We welcome you to the 2015 update to the Vermont Statewide EMS Protocols. These protocol updates are a significant step forward for EMS care in Vermont and represent the work of many people across the state. Specific feedback has been received from all 13 District Medical Advisors, numerous stakeholder groups, and a multitude of EMS providers, agencies and districts across the State. Whenever possible, protocol updates have been guided by the most recent and best evidence-based EMS literature. Of special note, Vermont has collaborated with all of the other New England states as a member of PEGASUS (Pediatric Evidence Based Guidelines: Assessment of EMS System Utilization in States) to incorporate the best evidence-based pediatric care into our protocols. The PEGASUS project offers Vermont and the other New England states an opportunity to better coordinate patient care over a large region and to bring each New England state’s protocols to a more uniform content. The PEGASUS project will create the largest US population cared for under common EMS protocols, will improve patient care and offer a unique opportunity to learn about the value and importance of prehospital medicine.
8/12/2016 Note: With the release of the Protocol App for both IOS and Android devices, we took the opportunity to make a few corrections and updates to the 2015 Vermont Statewide Emergency Medical Services Protocols. The links below represent the most recent update.
Vermont EMS Statewide Protocols Version 2015 released 8/12/16 (incorporate the 2015 AHA Guideline changes into this draft as protocols are implemented)
- Summary of changes (Excel spreadsheet)
2015 AHA Guideline Updates Effecting 2015 Vermont EMS Protocols (3/1/16) - We have reviewed the recent AHA resuscitation guidelines and made a few small changes to the EMS protocols to reflect the current best practices. These include a couple of medication changes and the suspension of the post-resuscitation induced-hypothermia protocol. Agency heads of service should review these changes and assure that training occurs for all personnel on your agency roster. Once all of your personnel are trained on these updates, each agency may begin to use these modifications. Please attempt to make this transition no later than July 1, 2016. Please contact us with any questions.
Vermont EMS Quick Reference Guide (updated version pending) - provided to hospital and emergency department staff in printed form and is available here for downloading.
Protocol Implementation and Transitions to New Scope of Practice Model
These protocols are written for the new Scope of Practice Model levels (EMR, EMT, AEMT and Paramedic), which include skills, medications and other interventions not allowed at the previous National Standard Curriculum levels (FR-ECA, EMT-B, EMT-I and EMT-Paramedic). When an entire agency has completed training on these protocols, they may begin to use these new protocols after 0001 hrs October 1, 2015 regardless of the transition status of their personnel.
All agencies must begin to use these protocols no later than 2359 hrs on December 31, 2015. From January 1, 2016 forward, these are the only statewide EMS protocols and must be followed by all providers, regardless of transition status. However, EMS providers who have not completed the appropriate transition course are ONLY authorized to function within the scope of their previous scope of practice (FR-ECA, EMT-B, EMT-I and EMT-Paramedic). Appendix 3 contains the scope of practice matrix which lists the skills that each provider level, both old and new, can perform.
2015 Statewide Protocol Resource Kit
2015 Statewide Protocol Resource Kit - Created as a guide for both EMS providers and EMS Services to complete the education modules for the Vermont Statewide EMS Protocols. This training is required for any level of licensure and does not require the provider to be transitioned to the new education standards. Thus, a provider that has not transitioned and completes this training will be authorized to use these new skills, but will still have to complete a transition course within their recertification period as outlined by the National Registry (see previously published guidance and FAQs on the VT EMS website). This training is also required within all initial EMR, EMT, AEMT, and Paramedic courses.
Excerpts from the Statewide Protocol Resource Kit
- Advanced Spinal Assessment and Spinal Motion Restriction Practical Chart
- Class Roster for Record Keeping
- CPAP Training Chart
- Tracking Documents:
Prior Protocol Education
The education modules below are available only on this website. Other modules referenced in the 2015 Statewide Protocol Resource Kit are available through CentreLearn or through practical education at the service level. The Quick Reference Chart, located in the Statewide Protocol Resource Kit, gives information about the topic/skill, methods of presentation, and the scope of practice levels to which the training applies.
- Epinephrine 1:10,000 for AEMT Use Practical Chart
- Induced Mild Hypothermia Practical Chart
- AEMT Introduction to CPAP
- BLS Intranasal Naloxone
- Epinephrine for AEMT Use
- Induced Mild Hypothermia
- Resuscitation Initiation and Termination
- Systems of Care
- Intranasal Naloxone for Suspected Opioid Overdose - Enhancement of EMR scope of practice to include use of intranasal naloxone for suspected opioid overdose with severe respiratory depression
Instructions for opening the Presentations and Documents
- Click on the link for the presentation
- Choose Open. 'Save' or 'Save as' depending on your situation.
- At the Password screen, choose "Read Only." It is not possible to modify presentations.
Stroke Alert Screening Tool
Enhancement of EMR scope of practice to include use of intranasal naloxone for suspected opioid overdose with severe respiratory depression. Vermont EMS deems this enhancement appropriate in response to widespread public access to Naloxone for this purpose.
- EMR use of Naloxone
Memo from VT State EMS Medical Director Daniel Wolfson, MD to Vermont EMRs and VT District Medical Advisors outlining the education component
- EMR Intranasal Naloxone
As with past protocol education, the presentation can also be found on LearnEMS under the title 'EMR Intranasal Naloxone.'
Previous Vermont EMS Protocols - Effective dates 2007 - March 31, 2014
- Part I - Cover, TOC and Introductions
- Part Ii - Clinicals
- Part III - Non-Clinicals
- Part IV - Medications List
Chris Bell, Director