Maine EMS Allows Basic EMT's to Administer H1N1 Internasal Vaccine - Training Required

Basic EMTs who have completed the Maine EMS MediVax program are allowed to perform
intranasal H1N1 vaccine in the 2009/2010 season with the caveat that an ALS resource or
equivalent (nurse physician, or NP/PA) with the resources to care for adverse effects
(including allergic reactions) is available on scene.  A basic service cannot host a
vaccine clinic individually, but Basic EMTs can be used under the auspices of a larger
physician proscripted event to act as a resource for administering IN vaccine.

Jay Bradshaw, director of Maine EMS released this information this afternoon (11/06/09).
This is the training program that EMT-B's must complete to participate in administering the
internasal H1N1 vaccination. The program follows the same requirements as the Maine Medivax
program for the EMT-I, Critical Care and Paramedic. This means it must be taught by an IC
and a physician must have approved the training and the trainer. The protocol has also been
updated to reflect this change. Click here for the Updated Maine MediVax Protocol.Rosters must be sent in to
the regional EMS office, so the names of those completing the program can be placed on the
MEMA website so legal protection is obtained. CEHs will be awarded. 
It is important to remember that EMS-B' s cannot run their own stand alone clinics, but may
participate in those being run by others that have the proper resources to manage any
adverse reactions.The MDPB approved this program as did the Board of Maine EMS.

Maine EMS IC's can click here to download the revised PowerPoint presentation Maine Medivax program, which includes the Basic EMT intranasal material approved by the MDPB. 

It is suggested that the file be save into the same folder where you have the files from
the Medivax CD.  This should make it easier to play the video file also on the CD when you
get to that slide in the program. (Be sure to place the mouse pointer in the blank screen
and click the hand to run the video.

Common Question Concerning the Administration of Flu Vaccine by EMS Providers Nov 2, 2009

Jay Bradshaw, Director of Maine EMS reported receiving several calls in recent days regarding confusion about flu vaccine that has been attributed to conversations some EMS Providers have had with Dave Wacker at the Bureau of Labor. Jay knows Dave and called him on October 30, 2009 to understand both the question he was asked and his answer.

Dave explained to Jay, that the question asked was now that paramedics are trained to administer flu vaccines, could they could also administer Hepatitis B vaccines and be considered "licensed health care professionals" for purposes of doing the medical screenings required for vaccines and respiratory protection?

Dave's answer was that the Bureau of Labor does not have jurisdiction regarding vaccinations or licensed health care professionals and that you should call Maine CDC.

So it looks like there are really 3 different questions in play: 1) flu vaccine administration, 2) hepatitis vaccine administration, and 3) certification as a licensed health care professional. Since the origin of the original question is with regard to flu vaccine, the bottom line is that Maine EMS, Maine CDC, Maine EMA, and the AG's Office, have all affirmed that it is within the scope of practice for EMS providers to administer the flu vaccine as long as the EMS person meets the requirements of licensure and training and is administering the flu vaccines in accordance with the protocol adopted by the MDPB.

On Friday evening, the question again was asked at the Maine CDC Flu Help Desk. Jay wants to be sure everyone is clear, that there is no letter required for EMS providers to administer the flu vaccine.  By statute, the EMS scope of practice is established by the protocols approved by the MDPB.  The MDPB first approved the EMS MediVax program in 2007 for force protection, and then expanded it in August 2009 to include community vaccinations provided the vaccine was done as part of a physician prescribed event.

However, hepatitis B vaccines are not part of the MediVax program and therefore are not part of the current EMS scope of practice.

H1N1 Truth vs Fiction

On September 18, 2009 Dr. Dora Mills of the Maine Center for Disease Control provided a document responding to some of the most common questions and concerns she has seen about the H1N1 vaccine in the media, and some answers to them. This document is available by click above on H1N1 Truth vs Fiction. Dr. Mills will continue to expand this document, as more questions and concerns come to her attention. 
For More on H1N1

Maine EMS Medivax Program

The Maine EMS Medivax program is underway. Training materials are available from the regional office. Materials include a training CD with an Immunization Video, and all of the appropriate forms. If your service would like to particapte in this program, please review all the materials thoroughly and meet with your service medical director to develop your plan.

EMS Provider s at the EMT Intermediate, Critical Care, and Paramedic level once trained under this program can give vaccinations within the scope of the Maine EMS Medivax Training program. This program allows EMT-Intermediates and Paramedics who have been trained throught this program to administer both Seasonal and H1N1 Flu Vaccine.

A Few Key Points:

• Vaccination is not limited to “force protection.”
• The course must be taught by a currently licensed IC, who has been trained and is approved by the service level medical director.
•   If you do not have a service level medical director, please contact our office and we will talk with the regional medical director
• The CEH forms and the Governor’s Proclamation are not on the disk, but are included with the sample copies of the handouts.
• The program is worth MEMS continuing education hours and is preapproved for 1.5 ALS Topics and .5 ALS Skills.
• Practical skills above/beyond the video review on injections are strongly encouraged (either with an IV/IM manikin arm, an IM practice pad, or an orange). Most providers do not perform IM injections on a frequent basis and most providers have limited experience with children.
• A Maine EMS attendance sheet must be used for credit to be given.
• The roster must be signed by the IC and promptly returned to the Regional Office.
  This signed roster is the official documentation of approved training.
  These lists will be provided to Maine EMS and MEMA.

Protection from liability is linked to this roster, so signing legibly is imperative.

Regional Hospitals are willing to work with EMS services to provide vaccine. Contact your regional EMS office for assistance.

If you have any questions pleas call the regional office at 795-2880.

participating in this important project is appreciated