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Covering 16 counties in Maine · Protocols current as of June 17, 2026
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Maine Prehospital Treatment Protocols
Effective: December 1st, 2025 ↗
PDF document
1,176
Flashcards
602
Quiz questions
32
Medications
71
Resources
Study tools for Maine Prehospital Treatment Protocols
A few real flashcards and quiz questions from Maine's own protocols — the full set, plus a spaced-review deck, is in the app.
Flashcards
Anatomical location of the canine cricothyroid membrane
The cricothyroid membrane is located on the ventral aspect of the larynx, immediately ABOVE the cricoid cartilage and BELOW the thyroid cartilage. The medial portion of the membrane is termed the cricothyroid ligament, which is largely devoid of a major blood supply but may have small vessels near the cricoid and thyroid attachments.
Anatomical location of the cricothyroid membrane
The cricothyroid membrane is located immediately below the thyroid cartilage, between the thyroid cartilage superiorly and the cricoid cartilage inferiorly. It is identified by palpation with the non-dominant index finger while stabilizing the trachea with the thumb and middle finger.
Optimal patient positioning for intubation
Unless contraindicated, the patient should be positioned ear-to-sternal-notch with 30 degrees of head-of-bed elevation. This position optimizes laryngoscopic view and reduces aspiration risk.
Rule of 9's: What percentage does each major adult body region represent?
In adults, each arm = 9% (4.5% anterior, 4.5% posterior), each leg = 18% (9% anterior, 9% posterior), anterior trunk = 18%, posterior trunk = 18%, head = 9% (4.5% anterior, 4.5% posterior), and genitalia = 1%.
Why should bilateral chest decompression be considered in a K9?
The canine mediastinum is fenestrated, meaning a tension pneumothorax on one side can communicate with the other. After aspirating, the paramedic should consider decompressing the opposite side of the chest as well.
K9 Rule of 9s — TBSA percentages for key body regions
The K9 Rule of 9s assigns the following approximate TBSA values: Head 14%, Neck 9%, Thorax 18%, Abdomen 14%, each Forelimb 9%, each Hind Limb 11%, Genitals/Tail 5%. These are used to estimate burn size when calculating fluid resuscitation.
How many ribs does a canine have, and why is this clinically relevant?
Canines have 13 ribs, which is important for correctly identifying the 7th–9th intercostal space landmark for chest decompression. Using human rib-counting references without this knowledge could lead to incorrect needle placement.
K9 intraosseous (IO) access sites
The two approved intraosseous access sites in a K9 are the proximal humerus and the medial tibia. For GDV/Bloat, only a forelimb IO site (proximal humerus) should be used.
Quiz questions
According to the Chest Pain - General protocol, all patients presenting with chest pain should be transported for emergency medical evaluation because:
- EMS clinicians can reliably rule out cardiac causes in the field with available tools.
- ✓ It is difficult with the tools available to EMS clinicians to completely rule out a cardiac cause of chest pain.
- All chest pain is cardiac in origin until proven otherwise.
- Transport is only required if the patient has a prior cardiac history.
According to the protocol, in which of the following patient presentations should a 12-lead ECG be acquired?
- Chest pain only
- ✓ Chest pain, syncope, or shortness of breath
- Chest pain and shortness of breath only
- Cardiac arrest only
According to the Adult Refractory VF/VT protocol, dual-sequential external defibrillation (DSD) should be considered after how many unsuccessful defibrillation attempts?
- After 1 unsuccessful attempt
- After 2 unsuccessful attempts
- ✓ After 3 unsuccessful attempts
- After 5 unsuccessful attempts
According to the Cardiac Arrest Overview protocol, what is the target compression rate when using a CPR feedback device or metronome?
- 80-100 compressions per minute
- ✓ 100-120 compressions per minute
- 120-140 compressions per minute
- At least 60 compressions per minute
According to the Chest Pain Fibrinolytic Checklist, which blood pressure finding would raise a concern as a potential contraindication to fibrinolytic therapy?
- Systolic BP greater than 160 mmHg OR diastolic BP greater than 90 mmHg
- ✓ Systolic BP greater than 180 mmHg OR diastolic BP greater than 100 mmHg
- Systolic BP greater than 200 mmHg OR diastolic BP greater than 110 mmHg
- Systolic BP greater than 140 mmHg OR diastolic BP greater than 80 mmHg
A BLS crew has been working a cardiac arrest patient with unknown downtime. They find the patient to be cool to the touch (not from exposure), with no audible heart sounds and fixed/dilated pupils. No bystander CPR was performed. According to the protocol, what is the appropriate action?
- Begin resuscitation immediately and transport to the nearest ED
- ✓ Withhold resuscitation, as the criteria for doing so have been met
- Begin resuscitation and contact OLMC for guidance
- Withhold resuscitation only if rigor mortis is also present
Sourced from Maine's EMS authority
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Maine protocols — FAQ
Are Maine's EMS protocols available offline?
Yes. Download Maine's protocol set once and every protocol, medication, and hospital is available with no signal — built for basements, rural calls, and dead zones.
Are the protocols specific to my county in Maine?
Yes. Maine's protocols are scoped by county and region, so every provider sees exactly the set that governs where they respond. You can add more than one if you run in multiple areas.
Is Pocket Protocols official, or affiliated with Maine?
No — Pocket Protocols is an independent app and isn't affiliated with or endorsed by any EMS authority. We bring Maine's protocols into a faster, fully offline app and link the authority's own source for every set.
How do Maine protocol updates reach the app?
When the EMS authority publishes a new version and it goes live in Pocket Protocols, the app refreshes automatically — crews are never working from a stale copy. We monitor official sources for changes every day.
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