Maryland Institute for Emergency Medical Services Systems

The meeting focused on several critical operational and legislative updates. Key discussion points included the status of Mobile Integrated Health (MIH) and the need for EMT recommendations for the MSOP program, noting that only one-third of regional hospitals were meeting the 30-minute transfer of care goal. Legislative updates covered Maryland Senate Bill 369 concerning defibrillators in libraries and House Bill 593 addressing liability protection for defibrillation providers. Protocol updates for July 1, 2025, were approved, including medication dosage changes for Labetalol and Cephazolin, and the statewide requirement for Video Laryngoscopes was deferred to July 1, 2026. Clarification was provided regarding the definition of 'transfer of care time.' The transportation group is finalizing a regional offload policy and addressing discrepancies with alert and reroute criteria. Furthermore, discussions addressed the flux in Maryland hospital funding due to the impending end of the Maryland Healthcare waiver and the implications for hospital operations. New business involved updating escalation pathways for offloads. Hospital reports covered construction updates, requests for backboard removal assistance, and ongoing reviews of transfer times.

The meeting included a review of highlights from the Medical Director's Call and the Protocol Review Committee, noting the announcement of a new Medical Director in St. Mary's County. Key discussions centered on the expanded CMS's Rural Health Transformational Grant, potential legislative interest in compelling VAIP standard participation, and ongoing protocol reviews, including the whole blood protocol and tachycardia criteria adjustments. Revisions to the Pain Protocol aim to incorporate oral ibuprofen and IV Tylenol to decrease opioid dependence. A significant change concerning DEA licensing will shift responsibility from the Medical Director to the agency itself. Pediatric discussions covered an anti-epileptics dose trial, changes to the crush injuries protocol (allowing high dosage albuterol administration without consultation), approval for ketamine administration for refractory seizures, and approval for BLS providers to obtain 12 leads. The committee also discussed Metoprolol as a backup drug for symptomatic Afib and approved an amendment regarding ultrasound use in traumatic arrest for PEA assessment. Furthermore, there were reports on upcoming training opportunities, updates on Mobile Integrated Health (MIH) program progress across various counties, and updates regarding cardiac device funding and ambulance inspections via the VAIP program. Finally, the successor for the Regional Medical Director was discussed, with Dr. Chizmar stepping in temporarily.

Key discussions included a legislative update on universal ambulance equipment inventory and public AED access simplification. The State EMS Medical Director reported on initial phases of the 2026 Protocol update, considering additions like TXA for angioedema, adjustments to midazolam and ketamine use for seizures, and revisions to major trauma protocols to better emphasize hemorrhage control. Updates were provided on expanding labetalol use and establishing a working group for EMT CPAP curriculum (a 2027 consideration). Functionality issues with the emergency department Advisory system (EDAS) due to Image Trend updates were addressed, alongside the release of 'Automated Information' (AI Assist) in eMEDS for dictation in reports. The growing issue of drug adulterants and their effect on overdose recovery was noted, and expansion of the whole blood pilot program was detailed. The MIEMSS Region III Report covered the status of EMS grants (cardiac device and ALS training), performance improvement work group initiatives, and participation in regional exercises (E-PLEX at BWI and a mass casualty drill). The EMSC Report highlighted upcoming S.T.A.B.L.E. and pediatric disaster courses. Old business addressed the Region III hospital off-load policy update. New business involved LP35 and Lifenet capability issues; specifically, St. Agnes extended its LifeNet contract, though the Ascension parent company appears to be transitioning software systems, raising concerns about future EKG reception capabilities which were scheduled for further offline discussion.

The document outlines the Maryland Fire and Rescue Institute (MFRI) as the state's comprehensive emergency services training and education organization. Its mission is to prepare individuals and agencies to protect life, property, and the environment through quality programs that adapt to evolving needs. MFRI operates under core values including academic excellence, student success, and professionalism. The institute details student program statistics for 2025, a fiscal year 2026 budget, grant funding achievements in FY25, and various collaborative initiatives and partnerships aimed at enhancing training tools, protective equipment, and life-saving skills for first responders.

The meeting agenda included opening remarks, the Chair's report, and updates from various program areas: SEMSAC/Legislative Update, State EMS Medical Director Report, MIEMSS Region III Report, and the Maryland EMSC Report. Committee reports covered the Maryland Region III Health & Medical Coalition and Transportation. Under New Business, council elections for Chairperson, Vice Chairperson, and Secretary were scheduled for the next meeting in November, with selections taking roles in January 2025. Regional Roundtable Reports included updates on EMS Operations, noting a new Fire Chief appointment and participation in the Emergency Department Wait Time Reduction Committee.