Emergency Medical Services

Emergency Medical Services

Vermont’s Emergency Medical Services system – or EMS – responds to medical emergencies every day. EMS is an integrated system for providing emergency medical treatment and transportation of sick and injured patients.

The Vermont Office of Emergency Medical Services works on behalf of Vermonters to ensure that the EMS system is adequately equipped and prepared to provide the best out-of-hospital emergency care possible. There are nearly 180 ambulance and first responder agencies in the state, and most of our nearly 3,000 licensed EMS personnel are volunteers. 

Recent Updates:

 

Interfacility Transfers Protocol (Updated February 23, 2022)

Vermont Healthcare and EMS Preparedness Conference Virtual Education Series

The Vermont Healthcare and EMS Preparedness Conference is once again a virtual series in 2022.  See below for links to watch sessions held earlier in the year and to register for upcoming offerings. More sessions will be added throughout the year.

Webinar Series Kickoff Event (held March 18 and 19, 2022)

Thursday, April 28, 2022 at 7:00PM
“What’s Your Sign? Assessment Signs to look for from BLS to ALS” - Ruben Farnsworth

Reuben started his career in EMS as an EMT-B on a rural volunteer service and is currently a Critical Care Paramedic and Shift Captain with Delta County Ambulance District. Reuben owns and operates RockStar Education and Consulting and teaches full time all over the country on topics from CPR to Paramedic Refresher and everything in between. Reuben was recently invited to participate in the Job Analysis Subject Matter Expert Group for the CCP-C exam with the IBSC.  In his spare time Reuben enjoys hunting, fly fishing, and belongs to the Masonic Lodge.  CCP-C, CP-C, NRP.
 
 
Wednesday, May 18, 2022 at 7:00PM
 
About the presenter: Jon retired from EMS and Public Safety after starting his career in 1971. Jon is an engaging educator who has presented at many state and national conferences across the US and Canada. Jon has served in many capacities: firefighter, ski patroller, Paramedic, Paramedic Program Coordinator, State EMS Training Coordinator and EMS Chief. He was the first Chief of EMS of the Town of Colonie EMS Department Jon continues to practice as a Paramedic, continues as an active volunteer firefighter and alpine ski patroller. In the summers he works as a Seasonal Ranger/Paramedic in Grand Teton National Park, Jackson Hole, WY.
 
 
Tuesday, June 7, 2022 at 7:00PM
 
About the Presenter: Timothy S. Redding has been involved in EMS for over 25 years. He has been teaching both hospital and prehospital emergency personnel for over a decade and is certified as an instructor by the American Heart Association, the US Department of Homeland Security, the State of New Hampshire, and the Commonwealth of Massachusetts, among others. Tim is an experienced paramedic and has worked in challenging urban and rural EMS systems.  Tim was named New Hampshire EMS Educator of the Year for 2017.
LIGHTS - An Online EMS Licensing and Course Management System

The Vermont EMS LIGHTS database is an online EMS license management system built by ImageTrend, the creators of the Vermont SIREN incident reporting system. Its web-based functionality replaces paper applications and allows users to apply for and manage agency and personnel licenses, enroll in EMS courses and exam sites, update demographic information, and look up licensing records.     

Vermont Statewide EMS Protocols

The Vermont EMS Office is committed to supporting the delivery of excellent, evidence-based emergency care to all Vermonters and our visitors. To that end, we are constantly reviewing our treatment protocols, and we publish one major revision every two years.  You can download the most recent version below:

Other Important Updates

Measles Protocol and Drip Rate Charts

Measles Guidance Medical Procedure - There has been an increased number of measles cases and multiple outbreaks in the U.S.  These guidelines address precautions that should be taken by EMS personnel when evaluating and transporting persons with suspected measles infection.

Adult Drip Rate Reference - Appendix 3 - It has come to our attention that the doses for nitroglycerine, epinephrine, and norepinephrine in Appendix 3: Adult Drip Rate Reference, were incorrectly listed as mg/min.  All three of these doses have been corrected to mcg/min.

Fentanyl and Carfentanil Exposures in First Responders

The risk of significant opioid exposure is minimal for first responders who encounter fentanyl, carfentanil or other fentanyl analogs in the field. The evidence suggests that limited precautions, such as nitrile gloves, provide sufficient protection from harm. Use of excessive protective equipment could delay patient care and prevent first responders from performing their duties well.

Fentanyl and Carfentanil Fact Sheet from the Northern New England Poison Center

EMS in the Warm Zone

Active shooter and mass casualty incidents are becoming more common in our society and can happen in any community large or small.  The historical practice of EMS staging until the scene is “safe” may no longer be operational best practice.  Clearing a scene can take hours, yet certain types of injuries require emergent medical care within minutes in order to save lives.  Research has shown that such “point-of-wound” care is essential for treating victims of massive hemorrhage, airway compromise, and tension pneumothorax.  By entering the “warm zone”, EMS providers may perform these time-critical interventions to save lives.  We have just published the "Vermont Active Threat Best Practice Guide", which offers guidelines to help agencies who choose to coordinate with local law enforcement to perform these interventions as safely as possible.  You will find a training course and PDF of the guidelines posted on CentreLearn under the course title: EMS in the Warm Zone: Active Threat Best Practice Guide.  Special thanks to Colleen Nesto – Essex Rescue, and Lt. Hugh O’Donnell – VSP, for help in preparation of these materials. Thank you for your service and be safe. 

An Introduction to Vermont EMS in the Warm Zone (LearnEMS)

EMS in the Warm Zone - Active Threat Best Practice Guide (PDF)

Nitrous oxide for acute pain control

Given the current state of the opiate epidemic, many Vermont EMS agencies have expressed an interest in using nitrous as an alternative to opiate use for pain control.  We have updated the Pain Management – Adult 2.17A protocol with more information regarding indications and contraindications for the use of nitrous oxide for acute pain control.  In addition, we have posted a training course on CentreLearn and an accompanying Nitrous Start Up Guide document that provides useful information for how to use nitrous at your agency.  Agencies wishing to use nitrous should train on these materials and get approval from the local District Medical Advisor.  The course, start up guide, and updated protocol are posted on CentreLearn under the course title: Nitrous Oxide for Pain Managment.  The protocol will also be updated to our website and protocol app.  Special thanks to Sarah Lamb and Richmond Rescue for help in preparation of these materials.

Nitrous Oxide (LearnEMS)

Nitrous Oxide Start-Up Guide (PDF)

Cardiac Epinephrine 1:10,000 (0.1 mg/mL) SHORTAGE

Our office has recently been notified about a potential shortage of prefilled epinephrine syringes (1:10,000 “cardiac epinephrine).  Although the scope of the shortage is still a bit unclear, it appears that the prefilled syringe dosing will be in short supply at least through the summer months.  To address this issue, Dr. Wolfson has created alternative dosing/administration instructions to enable the use of 1:1,000 epinephrine for those previously authorized by protocol to administer the drug.  Those instructions are attached. 

Our office has recently been notified about a potential shortage of prefilled epinephrine syringes (1:10,000 “cardiac epinephrine).  Although the scope of the shortage is still a bit unclear, it appears that the prefilled syringe dosing will be in short supply at least through the summer months.  To address this issue, Dr. Wolfson has created alternative dosing/administration instructions to enable the use of 1:1,000 epinephrine for those previously authorized by protocol to administer the drug.  Those instructions are attached. We have done our best to provide a simple and easy solution to work around this shortage.  However, as with any change from standard practice, a new procedure requires familiarization and practice to minimize the possibility of error.  We would further suggest that providers cross check any medication dose with a second provider before administration.

Please remember that the alternative administration instructions should only be used if prefilled syringes are not available. 

If there are any questions regarding the new procedure, please feel free to contact our office. 

We will continue to monitor this and any other potential medication shortages and will do our best to keep you updated.

In This Section

The Vermont EMS LIGHTS database is an online EMS license management system. Learn more about using this new system.

Vermont EMS has played an active role in combatting the COVID-19 pandemic. Below are some resources to assist you and your agency during the COVID-19 response. 

If you are interested in becoming a Vermont EMS practitioner, we recommend that you contact the EMS agencies near you to find out how to become a member or employee of their organization.

There are a number of programs and initiatives for EMS agencies looking to expand their scope of practice, increase their volunteer ranks and become more engaged in their community.

The Vermont Statewide Incident Reporting Network (SIREN) is a comprehensive electronic prehospital patient care data collection, analysis and reporting system that has been in use since 2010.

Find out about upcoming EMS trainings, class schedules, practical exam schedules, leadership calls, regional and EMS Advisory Committee meetings.

The Vermont EMS office licenses nearly 180 ambulance and first responder agencies and 2,800 licensed patient care providers.

Find contact information for Vermont EMS Office staff, EMS services, and EMS district chairs, training coordinators and medical advisors.

Save lives in your community and become an EMS practitioner! Check out EMS employment opportunities.

Here are important documents you will need to take a practical exam, apply for or renew a personnel license, operate an EMS agency, provide training, become a HeartSafe community, or offer Public Access Defibrillation.