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 and other devices. It can be found in the App Store (iOS) 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).
Current Pre-Hospital Care
Protocols (PDF) (Dec 1, 2025)
Application for a Special
Circumstances Protocol
Protocol Suggestions
The MDPB reviews suggestions for new or changes to existing protocols during the 2-year cycle of protocol revision and review. The MDPB seeks input for revisions from key stakeholders including EMS Clinicians, EMS Service Leadership, EMS Medical Directors, physicians, advanced practice providers, nurses and anyone who is, or may be, impacted by protocol changes.
Maine EMS has established several avenues that allow stakeholders to participate in the protocol review process. Stakeholders may:
- Reach out to your Regional Medical Director. Each of the four Maine EMS regions has a Medical Director (name and email address available on the MDPB website who is available to discuss and advance your ideas. Ideas, comments, and suggestions should be submitted using the template provided below.
- Reach out to either the ALS or BLS Representative to the MDPB. Their contact information can be found towards the bottom of the table on the MDPB website. Ideas, comments, and suggestions should be submitted using the template provided below.
- Contact Maine EMS. Stakeholders may also download and fill out the form below, and mail to: Maine EMS Attention EMS Education Coordinator 152 State House Station 45 Commerce Dr., Ste. 1 Augusta, ME 04333
Please use this form to submit a protocol suggestion. Please read the entire form first. If there is more than one suggestion and they are unrelated, please use a new form for each suggestion.
2025 EMS Protocols
The Maine EMS Medical Directions & Practices Board has completed the revision process for the December 1, 2025, EMS prehospital care protocols. After two years of review and input, the new protocols will provide an updated set of guidelines and evidence-based care.
On December 1, 2025, all previous versions of the Maine EMS protocols will sunset and no longer be valid and the "December 1, 2025 Maine EMS Prehospital Treatment Protocols" will go into effect.
All EMRs, EMTs, AEMTs, and Paramedics must complete the protocol update before responding to EMS calls on or after December 1, 2025.
Maine EMS 2025 Prehospital Protocol Update Bulletin (PDF) (8/29/25)
2025 Protocol Resources
- 2025 Maine EMS Protocols (PDF) (10/29/25) Note: Ver 10.29 on front cover is most current version
- Protocol Change Summary (PDF) (9/6/25)
- Protocols Needing OLMC (PDF) (10/27/25) - Note: Ver 3 is most current version
- White Paper - Mandated Reporting Requirements for EMS Clinicians (PDF) (9/6/25)
- White Paper - IV Medication Preparation (PDF) (9/6/25)
- Deaf and Hard of Hearing Communication Card (PDF) (updated 9/26/25)
- 2025 Protocol FAQs (PDF) (11/22/25) - Note - this is a living document and may be updated as needed, current version is v4
- Protocol Formulary (PDF) - In process of being finalized
- Operational Bulletin Operational K9 Protocols (PDF) (11/19/24)
- Vet after-hours and 24/7 clinics (PDF) (11/19/24)
2025 Protocol Education
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. CEH credit will be awarded.
The update can be completed in one of two ways:
1. Complete one of the live virtual webinars, OR
2. Complete the update on MEMSEd 24/7 by logging into your MEMSEd account.
OPTION 1 - No longer available - sessions completed
- Sept 15,2025 0900-1200 - completed
- Sept 23, 2025 1300-1600 - completed
- Oct 21, 2025 1700-2000 - completed
- Nov 15, 2025 0900-1200 - completed
OPTION 2 - MEMSEd Protocol Update
- The 2025 Maine EMS Protocol Update course will be live and open for enrollment soon.
- EMS clinicians who do not attend a live virtual webinar MUST 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.
- Clinicians will only receive CEH credit for ONE course (live webinar OR the MEMSEd course).
- 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.
For further resources, please visit the MDPB Resources page.
For reference only: 2023 Pre-Hospital Care Protocol Documents
These EMS protocols went into effect on January 31, 2024 and were updated and replaced on December 1, 2025. They are for reference ONLY and are not to be used clinically.
- Maine EMS Protocol App: The protocol app is available free for all users for smartphones and tablets on the Apple Play Store (iOS Users) and Google Play Store (Android Users). Current users will need to perform a manual update by users within their app on or after January 31, 2024.
- 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.
2023 Protocol Resource Documents
- Maine EMS 2023 Protocols (PDF) (2/27/25)
- 2023 Change Summary Document (PDF) (12/7/23)
- 2023 EMS Protocols FAQ (PDF) (2/29/24) Note: This document will be updated from time to time if additional info is needed
- 2023 Formulary Update (Requested from MDPB)
- New Definitions - Purple Section (PDF) (12/7/23)
- Maine Child Safe Haven Law (PDF) (12/7/23)
- Maine Stroke Alliance Plavix Statement (PDF) (12/7/23)
- Suggested Additional CEH Topics for Training (PDF) (11/21/23)
2024 Operational K9 Protocols & Documents
- Operational Bulletin Operational K9 Protocols (PDF) (11/19/24)
- Maine EMS OpK9 2024 Protocols (PDF) (11/19/24)
- Vet After hours and 24 hour 7 day clinics (PDF) (11/19/24)
2023 White Papers
- Other New 2023 Protocol (Trauma Triage, Strangulation & Fever (PDF) (12/7/23)
- 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 Maintenance (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 only: 2021 Pre-Hospital Care Protocol Documents
-
These EMS protocols went into effect on December 1, 2021 and were updated and replaced on January 31, 2024. They are for reference ONLY and are not to be used clinically.
-
2021 Maine EMS Protocols (PDF) (12/7/21)
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
- 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.
- 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 - 2021 Protocols/treatments where OLMC may be needed/required (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 - 2021 Protocols/treatments where OLMC may be needed/required (PDF) (10/20/21)
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)