The Office of the State EMS Medical Director (OMD) ensures that patients who interact with the Maryland EMS system receive consistent, high-quality out-of-hospital medical care. OMD provides leadership and coordination for state medical programs, protocols, and quality assurance. The office acts as a liaison with the regional programs and clinical facilities and promotes creative, responsive, and scientifically sound programs for the delivery of medical care to Maryland citizens.

Maryland EMS Protocols

The Maryland Protocols for Emergency Medical Services In order to reflect best practices and evidence-based medicine, The Maryland Medical Protocols for Emergency Medical Services are updated annually by the Protocol Review Committee with multidisciplinary input from medical directors, emergency physicians, nurses, and EMS clinicians from across the state. State EMS Medical Director Timothy P. Chizmar, MD, FACEP, FAEMS, presented the changes for 2023 to the Statewide EMS Advisory Council and the Maryland EMS Board for approval.
Maryland EMS Protocol Page

Regional Medical Directors

The Office of the Medical Director (OMD) coordinates a network of Regional EMS Medical Directors, all of whom serve on the Protocol Review Committee, as well as on their respective regional councils. In addition, they serve as resources to jurisdictional medical directors and lead quality improvement initiatives within their regions of the state. In conjunction with EMS Preparedness and Operations and the Office of Care Integration, the Regional EMS Medical Directors provide oversight for the statewide EMS base station program, which provides for online (real-time) medical consultation for Maryland’s EMS clinicians.
Regional Programs Page

EMS Medical Directors by Region:

Hospital Base Stations

There are 47 Maryland hospital base stations designated by the EMS Board. All physicians and nurses who answer a base station call are required to successfully complete the MIEMSS Base Station Communications Course for Emergency Department Personnel and the 2023 Maryland EMS Updates for Hospital Base Station Personnel training video in order to communicate with EMS clinicians and provide appropriate online medical consultation. The base station course was offered at multiple hospitals entirely in a virtual format or in-person with appropriate social distancing measures in place in FY 2023, resulting in 432 base station certificates issued to emergency physicians and nurses. Additionally, three emergency medicine physicians became new MIEMSS-approved base station instructors over the past year.
Hospital Base Station's Page

eMEDS® - electronic Maryland EMS Data System

The electronic Maryland EMS Data System (eMEDS®) uses commercial software provided and hosted by ImageTrend®, an industry leader for emergency patient care reporting solutions. MIEMSS owns a statewide site license for the eMEDS® system, allowing Maryland’s EMS services to use it without cost, alleviating the burden on local funding. All of Maryland’s jurisdictional EMS operational programs (JEMSOPs) and many licensed commercial ambulance services submit patient care reports directly into eMEDS®. Maryland has one of the few statewide comprehensive prehospital patient care reporting systems in the nation. eMEDS® provides timely information to hospital emergency department physicians and nurses through an application called Hospital Hub. All healthcare facilities in Maryland have access to the eMEDS® Hospital Hub to obtain prehospital patient care reports.
eMEDS® Page

Cares Program

MIEMSS works with the Cardiac Arrest Registry to Enhance Survival (CARES) in order to measure and ultimately improve emergency cardiac care in Maryland. CARES is an out-ofhospital cardiac arrest registry for the United States, facilitating uniform data collection and quality improvement in each state and nationally.

With the updated and consolidated Cardiac Arrest tab in eMEDS®, the statewide prehospital patient care reporting system, EMS clinicians can readily enter comprehensive prehospital cardiac arrest information. MIEMSS can then export the prehospital information directly to CARES when it is first entered, saving time for clinicians and EMS CARES coordinators. Using a single patient care record for CARES submission makes Maryland one of the first states to incorporate this process within their electronic patient care reporting documentation. Maryland hospitals then enter outcome data into the CARES report for those cardiac patients who receive ongoing care in the ED.
Cares Program Page

EMS Medical Directors’ Symposium

The 28th Annual EMS Medical Directors’ Symposium was held in-person on April 12, 2023. The Symposium was attended by regional, jurisdictional, and commercial ambulance service medical directors, base station physicians and coordinators, highest jurisdictional officials, quality assurance officials, and MIEMSS personnel. This year’s keynote speaker was Sheldon Cheskes, MD, CCFP (EM), FCFP, DRCPSC, who serves as the Medical Director, Sunnybrook Center for Prehospital Medicine, and Professor Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto. Dr. Cheskes’ presentation was entitled, “Dose VF: Defibrillation Strategies for Refractory Ventricular Fibrillation.” Other Symposium presentations included: • “MIEMSS Executive Director Updates”; Theodore R. Delbridge, MD, MPH • “Continuous Quality Improvement in the Maryland EMS System”; Timothy P. Chizmar, MD, FACEP, FAEMS • “Pediatric T’s: Rationale for Changes in Tubes and Trauma Tree”; Jennifer Anders, MD, FAAP • “Pre-Hospital Whole Blood in Maryland”; Douglas J. Floccare, MD, MPH, FACEP • “The Wall Time Challenge”; Kathy Jo Marvel, NRP; Scott Wheatley, NRP

Cardiac Arrest Steering Commitee

The Cardiac Arrest Steering Committee (CASC), as authorized by the State EMS Board, provides guidance to MIEMSS’ medical and executive leadership teams on matters related to sudden cardiac arrest in Maryland. The committee actively works on matters related to public safety by answering point engagement, prehospital cardiac arrest management performance improvement, and further development of a comprehensive statewide system for the treatment of sudden cardiac arrest. CASC collaborates with MIEMSS’ Media Services and Public Information to develop public messaging campaigns intended to increase bystander use of CPR and AEDs. In FY 2023, CASC evaluated two new education and implementation strategies that use feedback of high-fidelity simulation data on CPR performance to inform, educate, and prepare EMS clinicians, and used telephone CPR data to prepare 9-1-1 Specialists. The results of these trials are positive and have been presented to the 9-1-1 Board and to the State EMS Advisory Council (SEMSAC). The Office of Care Integration (OCI) is currently working to develop the results from the pilot programs and identify a few communities for early adoption. It is anticipated that survival rates will improve in those communities that implement these new educational and quality improvement strategies.

County EMS Assessment / SWOT Analysis

The Office of the Medical Director and the MIEMSS Regional Offices, upon request from the leading County Official(s), will facilitate a SWOT (Strengths, Weaknesses, Opportunities, and Threats) process though a broad constituency County task force to address selective EMS issues to improve the delivery of prehospital medical care. The SWOT process has been instrumental in addressing individual EMS Operational Program issues such as rising ambulance scratch rates, financial solvency, timely delivery of quality BLS/ALS services, establishing countywide standards for the County's EMS service, and developing sustainable and adaptive strategies to maintain a robust EMS system and an accountable EMS service.

The Somerset County Commissioners requested the assistance of State EMS Medical Director Timothy P. Chizmar, MD, FACEP, FAEMS, and the MIEMSS Region IV office to facilitate a SWOT analysis. The Somerset County EMS Task Force included representation from Somerset’s fire and EMS companies, Somerset County Emergency Services (9-1-1 Center), Somerset County Health Department, TidalHealth, mutual aid fire and EMS companies, and the Maryland Fire and Rescue Institute. A detailed geographic analysis of EMS calls was prepared with technical assistance from the Eastern Shore Regional GIS Cooperative. The SWOT report was presented to the Somerset County Commissioners on May 2, 2023.