The State of fb88 uses statewide EMS protocols for the care of patients in the pre-hospital environment. Protocols are developed by the fb88 EMS Medical Direction & Practices Board (MDPB)Ìýand are reviewed/updated on a 2-year cycle.
fb88 EMS protocols are available via a freeÌýapp for smartphones and other devices.Ìý It can be found in the App Store (iOS) or Google Play (Android) as the "fb88 EMS Protocol App" from fb88 Emergency Medical Services.Ìý StatewideÌýprotocols are no longer printed by fb88 EMS but can be viewed, saved, and printed via the PDF link (below).
Current Pre-Hospital Care
Protocols (PDF) (Jan 31, 2024)
Application for a Special
Circumstances ProtocolÌý
Ìý
2025 EMS Protocols
The fb88 EMS Medical Directions & Practices Board has begun the revision process for the 2025 EMS prehospital care protocols.Ìý For info and schedule of webinars, please visit the MDPB Resources page.
fb88 EMS 2023 Statewide Protocols
fb88 EMS and the Medical Direction & Practices Board (MDPB) developed updatedÌýstatewide EMS protocols that went into effect on January 31, 2024.ÌýÌý
- fb88 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).Ìý Current users will need to performÌýa 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.Ìý In addition to monthly public meetings andÌývolunteering many work hours, the MDPB held statewide publicÌýprotocol discussion forums as well as protocol suggestion forms for submission directly to the MDPB.Ìý We encourage you to be involved and meeting information can be found at the MDPB web page.Ìý
View the fb88 EMS 2023 Protocols (PDF)Ìý(2/27/25) Note - this is an updated version with the following corrections:
- Annex - OD Green: Updated K9 protocols
- Grey 30-32: Updated regional fb88 EMS, and MDPB information
- Purple 5:ÌýThe MAP formula was corrected from 1/2(systolic pressure minus diastolic pressure) to 1/3(systolic pressure minus diastolic pressure)
- Red 15: #9.iiÌýwas corrected from mg/kg/min to mcg/kg/min
- Minor punctuation and grammar changes that do notÌýaffect clinical care.
- Please note:ÌýThe page numbers on the bottom left of each page are accurate to the section color, but NOT to the document as a whole - this was a limitation of time and programming.Ìý
- 2023 EMS Protocols FAQ (PDF)Ìý(2/29/24)ÌýNote: This document will be updated from time to time if additional info is needed
fb88 EMS 2023 EMS Protocol Update Education for all EMS clinicians.
Protocol update information was also sent to all fb88 EMS licensed clinicians on November 7, 2023 to the email on file for your EMS license.Ìý 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 fb88 EMS protocol update for their license level prior to using the fb88 EMS protocols that went into effect on January 31, 2024.Ìý All previous versions of fb88 EMS protocols have sunset and are no longer valid.
Please note that per fb88 EMS Rules, Chapter 5, §4, licensed fb88 EMS clinicians must complete the most recent fb88 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
MEMSEd Protocol Update
fb88 EMS offered a variety of live in person and live online updates leading up to the protocol rollout. EMS clinicians who did not attend one of these sessions 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.ÌýÌý
The MEMSEd protocol update course has been split into two separate courses, by level of licensure.Ìý Courses take approximately 3 hours to complete.
- 2023 fb88 EMS Protocol Update – EMR/EMT
- AEMT/Paramedics should not complete this course
- 2023 fb88 EMS Protocol Update – AEMT/Paramedic
- All AEMTs and Paramedics mustÌýuse 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 and will count as completion.
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 .
Certificates of completion are issued by MEMSEd upon completion of the course. fb88 EMS recommends clinicians download and save their certificates upon completion of the course.
2023 Additional Protocol Resource Documents
- 2023 Change Summary Document (PDF)Ìý(12/7/23)
- 2023 EMS Protocols FAQ (PDF)Ìý(2/29/24)ÌýNote: This document will be updated from time to time if additional info is needed
- 2023 Formulary Update (coming soon)
- New Definitions - Purple Section (PDF)Ìý(12/7/23)
- fb88 Child Safe Haven Law (PDF)Ìý(12/7/23)
- fb88 Stroke Alliance Plavix Statement (PDF)Ìý(12/7/23)
- Suggested Additional CEH Topics for Training (PDF)Ìý(11/21/23)
2024 Operational K9 Protocols & Documents
- Operational Bulletin Operational K9 Protocols (PDF) (11/19/24)
- fb88 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)Ìý(12/7/23)
- Bougie Use (PDF)Ìý(11/16/23)
- Dexamethasone Update (PDF)Ìý(11/16/23)
- Magnesium Sulfate and the Treatment of Eclampsia (PDF)Ìý(11/16/23)
- Naloxone Dispensation (PDF)Ìý(11/16/23)
- New England Donor Services Reporting (PDF)Ìý(11/16/23)
- Newborn Warmth Maintenance (PDF)Ìý(11/16/23)
- Out of Hospital Cardiac Arrest (PDF)Ìý(11/16/23)
- Oxytocin (PDF)Ìý(11/16/23)
- Pediatric Cardiac Arrest and Pediatric Post Cardiac Arrest (PDF)Ìý(11/16/23)
- Posterior Circulation Stroke (PDF)Ìý(11/16/23)
All current and previous MDPB white papers can be found on the MDPB ResourcesÌýpageÌý
For reference: 2021 Pre-Hospital Care Protocol Documents
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2021 fb88 EMS Protocols (PDF)Ìý(12/7/21)
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2021 Protocol FAQs v1.4 (PDF)Ìý(11/30/21)
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fb88 EMS Protocol Formulary (Excel)Ìý(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".Ìý This will result in a 5 page document (otherwise printing may result in many pages and poor results).
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fb88 EMS Protocol Formulary (PDF)Ìý(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)Ìý(1/12/23)
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NorepinephrineÌýInfusion Dosing Reference Chart (PDF)Ìý(1/12/23)
2021 Pandemic Protocols & Resources
Many additional resources can be found on the COVID ResourceÌýPage
- fb88 EMS 2020 Pandemic Statewide Protocol Update (PDF)Ìý(7/28/2020)
- Printable "Leave Behind Sheets" (PDF)Ìý(updated 7/28/2020)
- Physician OLMC Quick Sheet (PDF)Ìý(4/8/2020)
- Guidance forÌýFollow Up & Documentation for Home Care (PDF)Ìý(4/15/2020)
- Out of Hospital Cardiac Arrest during Pandemic White Paper (PDF)Ìý(4/30/2020)
- Pandemic Protocol FAQ (PDF)Ìý(4/10/2020)
- Please note the following protocols are replaced by the July 28, 2020Ìýprotocol update as directed in fb88 EMS Clinical Bulletin 2020-07-28-01
- Pandemic Protocol for Out of Hospital Cardiac Arrest (PDF)Ìý(updated 5/12/2020)
- Please note the following protocols are replaced by the July 28, 2020Ìýprotocol update as directed in fb88 EMS Clinical Bulletin 2020-07-28-01
2021 Protocol Resources
- EMT Scope of Practice Changes Overview & Guidelines 2021 (PDF)Ìý(updated 11/23/21)
- Note: Although the fb88 EMS protocols go into effect on December 1, 2021, EMTs and services have until March 1, 2022, to complete the mandatory training ofÌý"Nebulizer Use by EMTs Module".Ìý The CPAP and 12-Lead Acquisition Modules are optional skills for EMT LevelÌýServices and can be institutedÌýat any time after December 1, 2021.
- fb88 EMS is in the process of developing didactic education for these three modules for MEMSEd.Ìý EMTs must complete either these modulesÌýor paramedic ICs may develop their own lecture in place of the MEMSEd course.Ìý 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 theÌýrequired skill sheets below)Ìýwith a paramedic IC.Ìý In-person lecture and skills sessions must be submitted to an EMS regional office or training center for approval.ÌýPlease review the Overview & Guidelines document (above) for specifics.
- Lesson Plan Template for EMT Scope of Practice Expansion (DOC)Ìý(12/7/21)
- Nebulizer Use by EMTs Module
- This is aÌýrequiredÌýskill 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)Ìý(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)Ìý(11/16/21)
- Medication Cross-Check Skill Sheet (PDF)Ìý(11/16/21)Ìý
- Small Volume Nebulizer Lab Sheet (PDF)Ìý(11/16/21)
- Small Volume Nebulizer Skill Sheet (PDF)Ìý(11/16/21)
- Nebulizer with CPAP Skill Sheet (PDF)Ìý(11/16/21)
- CPAP Use by EMTs Module
- This is an optional skill for EMT LevelÌýServices.
- Instructors MUST refer to the EMT Scope of Practices Overview & Guidelines 2021 (above) for educational requirements.
- CPAP Lab Sheet (PDF)Ìý(11/16/21)
- CPAP Skill Sheet (PDF)Ìý(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)Ìý(11/16/21)
- 12-Lead Acquisition Lab Sheet (PDF)Ìý(11/16/21)
- 12-Lead Acquisition Skill Sheet (PDF)Ìý(11/16/21)
Ìý
- fb88 POLST Form (PDF)
- Infant Warming Mattress Specifications (PDF)
- Hospital Protocol Education Powerpoint PPT)Ìý(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 whereÌýOLMC may be needed/required (PDF)Ìý(10/20/21)
2021 Protocol Resources for Hospitals
- Hospital Protocol Education Powerpoint (PPT)Ìý(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 whereÌýOLMC may be needed/required (PDF)Ìý(10/20/21)
Interfacility Transports
Lifeflight ofÌýfb88 Protocols
- Critical Care Transport Protocols (April 2019) (PDF)
- Trauma Triage Protocols (PDF)Ìý
- Guidelines for Helicopter Transport (PDF)
- Clinical Launch Guidelines (PDF)
Emergency Shortage ProtocolsÌý
- Shortage Protocol - Fentanyl (PDF)
- Shortage Protocol - Fentanyl & Morphine (PDF)
- Shortage Protocol - Metoprolol (PDF)
- Shortage Protocol - Midazolam (PDF)