[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-365446-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-365446-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","prehospital-treatment-protocols-authorization-for-protocols","PREHOSPITAL TREATMENT PROTOCOLS - Authorization for Protocols","","Maine Emergency Medical Services issues prehospital treatment protocols under the authority of 32 MRSA §86.2-A through the Medical Direction and Practices Board (MDPB). EMS clinicians and regional EMS programs were invited to review and adopt the protocols, and regional medical direction will align treatments when adopted. Protocols are continuously reviewed, with revisions published on the Maine EMS website and substitutions considered for drug shortages. The document also acknowledges contributing medical directors and leadership.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/prehospital-treatment-protocols-authorization-for-protocols/365446/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/prehospital-treatment-protocols-authorization-for-protocols/365446.png","ImageObject",300,407,{"name":42,"@type":43},"Riley West","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who issues and oversees the Maine EMS prehospital treatment protocols?","Question",{"text":63,"@type":64},"The protocols are issued by the Medical Direction and Practices Board (MDPB) and govern the practice of Maine EMS licensees under 32 MRSA §86.2-A.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How are new or revised protocols handled and where are they published?",{"text":68,"@type":64},"Protocols are continually reviewed, and new or revised protocols are listed on the Maine EMS website (maine.gov/ems).",{"name":70,"@type":61,"acceptedAnswer":71},"Can substitutions be made during shortages of medications?",{"text":72,"@type":64},"Yes. The MDPB may entertain substitutions as needed for drug shortages when maintaining protocol function.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},365446,1790216737,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & 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Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","# PREHOSPITAL TREATMENT PROTOCOLS\n\nEffectiveDecember 1,2025  \nMaine Emergency Medical Services152 State House StationAugusta,Maine 04333  \nTEL (207)626-3860 TTY(207)287-3659FAX(207)287-6251  \n# AUTHORIZATION FOR PROTOCOLS\n\nThese protocols are issued by the Medical Direction and Practices Board(MDPB)and governthe practice of EMS licensees by the authority of 32 MRSA §86.2-A.All health care cliniciansin Maine involved in the EMS system and the regional EMS programs were invited toparticipate in the review and adoption of these protocols through their MEMS RegionalCouncils.  \nThe Regional Medical Directors agree that when treatments are adopted in their regions,they will be consistent with these protocols.  \nThe protocols willbe continually reviewed.New or revised protocols will be listed on theMaine EMS website(maine.gov/ems).The MDPB may entertain substitutions as needed fordrug shortages.  \n\n| Kelly Meehan-Cousee,M.D.   | Region 1 Medical Director   |\n| --- | --- |\n| Seth Ritter,M.D.   | Region 2 Medical Director   |\n| Timothy Pieh,M.D.   | Region 2 Medical Director   |\n| David Saquet,D.O.   | Region 3 Medical Director   |\n| Benjy Lowry,M.D.   | Region 3 Medical Director   |\n| Beth Collamore,M.D.   | Region 4 Medical Director   |\n| Matthew Sholl,M.D.   | Maine EMS Medical Director   |\n| Jack Lewis,D.O.,NREMTP   | Associate Maine EMS Medical Director   |\n| Kelly Klein,MD   | American College of Emergency Physicians   |\n| Bethany Nash,PharmD   | Clinical Pharmacist /Pharmacology Representative   |\n| Peter Tilney,D.O.   | At Large Physician   |\n| Rachael Williams,M.D.   | EMS for Children Medical Director   |\n| Colin Ayer,EMT-P   | ALS Representative   |\n| Emily Bryant,AEMT,PharmD   | BLS Representative   |\n| William D.O'Neal,AS   | Maine EMS Director   |\n\nThe Maine EMS Prehospital Treatment Protocols are dedicated to Maine's EMS clinicians,bothpast and present,as well as the numerous physicians,PAs,NPs,nurses and other medicalpersonnel who have provided their time and guidance over the years to make the developmentof these protocols possible.This document reflects the planned review,which occurs every twoyears,by the Medical Direction and Practices Board.The MDPB attempts to combine the bestavailable evidence from the current literature and medical consensus together to produceprotocols that will enhance prehospital care in the State of Maine.  \nMany individuals have spearheaded the effort for this work to become a reality.Although thereare too many to mention individually,it is important to realize the common commitmentshared to empower a continuously improving system where those citizens who need emergencymedical assistance receive the best care possible.  \nFor those of you reading this document,please keep in mind the great commitment andsacrifice that Maine EMS clinicians make daily in the course of providing superlative  \nprehospital care.Their work is physically,emotionally,and mentally stressful,yet 24 hours aday,365 days a year,these individuals provide care with the skill and compassion that promisesthe best prehospital care for all of the citizens of Maine.What you do matters and we thankyou.  \nThe MDPB would like to particularly recognize the efforts of two former MDPB members anddedicate the 2025 Maine EMS Protocols to these individuals.First,Dr.Kate Zimmerman,for herservice initially as the Region 1 Medical Director then as the Associate State Medical Director.Her efforts have been instrumental to this Maine EMS Protocol update as well as prior updates.The MDPB is grateful for her leadership,dedication,and engagement with the Maine EMSsystem.Second,Dr.Kevin Kendall,who served as the Maine ACEP Representative to the MDPB,and whose passion for prehospital care and engagement in the Maine EMS system acts as amodel for subsequent Maine EMS physicians.  \n# Table of Contents\n\n\n| Protocol Name   | Color and Number   |\n| --- | --- |\n| Foreword   | Brown 1-6   |\n| Definitions   | Purple 1-8   |\n| Pre-Intubation Checklist   |","cbCaikCV3JW2ikwS","https://ap.wps.com/l/cbCaikCV3JW2ikwS","pdf",44592457,223,"English","# Authorization for Protocols\n# Table of Contents\n## Foreword\n## Definitions\n## Pre-Intubation Checklist\n## Airway Algorithm\n## Confirmation and Monitoring of Advanced Airways\n## Failed Intubation Algorithm\n## Post Intubation/BIAD Pain Control\n## Respiratory Distress with Bronchospasm\n## Anxiolysis in CPAP\n## Pulmonary Edema(without shock)\n## Pulmonary Hypertension Complications\n## Surgical Cricothyrotomy\n## Tracheostomy Care\n## Chest Pain -General\n## Chest Pain -Suspected Cardiac Origin/STEMI Criteria\n## Guidelines to the Prehospital Use of 12-Lead ECGs by the ALS Clinician\n## Chest Pain-Fibrinolytic Checklist\n## Chest Pain -Uncertain Etiology\n## Cardiac Arrest Overview\n## Adult Cardiac Arrest\n## Refractory VF/VT\n## Termination of Resuscitation\n## Adult Post-Resuscitation Care &Checklist\n## Pediatric Cardiac Arrest\n## Pediatric Post-Resuscitation Care\n## Pediatric Cardiac Arrest Medications and Dosages\n## Adult Tachycardia\n## Pediatric Tachycardia\n## Adult Bradycardia\n## Pediatric Bradycardia\n## Cardiogenic Shock\n## Syncope\n## Ventricular Assist Devices\n## Hyperkalemia\n## Allergy /Anaphylaxis\n## Altered Level of Consciousness\n## Diabetic/Hypoglycemic Emergencies\n## Seizure\n## Stroke\n## Medical Shock\n## Abdominal Pain\n## Nausea and Vomiting\n## Fever\n## Trauma Triage\n## Spine Assessment &Management\n## Glasgow Coma Scale","[{\"question\":\"Who issues and oversees the Maine EMS prehospital treatment protocols?\",\"answer\":\"The protocols are issued by the Medical Direction and Practices Board (MDPB) and govern the practice of Maine EMS licensees under 32 MRSA §86.2-A.\"},{\"question\":\"How are new or revised protocols handled and where are they published?\",\"answer\":\"Protocols are continually reviewed, and new or revised protocols are listed on the Maine EMS website (maine.gov/ems).\"},{\"question\":\"Can substitutions be made during shortages of medications?\",\"answer\":\"Yes. The MDPB may entertain substitutions as needed for drug shortages when maintaining protocol function.\"}]","PREHOSPITAL TREATMENT PROTOCOLS - Authorization for Protocols | PDF",1790160974,562]