title: Pharmacist input into statewide treatment protocols for emergency medical services.
abstract: OBJECTIVE
  A pharmacist's role in helping Vermont health officials standardize pharmacotherapy-related protocols used by emergency medical services (EMS) personnel across the state is described.
  
  
  CONCLUSIONS
  Pharmacists with expertise in emergency medicine (EM) or critical care are ideally positioned to provide guidance on optimizing and standardizing medication-use aspects of state and local EMS protocols. In 2012, the medical director of the EMS division of the Vermont Department of Health requested that an EM pharmacist at a Burlington academic medical center review draft EMS protocols designed to replace the existing patchwork of local protocols with statewide standards of care; among the 92 draft protocols reviewed, 62 pertained to medication use. The pharmacist provided a wide range of suggestions on 33 protocols, including (1) evidence-based recommendations on use of vasopressor agents for septic shock, (2) recommendations to optimize medication ordering and preparation in the prehospital setting, (3) recommendations on prehospital management of pediatric shock and appropriate use of chemical restraints, and (4) recommendations to promote use of smart infusion pumps by EMS personnel. All of the pharmacist's suggestions were incorporated into the final protocols, which took effect in March 2014. The protocols have helped standardize care for patients receiving EMS services throughout Vermont while reducing the potential for medication errors.
  
  
  CONCLUSIONS
  An EM pharmacist participated in the review and development of statewide EMS treatment protocols that focused on choice of medication therapy, dosage, administration, and identification and minimization of potential risks of medication errors.
authors.affiliation: Meghan E. Groth, Pharm.D., BCPS, is Pharmacist Clinician, Emergency Medicine; and Wesley D. McMillian, Pharm.D., BCPS, FCCM, is Manager, Pharmacy Clinical Practice, Fletcher Allen Health Care, Burlington, VT. Daniel L. Wolfson, M.D., FACEP, is Emergency Medicine Physician, Fletcher Allen Health Care, and Emergency Medical Services Medical Director, Vermont Department of Health, Burlington. meghan.groth@vtmednet.org.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Groth
authors.affiliation: Meghan E. Groth, Pharm.D., BCPS, is Pharmacist Clinician, Emergency Medicine; and Wesley D. McMillian, Pharm.D., BCPS, FCCM, is Manager, Pharmacy Clinical Practice, Fletcher Allen Health Care, Burlington, VT. Daniel L. Wolfson, M.D., FACEP, is Emergency Medicine Physician, Fletcher Allen Health Care, and Emergency Medical Services Medical Director, Vermont Department of Health, Burlington.
authors.forename: Wesley D
authors.initials: WD
authors.lastname: McMillian
authors.affiliation: Meghan E. Groth, Pharm.D., BCPS, is Pharmacist Clinician, Emergency Medicine; and Wesley D. McMillian, Pharm.D., BCPS, FCCM, is Manager, Pharmacy Clinical Practice, Fletcher Allen Health Care, Burlington, VT. Daniel L. Wolfson, M.D., FACEP, is Emergency Medicine Physician, Fletcher Allen Health Care, and Emergency Medical Services Medical Director, Vermont Department of Health, Burlington.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Wolfson
mesh_terms: D002648:Child; D002985:Clinical Protocols; D004358:Drug Therapy / Q000592:standards; D004632:Emergency Medical Services / Q000458:organization & administration*; D004635:Emergency Medicine / Q000458:organization & administration; D055416:Evidence-Based Emergency Medicine / Q000458:organization & administration; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role; D014707:Vermont