMS license number
- 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 Christopher.Azevedo@maine.gov. 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).
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)
- 2023 EMS Protocol Update Education (PDF) (11/2/23)
- 2023 EMS Protocol Update Education Webinars (PDF) (11/7/23)
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
Email: Christopher.Azevedo@maine.gov
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
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Complete 2021 Maine EMS Protocols (PDF) (12/7/21)
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Corrections:
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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).
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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).
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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).
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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.
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2021 Protocol FAQs v1.4 (PDF) (11/30/21)
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Maine EMS Protocol Formulary (Excel) (4/20/2022)
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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).
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Maine EMS Protocol Formulary (PDF) (4/20/2022)
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This is the same document as above but in PDF format and prints as a 5 page document but is smaller font.
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Epinephrine Infusion Dosing Reference Chart (PDF) (1/12/23)
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Norepinephrine Infusion Dosing Reference Chart (PDF) (1/12/23)
2021 Pandemic Protocols & Resources
Many additional resources can be found on the COVID Resource Page
- Maine EMS 2020 Pandemic Statewide Protocol Update (PDF) (7/28/2020)
- Printable "Leave Behind Sheets" (PDF) (updated 7/28/2020)
- Physician OLMC Quick Sheet (PDF) (4/8/2020)
- Guidance for Follow Up & Documentation for Home Care (PDF) (4/15/2020)
- Out of Hospital Cardiac Arrest during Pandemic White Paper (PDF) (4/30/2020)
- Pandemic Protocol FAQ (PDF) (4/10/2020)
- Please note the following protocols are replaced by the July 28, 2020 protocol update as directed in Maine EMS Clinical Bulletin 2020-07-28-01
- Pandemic Protocol for Out of Hospital Cardiac Arrest (PDF) (updated 5/12/2020)
- Please note the following protocols are replaced by the July 28, 2020 protocol update as directed in Maine EMS Clinical Bulletin 2020-07-28-01
2021 Protocol Resources
- EMT Scope of Practice Changes Overview & Guidelines 2021 (PDF) (updated 11/23/21)
- Note: Although the Maine EMS protocols go into effect on December 1, 2021, EMTs and services have until March 1, 2022, to complete the mandatory training of "Nebulizer Use by EMTs Module". The CPAP and 12-Lead Acquisition Modules are optional skills for EMT Level Services and can be instituted at any time after December 1, 2021.
- Maine EMS is in the process of developing didactic education for these three modules for MEMSEd. EMTs must complete either these modules or paramedic ICs may develop their own lecture in place of the MEMSEd course. Once the overall 2021 protocol course (via MEMSEd or one of the previously offered webinars) and the expanded scope didactic lecture (via MEMSEd or in-person by a paramedic IC) are completed, EMTs must complete in-person skills education (using the required skill sheets below) with a paramedic IC. In-person lecture and skills sessions must be submitted to an EMS regional office or training center for approval. Please review the Overview & Guidelines document (above) for specifics.
- Lesson Plan Template for EMT Scope of Practice Expansion (DOC) (12/7/21)
- Nebulizer Use by EMTs Module
- This is a required skill for EMTs & EMT Level Services.
- Instructors MUST refer to the EMT Scope of Practices Overview & Guidelines 2021 (above) for educational requirements.
- Nebulizer Use By EMTs Powerpoint (PPT) (11/24/21)
- Paramedic ICs may use this for the didactic education portion OR develop their own, approved by a regional office or training center.
- Medication Rights Administration Skill Sheet (PDF) (11/16/21)
- Medication Cross-Check Skill Sheet (PDF) (11/16/21)
- Small Volume Nebulizer Lab Sheet (PDF) (11/16/21)
- Small Volume Nebulizer Skill Sheet (PDF) (11/16/21)
- Nebulizer with CPAP Skill Sheet (PDF) (11/16/21)
- CPAP Use by EMTs Module
- This is an optional skill for EMT Level Services.
- Instructors MUST refer to the EMT Scope of Practices Overview & Guidelines 2021 (above) for educational requirements.
- CPAP Lab Sheet (PDF) (11/16/21)
- CPAP Skill Sheet (PDF) (11/16/21)
- 12-Lead Acquisition by EMTs Module
- This is an optional skill for EMT Level Services.
- Instructors MUST refer to the EMT Scope of Practices Overview & Guidelines 2021 (above) for educational requirements.
- 12-Lead ECG Placement Job Aid (PDF) (11/16/21)
- 12-Lead Acquisition Lab Sheet (PDF) (11/16/21)
- 12-Lead Acquisition Skill Sheet (PDF) (11/16/21)
- Maine POLST Form (PDF)
- Infant Warming Mattress Specifications (PDF)
- Hospital Protocol Education Powerpoint (PPT) (10/20/21)
- This is aimed at hospital clinicians who provide online medical control and is a high-level overview only
- Hospital OLMC Reference - Protocols/treatments where OLMC may be needed/required (based on 2021 protocols) (PDF) (10/20/21)
2021 Protocol Resources for Hospitals
- Hospital Protocol Education Powerpoint (PPT) (10/20/21)
- This is aimed at hospital clinicians who provide online medical control and is a high-level overview only
- Hospital OLMC Reference - Protocols/treatments where OLMC may be needed/required (based on 2021 protocols) (PDF) (10/20/21)
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:
- 2021 MEMS Protocols and the 2019 National EMS Scope of Practice (PDF) (June 4, 2021)
- Obstetric / Gynecological Emergencies (PDF) (June 4, 2021)
- EPIC Traumatic Brain Injury Protocol (PDF) (June 4, 2021)
- Acetaminophen (PDF) (June 4, 2021)
- Medical Shock (PDF) (June 4, 2021)
- Other White Papers from the MDPB
Interfacility Transports
Lifeflight of Maine Protocols
- Critical Care Transport Protocols (April 2019) (PDF)
- Trauma Triage Protocols (PDF)
- Guidelines for Helicopter Transport (PDF)
- Clinical Launch Guidelines (PDF)
Emergency Shortage Protocols
- Shortage Protocol - Fentanyl (PDF)
- Shortage Protocol - Fentanyl & Morphine (PDF)
- Shortage Protocol - Metoprolol (PDF)
- Shortage Protocol - Midazolam (PDF)