Special Circumstances Protocols

Maine EMS has standardized statewide treatment protocols that address most of the emergencies  encountered by EMS personnel.  These protocols are updated every 2 years and are available for download here.

On occasion, there are situations when a patient has a specific medical condition that requires emergency  medical treatment, which may not be part of the Maine EMS Prehospital Treatment Protocols.

In these situations, patients, parents, and legal guardians may request a Special Circumstances  Protocol that would identify the patient’s special medical condition and the treatment(s) required  in the event of an emergency. 

To request consideration of a special circumstances protocol, please utilize the following steps:

  1. Contact your local EMS service and discuss with the local service director, the service medical director or the regional medical director.
    1. If you are unsure of who this or need contact information, please contact Maine EMS at 207-626-3860 or email at maine.ems@maine.gov
  2. Submit the request for regional review via the special circumstances request form (download link below).
    • Special Circumstances Protocols must be written in a manner that includes treatment orders that are consistent with the license level of EMS providers
    • Maine EMS is available to assist with information about  these levels and in drafting the protocols.
    • This form will need to be completed by the patient's primary care provider
  3. The request will be reviewed by the State EMS Medical Directions and Practices Board (MDPB) at a monthly meeting.
  4. The MDPB will consider the request and develop next steps as appropriate for the EMS system.
  5. If approved, the state EMS medical director will sign the form and it will be returned to the patient, parent, or legal guardian. 
  6. The Special Circumstances Protocol must be carried by the patient for access and use by EMS providers in Maine, along with any medications and devices that may be necessary. 
  7. The completed form may be photocopied as needed.   

Maine EMS providers are authorized to follow Special Circumstances Protocols that have been approved by Maine EMS when presented with the approved protocol (original or legible photocopy) and the necessary medication, device  or therapy.