Attached is the letter that went out to all Providers/Agencies to outline this new procedure. It is also below:


The New York State EMS Collaborative Protocols are now available. These protocols are effective immediately for all Monroe-Livingston Regional EMS providers upon completion of the required training. Agencies are required to assure that their providers are updated to these standards no later than June 1, 2017 through the Cypherworx learning management system. Instructions on how to complete this process are included as an attachment to this advisory.


  • There are significant changes to the formatting of the protocols and providers must take time to familiarize themselves with these changes.
  • There is a smart phone application available for both Android and Apple users entitled “NYS Collaborative EMS Protocols”. It is encouraged that providers use this application when completing the training modules to help familiarize themselves with navigating through the application and protocols. Those applications can be found at the Apple App Store and the Android Marketplace by searching “NYS EMS Collaborative”.
  • Please note that the formulary included in the Collaborative Protocols is the comprehensive list. Based on the needs of our region we will not be using all of the medications approved. The regionally approved formulary is attached.
  • Patella Reduction is a procedure that has been added for EMTs and Paramedics.


BLS: All BLS providers must complete both the BLS Update and Patella Reduction educational modules.

Although included in the Collaborative Protocols, the Monroe-Livingston Region will NOT be adopting the following procedures for BLS providers:


  • 12-Lead Acquisition
  • Nitrous Oxide Administration
  • Continuous Positive Airway Pressure


ALS: All ALS providers must complete the ALS Update, Patella Reduction and Ketamine educational modules.

MLREMS is adopting the following changes to formulary:


  • Fentanyl increased to maximum of 200 mcg and based on weight
  • Phenergan has been removed
  • Procainamide has been removed
  • Decadron has replaced Solumedrol
  • Dextrose 10% has replaced Dextrose 50% and Dextrose 25%